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Annotated Bibliography

Kristina Stark
Copyright @ 1997 Kristina Stark. All Rights Reserved.

April 22, 1997

This annotated bibliography explores the topic of reproductive technology as it affects women of color. The articles are varied. One article is not a journal article or a law review but it discusses the results of technology gone awry when a lab error leaves a white couple with one white twin and one black twin. The focus is on the implications for the black child being raised in a white family. Another article on transracial adoption focuses on this as well. Very little research exists concerning advanced, "state of the art" reproductive technology and race. Those that do take different approaches. Some feel that eugenics is a major concern based on the history of racism in the United States. Others do not see eugenics as a "real" issue. Many articles focus on access to basic reproductive technology such as abortion and prenatal care.



Andrzej Kulczycki, Malcolm Potts, & Allan Rosenfield, Abortion and fertility regulation, The Lancet, Vol. 347, No. 16, Page 1663, 1996.
This article reviews the cultural differences as they correspond to abortion rates worldwide. In the USA, about 60% of all pregnancies are unwanted, with half of these resulting in abortion. Of these United States women, those who are young and unmarried are more likely to choose abortion. World wide, urban and educated women are more likely to terminate than are rural women. One major difference between the United States and other cultures is that abortion is considered more as a contraceptive rather than controversial matter. The health aspects of abortion are discussed. "In developed countries, mortality associated with childbirth is 11 times higher than that for safely performed abortion procedures, and 30 times higher than for abortions up to 8 weeks' gestation. Early termination of pregnancy ranks among the safest and easiest of surgical procedures." The article discusses the importance of access to safe abortion. In addition, this article discusses research that shows that "rates of abortion and abortion-related mortality will decline most where a full range of contraceptive options is readily available free of charge and at low cost; where there is widespread access to sex education and information; where the sociocultural context promotes contraceptive responsibility; and where abortion services are publicly funded so that, when needed, abortion is performed early in pregnancy."[Back]


Article, Black and White Twins Born After Test Tube Mix-Up, Jet, Volume 88, Issue 11, Pages 34-37, 1992.
This article was included in this annotated bibliography to serve as an example of problems with reproductive technology that our society may not be ready to deal with. The Stuarts, a white couple, went to a highly reputable fertility clinic in order to take place in IVF. The idea was for Mrs. Stuart to be inseminated with the sperm of her husband, Mr. Stuart. However, nine months later, Mrs. Stuart gave birth to two sons - one is white and the other is biracial black/white. The hospital has admitted that Mrs. Stuarts eggs were fertilized with sperm from her husband and a black man who was in the clinic earlier that day for a similar procedure performed on his wife. Apparently, the technicians did not correctly clean the container before adding Mr. Stuart's sperm. Although the family adores both boys and seems very open to the biracial child exploring his black heritage, it still poses great ethical dilemmas. [Back]


This article discusses "numerous breaches of medical ethics that have a disproportionate impact upon communities of color." Beginning with the use of live slaves as "subjects" for medical school experiments in the nineteenth century, discriminatory and harmful treatment of African Americans is traced to modern day "welfare reform" in the form of Norplant legislation. This history presents the blatant horrors of research on slaves to the more subtle measures used today. In addition to the temporary sterilization of poor women by Norplant, penal sterilization is also discussed. These include such things as physical and chemical castration and Norplant. Constitutional issues are the focus. Lastly, the impact of legal abortion on women of color is highlighted. The idea is that white women have greater access to safe abortion even when it is not legal (because they have greater access to foreign performed abortions) and that minority women are protected from back alley practitioners only so long as the practice is legal in the United States. [Back]


This article's concern is that "compulsory sterilization of poor single mothers might well be taken seriously by many in this country who are attracted to genetic essentialism and search for low-cost solutions to social problems." Considering that the racist stereotype of the welfare mother is young, black, has many children to avoid having to work, and is of low intelligence, there is concern that young black women may be particularly singled out for these procedures. The distinct possibility of such racist sterilization procedures is amplified by research showing that 97% of all obstetricians "favor the sterilization of welfare mothers" and exert great influence over the child-bearing population as a whole. The author feels that sterilization is simply a "disguised form of eugenics" and that black women are particularly susceptible to such programs as they are at the "intersectional axis of race, gender, and class." After exploring the impact of race, gender, and class on black women, the author reviews the history of eugenics and racism in the United States with a particular focus on compulsory sterilization laws. U.S. caselaw is discussed. Roe v. Wade provided women a fundamental right to reproductive autonomy. "However, in light of Planned Parenthood of Southeastern Pennsylvania v. Casey, the degree to which women are in charge of their reproductive autonomy is unclear." Reproductive rights are also discussed under the broad right to privacy.[Back]


Joan C. Callahan and Dorothy E. Roberts, A Feminist Social Justice Approach to Reproduction-Assisting Technologies: A Case Study on the Limits of Liberal Theory, 84 Ky. L.J. 1197 (1995/1996).
The question or problem addressed in this law review article is the statistically significant phenomena of racial discrimination in the prosecution of drug use during pregnancy. "Despite the fact that drug use during pregnancy seems to be equally prevalent among women of all races in the United States, studies are beginning to show that black women are nearly ten times more likely than other women to be reported to child welfare agencies for drug use during pregnancy, and that at least seventy percent of the prosecutions are of women of color." (P. 1198). In addition, more than 80% of caesarean sections ordered by U.S. courts are performed on women of color - with almost all of them being performed in public hospitals. 75% of all women placed on Norplant in this decade as a condition of probation have been minorities, with all of them being welfare participants. Another inequity pointed out by the authors is that almost all children resulting from surrogacy agreements that are the biological child of both the surrogate mother and the adopting father are given to the father to raise, neglecting the genetic tie of the surrogate to the child. The authors point out all of these phenomena in an effort to show inequities in human reproduction according to sex, race, and class. The authors argue that "contemporary liberal theory" is responsible for the inequities between the races in the context of this article and that a "feminist social justice approach" is the more appropriate model. Although feminism is not monolithic, it is fairly consistent in rejecting the extreme individual liberty emphasized in contemporary society. Instead, feminism advocates "nurturing of individuals and communities, the sustaining of relationships, the relief of suffering, and attention to appropriate substantive equality." In other words, social responsibility and morality play a more prominent role in this approach. Aspects of both theories (liberal and feminist) are discussed in great detail as are other philosophical approaches to justice with an emphasis on the concepts of harm, exploitation, and voluntariness.[Back]


John Lynxwiler & David Gay, THE ABORTION ATTITUDES OF BLACK WOMEN: 1972-1991, Journal of Black Studies, Volume 27, Number 2, Pages 260-277 (1996).
This journal study looks at the abortion attitudes of African American women over a twenty year time span in an attempt to define what factors influences the position of black women in identifying as either pro-choice or pro-life. Factors that remained steady across both decades were attitudes toward premarital sex and perceptions of ideal family size. Black women supporting liberal divorce laws and who were employed full-time (more important in the 1970's than in the 1980's) also tended to identify more as pro-choice. Religious affiliation is another important determinant - with members of the Black Protestant Church being more pro-choice (this church has a relatively relaxed position on abortion). The authors conclude that race is a necessary factor in any research concerning abortion attitudes as people of different cultures have different values. However, they also hypothesize that in the future support for legal abortion will be seen more as related to class rather than to issues of race (with the caveat that "patterns that may have been interpreted as race differences in the past increasingly are intertwined with, and should be understood as, shifts in socioeconomic status). (p. 274). [Back]


This article discusses egg donation as it relates to "the importance of genetic considerations in shaping legal and social policy on egg donation." Various forms of reproductive technology are discussed as well as the complex ethical issues involved. The science of genetics is explored, with a focus on problems involving genetic predispositions to criminal behavior or certain biological diseases. Another aspect of this discussion is the fear of eugenics programs being created. Selective breeding could result in racial discrimination. This idea is extrapolated to how society would react to a strain of superior humans - and how the rest of humanity could conceivably fall by the wayside. Court decisions on the rights of surrogates versus the rights of the adoptive parents are unpredictable at best. Some courts feel that the genetic tie gives the surrogate a right to the child while others view this more as a contract agreement and award the child to the contracting adoptive parents. Legal opinions involving adoptions where there was no surrogate are also discussed. Most of these cases arise where the biological parents have not given valid consent to the adoption. Again, the various jurisdictions have very different opinions on the issue. Other issues are transracial adoptions and whether or not a particular race can lay claim that it is the only one capable of raising its children. After reading this article, one walks away with the same sense of confusion reflected by American case law... The tie between genetics and parenthood is a complex issue that will take many years to resolve. This is especially true in light of rapidly changing technology that our laws cannot keep up with. [Back]


Ken Daniels & Karyn Taylor, FORMULATING SELECTION POLICIES FOR ASSISTED REPRODUCTION, Soc. Sci. Med., Vol. 31, No. 12, pp. 1473 - 1480, (1993).
This journal article considers selection policies used to decide who is allowed access to assisted reproduction. Basically, this decision is made by the medical providers themselves, without any sort of public or legal responsibility. The authors' concern is that the individual value system of the provider is being forced upon would-be parents. This is evidenced by the facts that there is a widely held belief that access to fertilization techniques should be limited to heterosexual married couples and access should be restricted to those exhibiting appropriate family values. The implication is that the medical practitioner is the one who decides what "appropriate family values" are. There is little legislation on this point. However, The National Bioethics Consultative Committee (in Australia) has summarized several criteria followed by many clinics. Several examples of exclusionary criteria are also listed. These exclusionary criteria discriminate on the basis of age, life-style, marital status, cultural background, and nationality. Although this would seem generally wrong, it makes little difference what an ethics code says when the real power is still with the medical practitioners. "Until the attitudes of those professionals running the programmes change, simply removing discriminatory criteria from the formal selection procedures will not prevent discrimination occurring in the selection process." (P. 1478).[Back]

This article begins by stating the basic myths and stereotypes surrounding welfare and, more particularly, welfare mothers. Legislation attempting to use Norplant as a form of probation or welfare reform is discussed. The main point of this article is that "the unconstitutional conditions doctrine must be part of the discourse regarding welfare reform and contraceptives, especially if the government begins to mandate the use of contraceptives such as Norplant." A government cannot do indirectly what it cannot do directly (i.e. condition a government benefit on the giving up of a fundamental right). Females exclusively, and minorities disproportionately, are affected by Norplant legislation. This raises equality issues. In addition, the Due Process Clause of the Fifth and Fourteenth Amendments protects the rights of privacy and autonomy of the individual (liberty interest). The role of the unconstitutional conditions doctrine is discussed as providing legislatures and courts "with the proper framework against which to view the constitutionality of such conditions." Many effects of Norplant legislation are discussed, including coercion and the ability of the government to "engage in the social engineering of family structures by gender, class, and race." [Back]


This article discusses the wisdom of contemporary proposals to "reform" welfare by "denying increased AFDC for additional children while [a mother is] on welfare, cut spending for welfare programs, and enact a tough two-years-and-out provision with work requirements to promote individual responsibility." The history of the welfare and eugenics movements in the United States are reviewed with an emphasis on the belief that those who are economically disadvantaged are also genetically inferior. In so doing, the stereotype of typical welfare recipients as being "unmarried, young black women with several children, who are long-term dependents of the welfare system and whose dependency is in turn passed on from generation to generation" is examined and refuted. Although more whites receive assistance than blacks and the overwhelming majority of individuals are off welfare within two years, this is not the perception of the American public. Therefore, one must ask whether welfare "reform" that involves temporary sterilization is purely a cost containment proposal or whether there is subversive racism going on. Measures such as "family caps" and "Norplant bonuses" are extensively reviewed, with the major pros and cons of each being summarized. The Constitutionality of these measures is discussed, with the major focus being on equal protection and procreation as a fundamental right. [Back]

Nancy Leland, Donna Petersen, Mary Braddock & Greg Alexander, Variations in Pregnancy Outcomes by Race Among 10-14-Year-Old Mothers in the United States, Public Health Reports, Volume 110, Issue 1, Pages 53-58, 1995.
This research study looks at pregnancy rates and outcomes for young adolescents (ages 10-14) and makes comparisons based on race. Overall, pregnancy rates were seven times higher in the African American population. White mothers were both more likely to start prenatal care in the first trimester and to receive no prenatal care at all. Only 22.2% of whites and 20.4% of blacks received adequate prenatal care. Black mothers are more likely to deliver preterm, very preterm, and low birth weight infants than the white adolescents. Although there were significant differences between the races in some categories, the disparities were less striking than those typically seen in the general population. In the general U.S. population, blacks have approximately twice the infant and neonatal mortality rates and twice the percentage of low birth weight babies than whites. Although the white adolescents in the study had significantly poorer outcomes than adult white women, the same was not true in the black population. The authors suggest further studies in this area to determine the cumulative impact of poverty on blacks in this country that contributes to this problem in addition to identifying young girls who are pregnant relatively quickly so that prenatal care can be initiated. [Back]


Owen D. Jones, Reproductive Autonomy & Evolutionary Biology: A Regulatory Framework for Trait-Selection Technologies, American Journal of Law & Medicine, Vol. 19, No. 3, pp. 187-231 (1993).
This article looks at trait selection technology as it exists today and discusses social and legal ramification of such technology in the future. It begins by discussing evolutionary biology and how our genetic makeup as human beings changes and adapts naturally over time. It also examines and discusses specific trait-selection technologies such as sex selection techniques and genetic testing (the results of which may prompt a woman to have an abortion). Eugenics is also discussed. After looking at the scientific ramifications of each, the author concludes that such reproductive technology cannot be prohibited without satisfying a heightened scrutiny test under a line of legal reasoning culminating with Planned Parenthood v. Casey (112 S. Ct. 2791, 2805 (1992)). The personal liberty interest in using such technology is likened to the rights to contraception, interracial marriage, and freedom from physical restraint. Any infringement of the right to use this technology would be interfering with a "person's most basic decisions about family and parenthood." (The author takes this quote from Planned Parenthood v. Casey at 2806). Although the author eventually concedes that certain limitations must be put on this technology, he rejects arguments expressing concerns over eugenics. [Back]


This essay seeks to "create a gender-based equal protection framework that is attentive to the ways in which U.S. reproductive health policies impact on one particular subgroup of women -- adolescents." (P. 324). The article begins with the premise that the United States Legislature has passed laws affecting all females in the U.S. as if they constitute a monolithic group. These laws apparently presuppose that all women are "white, middle-class, able-bodied, heterosexual, [and] adult." (P. 326) The author advocates a new approach, one that takes differences such as age, race and class into consideration. Instead of looking at adolescent pregnancy as a problem because of the pregnancy and the age of the women, the author approaches it from the perspective that it is a problem because of the inadequate social resources devoted to facilitating the pregnancy. She also feels that the debate over teenage pregnancy and abortion focuses on the wrong variable when the argument is over the "problem of teenage sexual activity." Instead of looking at this, the point should be "the lack of access to and use of effective contraceptives during sexual activity that creates unintended pregnancy and early childbirth, and inadequate prenatal care that makes the pregnancies harmful to the pregnant woman and fetus." (P. 330). In addition, although there is ample literature on how race and reproduction coincide, there is almost no information available on "the special problems faced by adolescent women who are handicapped, lesbian, or victims of incest." (P. 341). The article goes on to discuss the specific problems encountered by adolescents and their children and comes to the conclusion that socioeconomic status, rather than age, is the greatest indicator of poor outcome in a teen pregnancy. Studies suggest that the more liberal a country is in discussing pregnancy, sexuality, and birth control, the lower the teen pregnancy rate and abortion rate. Ways to lower the negative outcomes to adolescent women and their children are to increase accessibility to information and contraception, make prenatal care more available, accessible abortion, and easily accessible adoption services. The article then concludes with an equal protection analysis of the teenage pregnancy dilemma and concludes that pregnant adolescents should be treated as a "suspect class" because of the "extensive record of society coercing pregnant adolescents to undergo childbirth, despite the dramatic negative consequences of such childbirth on the lives of the pregnant adolescents as well as her future offspring." (P. 366). The legislature also has an obligation to protect this group. Being covered under the equal protection clause would give the adolescent women of this country greater power and control over their bodies than the current protection under the right to privacy. [Back]


Ruth-Arlene W. Howe, REDEFINING THE TRANSRACIAL ADOPTION CONTROVERSY, 2 Duke J. Gender L. & Pol'y 131 (1995)
This essay discusses the highly debated and emotional topic of interracial adoption in the United States. The author's view is that essentially it is wrong for white (and impliedly other non- black races) to adopt African American children. It makes no difference that there are many black children without families. The important focus for society should be on facilitating strong black families "as opposed to token desegregation in the white world." (P. 138). The controversy this author sees with transracial adoption is that it is not about fulfilling the needs of black children, but rather on facilitating the right of white adults to adopt any babies they choose too. In a nut shell, "this Essay analyzes how eliminating same-race placement preferences in order to establish a new right for white adults affects Black children, Black families, and the Black community generally." (P. 139). [Back]

Susan E. Lederer, Sex, Race, and Science: Eugenics in the Deep South, Journal of American History, Vol. 82, No. 4, Page 1622, (1996) (reviewing Edward J. Larson, Sex, Race, and Science: Eugenics in the Deep South (1996)).
This book review discussed the 1991 exploits of Louisiana gubernatorial candidate, David Duke, including introducing a bill offering female welfare recipients money in they would agree to temporary sterilization via Norplant. The author of the book discusses the history of eugenics in the South and points out that David Duke is not the first, nor in all likelihood will he be the last, who attempts to diminish, if not altogether wipe out, the African American population. Early twentieth century laws regarding sterilization of "genetically defective" individuals are compared and contrasted with Nazi sterilization programs. The book focuses on the South in order to point out the racial component in eugenics proposals. For example, "[i]n South Carolina ... in the years between 1949 and 1960, 102 of the 104 sterilizations at the state mental health hospital were performed on Black women." [Back]


Kristina Stark was a 3rd Year Law Student at the University of Dayton School of Law at the time she competed this annotated bibliography for Health Care Law Class
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Professor Vernellia R. Randall
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The University of Dayton School of Law
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