Suffering Under Liberty and the Reproductive Health Policies of North Carolina

Guest post by Brittney Cobb, Charlotte Dominguez, and Andi DeRoin.  The authors are first-year social work graduate students at North Carolina State University. Along with completing advanced generalist practice education, they are advocating for policy change at the state level and fighting for social justice, equity, and a healthy community.

Reproductive health justice is vast, yet abortion seems to always be at the forefront of America’s consciousness. Over the past year, North Carolina conservatives have launched a new political offensive to limit health care access, legislate reproductive decisions, and disregard the bodily integrity of half the population. Though attacks like this are happening across the country, the recent legislative actions of North Carolina officials strike close to home for us North Carolina State University social work graduate students as we prepare to enter the career field.

Despite protests that SB 353 could further restrict access to abortion, and reminders that such action went against his campaign promises, Governor McCrory signed Senate Bill 353 into law on July 29th 2013.  Under this law, 1) medical providers in North Carolina have the right to refuse to perform abortions (despite already being able to do so), 2) sex-selective abortions are banned (despite having no evidence of prevalence), 3) providers must be present for an entire surgical abortion procedure or the administration of the first pill to induce a chemical abortion (despite no evidence of adverse safety or health effects), 4) the Department of Health and Human Services (DHHS) must write and enforce new rules for health clinics, which could include new ambulatory care standards and 5) motor vehicle operators are responsible when colliding with motorcycles they do not see.  Yes, you read that correctly– our legislators stuck limiting health care regulations onto a motorcycle-safety bill.

Redundant legislation and foggy rhetoric do not ensure women’s safety, nor do they prevent harsh interpretation from restricting access to abortion. Opponents of the bill fear the new regulations could potentially force health clinics to close their doors if they cannot meet the new standards.  National and State medical groups attest that the guidelines clinics currently run under are sufficient, and enforcing new regulations are unnecessary.  The effects of these new DHHS rules are inciting community uproar and concern.  Negative reaction from the bill comes from what we believe are the true motives of those who pushed for it to be signed into law.

To put it bluntly, those with a uterus will suffer under SB 353, but communities which rely on clinics for comprehensive health care will suffer the most. If clinics are forced to close under the new DHHS rules, many marginalized populations (which already have limited access to health care) will become even more pushed aside–by NC legislators. Without availability to those clinics, marginalized women will lose access to reproductive health care which could result in increased unwanted pregnancy and no safe access to abortions. Their reproductive livelihoods are being threatened by policies put in place that limit their access to these clinics.

It seems that the main moral value driving this policy is the right to life, while a woman’s right to bodily autonomy drives opposition.  The heart of the reproductive health debate seems to involve where priority is placed: on the unborn, or on the pregnant female.  Senate Bill 353 does not deny the right to abortion, but it infers a proposition to end them. For those who support a woman’s right to have complete control of her reproductive health, arguments such as these do not overshadow the existing life of a mother.

Abortion and reproductive health care providers, as well as individual advocates across the state, have made their voices heard both during and after the consideration and passage of SB 353. Though there is inspiration from past movements related to such ingrained and divided social justice issues, nothing seems to adequately prepare us for today’s fight.  The only seemingly viable option is to attempt to network with other states; together we can comprehensively and independently lobby lawmakers.  As reproductive rights are dismantled, we can harness the resulting disgust and outrage, empower all individuals to stand up for personal liberty and bodily integrity, and influence our state, our region, and our country.

Anti-Shackling: Reproductive Rights Behind Bars

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by Reposted with Permission.  Original posting available here

As prison abolitionists work towards a world without prisons, public health practitioners and prison reformers must work alongside them to expose and mitigate the severe injustices that compromise the health and wellness of every person behind bars. The incarceration system is an economic and social burden that is often shrouded in mystery, feeding off of the fruits of capitalism and other oppressive systems of power.  As of 2010, the U.S holds the highest incarceration rate and the largest population under correctional control in the world.  Today, women represent the fastest growing incarcerated population. Between 1980 and 2010, the number of women in prison increased by 646%– rising from 15,118 to 112,797 (The Sentencing Project). Today, 1 in 25 women in state prisons and 1 in 33 in federal prisons are pregnant upon prison admission (id). However, despite a rise in female and pregnant inmates, many “correctional” facilities have failed to meet even the minimum requirements of their basic healthcare needs. Meeting this minimum requirement includes banning the practice of shackling women before and during labor and after delivery.

Shackling women during their delivery and throughout their pregnancy is a public health issue because not only does it deprive mothers of the opportunity to be fully present and comfortable during their unique childbirth experience, it is dehumanizing, oppressive, and dangerous. Shackling also puts the mother and baby at an increased risk of medical complications during and after the delivery. According to Dr. Maureen Phipps, Associate Professor of Obstetrics and Gynecology and Community Health at Brown University, and chair of the American College of Obstetricians and Gynecologist’s (ACOG) committee on health care for underserved women, “if the fetal heartbeat slows, and an immediate Caesarian-section is required, the time lost to fumbling with shackle locks could cause brain damage and even death” (Women’s Prison Association).

Report Card on Mothers Behind Bars is a 2010 collaborative effort between Rebecca Project and The Women’s Law Center in Washington D.C “to expose the conditions of confinement for pregnant and parenting women […]” (National Women’s Law Center & The Rebecca Project for Human Rights, 2010). Their report card confirms that shackling actively inhibits the wellness of a mother’s reproductive experience because “[shackling] makes it difficult for doctors to adequately assess the condition of the mother and the fetus, and to provide prompt medical intervention when necessary. [Shackling] also make the process of labor and delivery more painful” (id).

According to Healthy People 2020’s (HP2020) Maternal and Child Health objectives ( U.S. Department of Health and Human Services, 2013), reducing maternal illness and complication related to pregnancy and increasing the proportion of infants who are breastfed are important pieces of improving overall health and well-being of women, infants, and children. HP2020 states “common [physical] barriers to a healthy pregnancy and birth include lack of access to appropriate healthcare before and during pregnancy. In addition, environmental factors can shape a woman’s overall health status before, during, and after pregnancy by: affecting her health directly and affecting her ability to engage in healthy behaviors.”

Prison is an environment that controls and limits human movement, making it difficult, if not impossible, for individuals to practice or learn about healthy behaviors. It is important for laboring mothers to move freely in order to identify comfort measures that will help the labor and delivery process go more smoothly. Shackling not only severely limits that movement, but it can cause medical complications and it prevents mothers from initiating a maternal bond with their newborn via breastfeeding (The Sentencing Project). Consequently, shackling undermines the maternal, infant and child health objectives of HP2020.  If HP2020’s maternal, infant and child health benchmarks consider the plight of incarcerated women, then addressing the issue and ending the dehumanizing practice of shackling women during their pregnancy is just one action that will help achieve HP2020 objectives and have a significant positive impact on the status of maternal and child health in the U.S.

We face a long road ahead in our struggle for reproductive freedom as about half of U.S states have yet to adopt or address any policy or law regarding the practice of shackling women before and during their labor and delivery (National Women’s Law Center & The Rebecca Project for Human Rights, 2010). 

Thankfully, the anti-shackling movement has made impressive progress that has been initiated by reproductive rights advocates from all corners of the issue . SPARK, a statewide community based and focused reproductive justice organization headquartered in Atlanta, GA, works for reproductive justice by developing radical tools to help shift the state of reproductive rights in Georgia and the U.S South (SPARK). Alongside SPARK in the anti-shackling and reproductive justice struggle is Birthing Behind Bars. Birthing Behind Bars is a national U.S campaign initiated and sustained by WORTH (Women on the Rise Telling Herstory). WORTH is ”an association of currently and formerly incarcerated women empowered by their own [birthing behind bars] experience”. They are part of the national movement to outlaw the practice of shackling pregnant mothers before and during their labor and delivery.  With their voice, WORTH has successfully moved New York State to prohibit the practice of shackling incarcerated women during their labor and delivery (id).