We need reproductive justice, not a higher birth rate | Liza Caruana-Finkel

Have we considered the dilemmas that people face when considering parenting, such as socio-economic conditions, work-life balance, parental leave, availability of support, and equal share of parental responsibilities? And what if you decide not to have children, or not to have a child at a particular point in time – can you access contraception, abortion, or sterilisation with ease and without repercussions?

‘Reproductive justice’ – a term coined by Black women in the US in the 1990s – combines reproductive health and rights with social justice, encompassing all the social, economic, and political factors that impact reproductive choices and decision-making abilities. It emphasises how everyone should have the right to control their own body, to decide if, when, and how to have children, and to take care of their children in safe, healthy, and sustainable communities.

Reproductive justice includes: comprehensive sex education, affordable contraceptives, equal access to safe abortions, good pregnancy care, prevention/care for STDs, a living wage to support families, safe homes, and more. It also acknowledges the intersecting factors (e.g. race and class) impacting marginalised women, trans people, and non-binary individuals differently.

Sexual and reproductive health are sorely lacking in Malta. The range of publicly available contraceptive options is inadequate, and STD rates are amongst the highest in Europe. With emergency contraception, pharmacists’ personal beliefs take precedence over duty of care. And abortion remains practically banned, inaccessible, and criminalised.

Despite potential legal repercussions, many are able to access medical abortion pills in Malta, while the more affluent can afford the costs of accessing legal abortions in other countries. Having to go abroad for healthcare is inhumane, but this discriminates most against individuals unable to travel. A pregnant teenager, a single mother without access to childcare, a woman living with an abusive partner, a disabled person with mobility issues, and an asylum seeker lacking travel documentation all face additional obstacles.

While many feel that Malta is overcrowded and attribute this to migrants, asylum seekers, and refugees, Maltese women are stigmatised and vilified for not having (‘enough’) children or for having abortions. While (white) Maltese women are guilted into having children, as though it is their duty to do so for the state, it is considered a burden for non-Maltese (especially non-white) nationals to have children. As recently highlighted by economist Marie Brigulio and medical doctor Joanna Delia, this paradox amounts to a racist and xenophobic sentiment.

Who is seen as ‘fit to parent’ is not limited to race or nationality. Disability, gender identity, sexuality, and age also affect whether someone is deemed ‘deserving’ or ‘responsible enough’ to have and raise children. Disabled people often face additional barriers in making autonomous decisions about their bodies and their lives. While disability is weaponised by anti-abortion groups, disabled people are left out of conversations on abortion, even though they may need abortions too. Despite the importance of “nothing about us without us,” disabled people are still routinely infantilised and stripped of agency.

For those who want to have children, our work-life balance leaves much to be desired. Malta has one of the lowest minimum wages in the EU, rising living costs, and parental leave at the legal minimum. If you also factor in the burden of domestic labour and care that is heavily placed on women, parenthood becomes a less viable and less alluring option. For those who are parents – have you ever felt constrained to make parenting-related choices you did not want to make? Did you decide to have only one child because of financial or social conditions? Did you feel forced to return to work only a few weeks after giving birth?

Finally, let’s talk about environmental issues. If we think of the overbuilt environment, constant construction, lack of green spaces, traffic pollution, cruise ship and power station emissions – can we honestly say that children are being born and raised in healthy and sustainable communities? Climate change-driven environmental factors (e.g. extreme temperatures and air pollution) are associated with pregnancy complications, such as increased risk of miscarriage and preterm birth. Concerns about the future in our rapidly changing environmental landscape have also led to reproductive anxieties. Research shows that some people are deciding not to have children or to have fewer children because of their ecological stances.

For reproductive justice to be achieved, we need to analyse power structures, address intersecting oppressions, center the marginalised, and join together across identities and problems. It is important to realise that the issues discussed here are not separate, but deeply linked and intertwined. There is no reproductive justice without disability justice, gender justice, environmental justice, and racial justice. In the words of feminist author Audre Lorde, “there is no such thing as a single-issue struggle because we do not live single-issue lives.” But if we work together, we can build a socially just society with reproductive freedom for all.

Liza Caruana-Finkel is an abortion researcher-activist and a member of Moviment Graffitti.