Abstract
Cohen and Joffe’s book, Obstacle Course: The everyday struggle to get an abortion in America, provides a comprehensive and organized look at an individual’s ability to obtain an abortion in the United States. The authors start with the decision to have an abortion and move from there to explain what happens when looking for a clinic and when someone cannot pay for an abortion procedure. They also include details of what individuals are likely to encounter when they arrive at the clinic, the informed consent and counseling process, and the abortion procedure, itself.
Using information based on more than 70 interviews with individuals who sought an abortion, providers (physicians and clinic staff), and volunteer escorts outside of the clinic, as well as numerous cited sources, the book explains the legislative and policy barriers (waiting periods, mandatory counseling, and viability laws) that individuals face. Additionally, Cohen and Joffe detail the personal barriers (e.g., financial, transportation, and childcare) when an abortion is considered.
Cohen and Joffe acknowledge from the start that they draw heavily on the concepts of reproductive justice, meaning that this book only provides a perspective from a more common viewpoint known as “pro-choice.” This perspective is consistent with the policy statement on Family Planning and Reproductive Choice, published in Social Work Speaks: The National Association of Social Work Policy Statements, 11th edition (2018). The term “reproductive justice” is significant because the concept was developed by women of color and places abortion within a broad context of a comprehensive set of issues regarding reproduction that includes the right to have a child, not to have a child, and the right to parent the children one has in a healthy and safe environment (p. 233).
Cohen and Joffe also offer an alternate vision if abortion were to be recognized as just another health-care procedure. Model ideas include geographically accessible abortion providers; affordable care, including Medicaid coverage; and fewer restrictions than is currently the case in the United States. In their hoped-for medical and political context, no one would have to delay an abortion procedure or face stigmatization about the decision to end a pregnancy.
The book captures the disturbing reality that an individual faces when trying to exercise her or their legal right to a medical service. Therefore, the book is appropriate for social work practitioners, students, and faculty. The stories woven throughout the book provide compelling testimony that helps explain barriers that all persons may face when she or they choose to have an abortion. These barriers affect in major ways anyone regardless of race or financial status but may prove insurmountable for those without means, often individuals of color and young people.
