#BlackLivesMatter, and Black Health Matters, too: Reproductive Justice

by Anna Katz, 2017-2018 Campus Leader at Duke University

This November, I had the privilege of attending the first annual Black Health Matters Conference at Harvard University.  Given my work as a NARAL Pro-Choice North Carolina Campus Leader and love for all things sexual health, I was particularly looking forward to Saturday’s panel Who and How: Sexual Health Activism for Our Most Underserved Communities.  As I ponder what shape my budding career might take, I am always thrilled to hear the varying ways activists approach this critical work.  With panelists working in academic, government, and the nonprofit sector, the event promised to offer several unique perspectives on sexual and reproductive health.

But perhaps most exciting was the opportunity to attend a reproductive health event that centered and amplified the voices of four Black women leaders in the sexual health field.  Mainstream reproductive rights activism historically sidelined women of color, trans women, poor women—virtually anyone who didn’t reflect middle- and upper-class white leadership.  Frustrated with this marginalization, a group of Black women created their own movement, coining the term “reproductive justice” in 1994.  Now a national leader in reproductive justice, SisterSong Women of Color Reproductive Justice Collective defines reproductive justice as “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.”  To ensure that these rights are universally recognized, they believe, we must analyze power systems, address intersecting oppressions, center the most marginalized, and build coalitions across issues and identities.

In doing this work, we must first contextualize sexual and reproductive health activism within a history of reproductive oppression.  Our nation has a broad and shameful history of sexual and reproductive coercion of Black folks and other communities of color, contributing to an abiding distrust of health practitioners and organizations like Planned Parenthood.  From the forced reproduction of enslaved African and African American women to the coercive sterilizations of the American Eugenics Movement, from J. Marion Sim’s surgical experimentation on enslaved women to the non-consensual extraction of Henrietta Lacks’ cervical cells, from contraceptive pill trials on Puerto Rican women to the infamous “Tuskegee Syphilis Study,” folks of color have continuously been stripped of bodily autonomy, often for the purpose of “advancing” reproductive science.  The generational trauma of such violating practices cannot be minimized; as activists, we must acknowledge our nation’s ugly histories and recognize where the mainstream reproductive rights movement has failed the most vulnerable.  The panelists echoed SisterSong’s push for centering those who have been marginalized and emphasized that paying lip service to historically subjugated groups is not enough. “Activism is a doing, not a saying,” explained panelist Jill Smith, HIV/STI Project Manager at the Maryland Department of Health.

I am proud to be working with NARAL Pro-Choice North Carolina, an organization that is committed to serving all North Carolinians and prioritizing those disproportionately impacted by harmful policies.  In an attempt to echo this commitment on Duke’s campus, I am building partnerships with groups that tend to be excluded from reproductive health conversations.  I am thrilled to be kicking off next semester with a sexual and reproductive health trivia night in collaboration with The Bridge, an online community for Black and Latina women.  Through such coalition-building, perhaps we can build an on-campus reproductive justice movement that is truly inclusive and intersectional.

Why are NC abortion rates declining?

Last week the Associated Press released new data showing that abortion rates are declining in nearly all states – including North Carolina. While anti-choice leaders are heralding these dropping abortion rates as proof of the success of anti-abortion legislation, this is far from the truth.

Since 2008, North Carolina has had the second-largest decline in abortion of all states that keep such statistics. Some people mistakenly credit the state’s abortion restrictions with this decrease in abortions, but the answer is more nuanced than that.

There has been a significant decline in both birth and abortion rates in many states, including North Carolina, since 2008.  These declines pre-date the introduction of many restrictive abortion policies, which began to surge in 2011, including here in North Carolina.  Decreased abortion and birth rates basically means that fewer women are getting pregnant; thus fewer women needing abortions or having babies.  Decreased pregnancy rates are most likely due to increases in highly effective, long-acting contraceptive use, which has skyrocketed in the last decade, from about 2% to almost 10% among reproductive-aged women.  The Healthy Youth Act, which broadened the public schools curriculum to include more information on how to prevent pregnancy, may also have played a role in the decrease in abortion rates in North Carolina. Restrictive laws do not decrease abortion rates; access to effective, long-acting contraception does.

The recently adopted abortion restrictions in anti-choice House Bill 465 – including a 72-hour waiting period for women seeking abortion services – will not decrease abortion rates. These restrictions are medically unnecessary. The American Medical Association and the American College of Obstetricians and Gynecologists both oppose waiting periods for abortion care for two main reasons: they have no medical value and they often cause unnecessary mental distress for patients. The truth is that medically accurate sex ed and access to highly effective contraception are the best ways to lower unplanned pregnancy rates, and thus to lower abortion rates. Limiting women’s access to safe, legal abortion has no such result.

Shoshannah Sayers is the Interim Executive Director for NARAL Pro-Choice North Carolina. She may be reached at shannah@ProChoiceNC.org or (919) 908-9321.

Women’s History Month Highlight: Doctor Rebecca Gomperts

Anna Lobastova, Co-President of the Reproductive Justice Club at ASU and Appalachian State University Senior

According to the World Health Organization (WHO), 21.6 million women experience unsafe abortions every year and 47,000 of these women die as a result of complications that arise from these procedures. Within both feminist and human rights discourses, safe and legal abortion is often regarded as an essential right that allows for people to preserve their health, economic stability, and bodily autonomy in the face of an often-desperate situation. However, not every country in the world recognizes legal abortion as an essential right that it is, leading to the colossal amount of injuries and deaths cited by WHO.

Dr. Rebecca Gomperts saw these global violations of human rights happening firsthand in her experience as an abortion provider. After spending time as a doctor on a ship for Greenpeace, she made the connection that there was a possibility for expanding international access to safe abortion without violating national laws or sovereignty. In 1999, she founded Women on Waves, an organization operating out of the Netherlands that sails around the world, providing services such as non-surgical abortion, contraception, and reproductive counseling on their ship. Because they operate out of international waters, people are able to obtain access without having to risk legal action that their country may otherwise impose on them.

Currently, Dr. Gomperts is the director of Women on Waves and is an excellent example of a woman making positive change in extremely trying circumstances. Aside from the under appreciation of abortion providers worldwide, she and Women on Waves face barriers such as the cost of running their organization, the intricate planning necessary for their work, and the inevitable issues they run into with foreign governments and global political differences. When Women on Waves sailed to Portugal, they were blocked from the port by a Portuguese Navy warship that had been ordered there by the conservative federal government. In Poland, her ship’s arrival was protested with the phrase “Welcome, Nazis”– an unfair comparison that was meant to sting, given the country’s history of suffering during World War II.

Even in often-oppressive political circumstances, Dr. Gomperts and Women on Waves continue to perform their incredibly challenging but incredibly necessary work, demonstrating that the fight for reproductive justice is alive and well. With heroes like Rebecca Gomperts and her organization, the future of reproductive health access looks brighter.

NARAL NC Discusses Implications and Impact of Hobby Lobby on Duke Law Panel

Last Tuesday, academics and advocates discussed the implications for reproductive rights and religious freedoms after the Burwell v. Hobby Lobby Supreme Court decision at Duke University Law School. The event was co-sponsored and organized by the Women Law Students Association (WLSA), the American Constitution Society (ACS), and the American Civil Liberties Union (ACLU), and funded by the Duke Bar Association (DBA).

On June 30, 2014 the Supreme Court issued a decision in the Hobby Lobby case. It held that closely held, for-profit companies with religious objections to following the federal health care law’s requirement to provide coverage for birth control in their employee health plan do not have to do so because they are protected by a federal law known as the Religious Freedom Restoration Act (RFRA).

Katie Karges, from the Duke Women’s Law Student’s Association, introduces the panelist and moderator Duke Law Professor Katherine Bartlett.

Judy Waxman, Vice President for Health and Reproductive Rights at National Women’s Law Center, stressed that the number one issue issue at stake in the Burwell v. Hobby Lobby Supreme Court decision is women’s health. Waxman explained that this decision has severe economic impacts for women. She noted that the cost of many of the contraception methods excluded by Hobby Lobby are some of the most effective and for workers earning the minimum wage, are close to a month’s full-time pay. She added that this decision allows a boss’s religion to trump an employee’s.

Stating that half of the pregnancies in the United States are unintended and that 99% of women will use some form of birth control in their lifetime, Kristine Kippins of the Federal Policy Counsel Center for Reproductive Rights used statistics to convey her message that the economic benefit of no-cost contraception on a woman’s life is great. Notably, Kippins stated that “religious liberty is supposed to be a shield not a sword.”

Suzanne Buckley, NARAL NC‘s Executive Director added that this decision is about discrimination against women, the burden of which will be felt most heavily by poor women, women of color,  hourly wage workers at corporations like Hobby Lobby, and women and families who are already struggling to make ends meet. She noted that 648,000 NC women are in need of publicly funded contraceptive services, and over 600,000 lack health insurance coverage. The vast majority of women that already lack insurance are women of color—51.5% of Hispanic women and 25.6% of black women in NC are uninsured.  Buckley emphasized that the ability to decide when, how, if and with whom to make a family is critical to women’s health and well-being and our economic security.  She stated that access to affordable contraception is critical to women’s ability to manage our future, and the families we already have.  She added, “The Hobby Lobby decision takes birth control out of the hands of women who need it—and may not be able to get it otherwise.”

Buckley also explained that North Carolina has a “contraceptive equity” law that requires insurance plans in NC to cover contraception. North Carolina’s contraceptive equity law is a separate legal requirement on insurance plans in NC that is not impacted by the Hobby Lobby decision. While NC’s contraceptive equity law (N.C. G.S. § 58-3-178) will remain in effect, NC’s law does not provide no-cost contraceptive coverage and does not cover employees of self-funded or self-insured companies.

Jessica Waters, the Associate Dean of the School of Public Affairs at American University, noted many implications of the Burwell v. Hobby Lobby Supreme Court decision. Waters noted how our justice system conflates gender and morality, but stressed how Hobby Lobby attacks women.

Jed Purdy, a Duke Law Professor, asked the audience to ponder whose freedom of religion should count: a corporation or an employee? Purdy questioned the definition of reproductive freedom: does reproductive freedom mean the right to choose, or does reproductive freedom require access and financial ability to make and follow through with a choice? Purdy stressed how the Hobby Lobby decision adds to the economic and social power of corporations.

Looking forward, the North Carolina General Assembly could try to amend NC’s contraceptive equity law to broaden the exceptions and allow certain for-profit corporations, all corporations, or any entity with a religious objection to get out of complying with the law. The NC General Assembly will also likely consider attempting to pass a state RFRA, thereby creating a state version of the Hobby Lobby decision.

It’s more important than ever that we vote to elect candidates that share out values, like access to affordable birth control and protecting North Carolina women and families.