The mind, the body, and reproductive health information

“There is an entire book to be written about the stigmatization and devaluation of the body in First Amendment jurisprudence” argues Stanley Fish; a jurisprudence which is built on “a vision of human life as something lived largely in the head.” ² The apparent primacy of mind over body in discussion of freedom of expression issues is nicely illustrated by the cover of The Right To Know. Against a blue background, a decapitated and shaven head (red lipstick signifying probable gender) sits pondering the tripartite division of its brain under the labels, Information, Family Planning, and AIDS. The remainder of the body is invisible. Needless to say, one cannot judge the book by its cover. However, what is illustrative about this pictorial absence is its uncanny mirroring of the similar partiality of women’s bodies in mainstream human rights and medical discourses on abortion and contraception. The fact that these discourses are mainstream “says much about the way that we have been conditioned to think about health, about women’s reproduction, and about the concept of human rights itself.” ³

The Right To Know centers on the primacy of reproductive health information in women’s health care and is a valuable and much-needed addition to human rights literature for several reasons. It makes explicit the connections between denial of a particular category of information and a range of gender-specific harms. It highlights that state censorship of information is only one of many forms of censorship (though often the most repressive) and that other institutions and social forces can have a determinative impact on the existence of a meaningful human rights culture. It exposes the potential and deficiencies of international human rights law in furthering a women’s rights agenda. In addition, it points the way forward for the development of human rights theory and practice in the area of reproductive health.

The analytical framework for The Right To Know is set out in the first two chapters by Lynn Freedman and Sandra Coliver, followed by a short chapter providing demographic, statistical, and other information on health and reproductive issues from a global perspective. The majority of the book is then devoted to detailed country reports combining public health, human rights, and family planning perspectives. The countries profiled are Algeria, Brazil, Chile, Ireland, Kenya, Malawi, Pakistan, the Philippines, Poland, and the United States. The text concludes with a list of human rights standards for the monitoring of government practice in relation to reproductive health information and a series of recommendations directed towards nongovernmental organizations and international aid donors.

Freedman’s chapter begins with the emphatic opening that some might think obvious: “This is a human rights report.” ⁴ Why is it necessary to make this point when “an estimated 500,000 women die each year from avoidable, pregnancy-related causes; unsafe abortions cause the deaths of between 60,000 and 200,000 women annually and result in long-term ill health for at least one million others; AIDS has killed an estimated 2.5 million people and the rate of HIV infection is thought to have doubled between 1990 and 1993[?]” ⁵ The sad truth is that only in the last fifteen years has human rights discourse begun to engage with the reality of many women’s lives. As Mertus and Goldberg have highlighted, up until then, “the very notion that women could have a claim to distinct and legally cognizable human rights was virtually unheard of in mainstream international dialogue.” ⁶ However, apart from this general history of marginalization of women from “human” rights, there is a second reason for Freedman’s emphasis on human rights principles. This is because the primary motivation behind the provision of “family planning” and “health” services to “developing” countries has been a concern with population growth:

Convinced that high population growth rates impede socioeconomic development, leaders...