Reproductive Justice: Voices Not Just Choices

What Is Reproductive Justice?

Indigenous women, women of color, and trans people have long fought for the right to make decisions about their bodies. Coined in 1994, the term reproductive justice is defined 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.”

One way to differentiate reproductive justice from reproductive rights is that the latter is the “legal right to access health care services such as abortion and birth control”. Initially, spokespeople of this women’s rights movement often included educated wealthy, middle class White women. This left marginalized communities and minority women who did not have easy access to their rights with minimized opportunities to voice their problems and experiences. This begs the question of what good are these rights, if they aren’t accessible. Built upon the United Nations human rights framework, reproductive justice is an intersectionality issue where reproductive rights and social justice are combined so the voices of LGBTQ+ people, marginalized women, and minority communities are uplifted.

Abortion as a Voice, Not a Choice

Choice comes from a place of privilege. The chance of deciding reproductive options is more easily accessible to middle class White women, while these same options are typically unavailable or restricted for poor, low-income women of color. These are the same marginalized women who historically bore the burden of unethical research in reproductive medicine from issues regarding the study of gynecology, to sterilization, and everything in between. For example, James Marion Sims, the father of modern gynecology, conducted medical procedures on enslaved Black women, which is unethical in more ways than one. No consent was given. A patient that has no knowledge of what is going on or what is being done to them cannot give consent. As an enslaved person, the patient was not seen as a human being, but rather as property, and therefore no consent was necessary. The medical procedure was purely experimental, and Sims’ likely had poor knowledge of what he was doing which made his actions torturous. Women like the patients Sims practiced on, women of color, women who were and are oppressed and marginalized, women with disabilities, and people of the LGBTQ+ community continue to be exploited, and it is important that their voices are heard now more than ever.

Source: Robert Thom, circa 1952. From the collection of Michigan Medicine, University of Michigan. Sims’ not only purchased Black women to conduct his inhumane experiments on, but he did so on the belief that Black women could not feel pain.

Often there are misguided notions that reproductive justice is just about abortion, and while access to abortions is a major component of the movement, the movement does not end there. Reproductive justice also goes on to include access to proper sex education, inclusive to all genders and sexualities, affordable contraception, and access to safe and healthy abortions. It’s not enough for abortion to be legalized. “Access is key,” meaning that the cost of the medical procedure is bearable. Medical expenses include travel to a medical provider, paid time off from work, prescription costs, dietary expenses, relocation, etc. all of which can cause difficulty in accessing care. As something that women of color, women with low incomes, and the LGBTQ+ community have brought to attention, reproductive justice is an umbrella that goes beyond the pro-choice versus pro-life debates. It calls into light that factors such as race and class in society affect each woman and LGBTQ+ persons differently. This means not every person has the choice to choose or not choose a pregnancy due to lack of access to services, stigma, or historic oppression, which is where the pro-voice movement intercedes.

The pro-voice movement is meant to “replace judgement with conversation” from both pro-choice and pro-life advocates. Abortion is an incredible emotionally and morally draining topic to converse on, and it’s a decision that should be void of politics and instead filled with empathy and compassion so an individual can make the healthiest choice and live their healthiest life. It is important to validate a person’s lived experiences and to acknowledge that they made the best decision they felt like they could with the resources available to them at the time.

Stigma Around Reproductive Health

There is lack of access to the topic of reproductive health due to incomprehensive sexual education in school systems. Access to this information, access to proper medical care, access to contraception and abortion “is a political, human rights and reproductive justice issue.” Some educational systems fail to mention how to obtain contraceptive methods, how to use them, and which methods are more suited for an individual. This lack of information and stigma around sexual education does not reduce the incidence of unsafe and “unprotected sex or rates of abortion.” In fact, lack of education around contraception and restrictive abortion practices leads to more unsafe abortions globally due to financial burdens as well as social and cultural stigma.

Source: Maria Nunes. An LGBTQ+ Pride event takes place in the Caribbean.

Another issue is heteronormativity which is the trend in sex education focusing “on straight, cisgender young people, but ignores LGBTQ+ youth.” These conservative views that do not cater to a whole population of young adults exacerbates this stigma around sexual and reproductive health. This leads to people feeling like they cannot ask questions due to fear of social repercussions or that their sexuality is abnormal. Not being provided with “information to address their health needs, leaves the LGBTQ+ youth at risk for sexual violence and unprotected sex,” making them more vulnerable to various sexually transmitted diseases, teen pregnancy, and mental health disorders. As important as it is it to address reproductive justice and reproductive health as a women’s issue, it’s even more important to know that LGBTQ+ people “can get pregnant, use birth control, have abortions, carry pregnancies, and become parents.” Part of fighting for and providing reproductive justice involves activism against controlling reproductive voices, and often controlling sexualities and gender expressions are synonymous with gatekeeping those voices.

Providing access to sexual and reproductive healthcare to LGBTQ+ people is one way to ensure that all communities are able to have information, resources, and the power to make their own decisions about their bodies, genders, sexualities, families, and lives. Access to reproductive healthcare can come in the form of gender affirming care and treatment for transgender, nonbinary, and gender nonconforming individuals. Having free access to reproductive education is a foundational piece within the reproductive justice movement. Talking about the framework around sex and reproductive justice is so much more than sex. It involves intersectionality and considerations of reproductive health regarding pregnancy, abortions, racial and class division and discriminations, maternal mortality rates, and environmental conditions. It’s about the dichotomies between oppression and liberation, individuality and collectivity, and most importantly choices and voices.

Source: Terry Moon for News and Letters. An individual in Chicago attends a protest in support for Planned Parenthood.

What Are Three Things I Can Do?

  1. Understand that it’s not about being pro-choice or pro-life. Understanding abortion is about validating people’s stories and experiences. If you haven’t experienced abortion or don’t know of someone who has, the first step is to come from a place of compassion and empathy.
  2. Know that reproductive justice goes beyond being a women’s issue. The same resources and information given to women need to be disseminated throughout the LGBTQ+ community.
  3. Research organizations such as SisterSong, Planned Parenthood, and URGE to start your activism and make your impact.

Women’s Rights are Human Rights: Ireland Continues to Criminalize Abortion

Tomorrow, May 25, Ireland will vote on a referendum of their Eighth Amendment: the abortion amendment. The referendum posits safe and regulated healthcare, as well as the removal of the stigma placed on both the women who seek abortions and the doctors who perform them. **This is a repost from the fall of 2016. 

March for Choice in Dublin On Saturday 29th. September 2012. Source: William Murphy, Creative Commons.
March for Choice in Dublin On Saturday 29th. September 2012. Source: William Murphy, Creative Commons.

Abortion. It is a heavily debated topic. From the beginning, its very existence is consistently brought up in philosophy papers and classes as a moral question. The negative connotation associated with abortion can make many people cringe when they simply hear the word. In the United States, it is an issue that conservatives and progressives rally around, but for different reasons. Classic conservative ideology revolves around public virtue, self-reliance, freedom, and cultural solidarity. One might argue that if classic conservatism highly values freedom, then the ideology would advocate for the freedom to choose whether to have an abortion or not. However, modern conservatism has implemented a little twist in such ideological freedom. Modern conservatism has emphasized the nuclear family model and to a degree, Christianity. Ronald Reagan once said, “We cannot diminish the value of one category of life — the unborn — without diminishing the value of all human life.”  We see a shift in ideological values. The argument could be made that modern conservatives still value freedom as much as the classic conservative ideology does. The new paradigm frames the issue of abortion as not about the freedom to choose, but rather the act of having an abortion is committing the act of murder. This places a negative stigma with regards to abortion due to the fact that murder is socially condemned and lawfully illegal. Progressive ideology tends to promote social justice, egalitarianism, and inclusiveness. It tends to frame the issue of abortion as the mother’s right to choose whether to continue the pregnancy or not because a fetus is a part of her body, and not a human being considering that it has not been birthed. The belief that abortion is immoral stems from the emphasis on family values as well as religious interpretations that consider abortion an act of murder. In relation to all of these things, is it fair for a national government to ban abortion? I’m not talking about defunding Planned Parenthood or limiting the amount of abortion clinics in a country. Is it fair for a national government to blatantly make abortion illegal and a punishable crime? The United Nations Human Rights Committee doesn’t think so in relation to Ireland’s ban on abortion.

Ireland’s deep-rooted Catholic tradition appears in many of its laws, one of those being the country’s eighth constitutional amendment. The amendment of 1983 established a nationwide ban on abortion. The amendment reads: “The State acknowledges the right to life of the unborn and, with due regard to the equal right to life of the mother, guarantees in its laws to respect, and, as far as practicable, by its laws to defend and vindicate that right.” It can be debated that this amendment implies that the unborn fetus has more rights than the person carrying the child. So, when it comes to the United Nation’s definition of Human Rights, who do those rights extend to? Can an unborn fetus have human rights? Once again, the United Nations says “no.” The broad definition of human rights given to us by the UN states “human rights are universal legal guarantees protecting individuals and groups against actions which interfere with fundamental freedoms and human dignity.” The word “individual” has been deemed insufficient as to identifying if that entity must have already been born in order to take ownership over human rights. Due to the need for clarification on what makes someone an “individual,” there have been a few other conventions and commissions within the UN that has attempted to resolve such confusion on this controversial issue. For example, the Convention on the Rights of the Child does not identify one’s right to life until birth.  However, the CRC does say, “the child, by reason of his physical and mental immaturity, needs special safeguards and care, including appropriate legal protection, before as well as after birth.” Rhonda Copelon, Christina Zampas, Elizabeth Brusie, and Jacqueline deVore argue that “this reflects, at most, recognition of a state’s duty to promote, through nutrition, health and support directed to the pregnant woman, a child’s capacity to survive and thrive after birth…” They also argue that access to safe abortions to pregnant adolescent women is a human right given to women under the right to adequate health. That is, providing safe abortions will decrease the maternal mortality rate due to the decrease in unsafe abortions.

Ireland’s law on abortion insinuates that if the fetus has any sort of problems in the womb, that the mother will still be subject to carry it to full term. In the 2011 case of Amanda Mellet, 21 weeks into pregnancy, the fetus was diagnosed with Edwards’ Syndrome and congenital heart defects that led doctors to believe that it would either die in the womb, or perhaps only live a few hours after being born. Amanda and her husband had requested an exception to the ban on abortion because of the emotional toll that carrying the fetus to full term would bring upon the both of them, but especially for Amanda who would literally have to carry the fetus whose life was already predetermined to end in just a matter of time. The Mellet couple was denied such an exception due to the fact that the mother’s life was not at risk. However, they traveled to Liverpool where they would be provided a safe abortion by a doctor without being criminalized.

About Ten Thousand People Attended A Rally In Dublin In Memory Of Savita Halappanavar. Source: William Murphy, Creative Commons.
About Ten Thousand People Attended A Rally In Dublin In Memory Of Savita Halappanavar. Source: William Murphy, Creative Commons.

Ireland’s abortion ban carries a heavy weight on the issue of the mother’s health. Although Irish Law claims that the only exception for a woman to get an abortion is if her life is at risk, doctors claim that the language used for exceptions is very vague and medical professionals would rather not perform one at all rather than risk going to prison for following their own interpretation of the exception to the law. In 2012, Savita Halappanavar was in extreme physical and emotional discomfort when she knew she was miscarrying, but her request for an abortion was denied because doctors said that the fetus still had a heartbeat. She arrived at the hospital on Saturday. On Wednesday, it was discovered that the heartbeat of the fetus had stopped; Savita died due to septicemia one week after arriving at the hospital. It is believed that if the doctors would have performed an abortion, Savita would have lived.

The United Nations Human Rights Committee ruled that Ireland’s abortion ban is a violation of women’s human rights because the law “subjects a woman to cruel, inhuman, and degrading treatment.” Such a ruling should not come as a shock to the international community considering UN legislation has insisted that the rights of the unborn are non-existent. Ireland’s law arguably gives more rights to the unborn than it gives to the human. Ireland is creating a social stigma that labels women who get an abortion as murderers and criminals.

Under Irish law, women who have had an abortion within the country are subject to up to fourteen years in prison. So, what’s the solution? Ireland insists that women who want access to a safe abortion should get one out of the country. According to Amnesty UK, a minimum of ten women and girls travel out of Ireland and into England every day in order to get access to a safe and legal abortion. However, not everyone is fortunate enough to travel out of the country to acquire proper medical treatment due to the expense of making such a trip. Also, those who are refugees or asylum seekers are not legally able to leave Ireland at all. Therefore, although Ireland may think that they are being reasonable by allowing women to receive abortions elsewhere, they are still impeding on the human rights of women. Even for the ones who can afford to travel, it is still an expense and a nuisance to have to leave one’s own country for such a procedure; especially for those who are experiencing extreme pain and suffering due to a complicated pregnancy.

The United Nations Human Rights Committee looked at the case of Amanda Mellet (the Center for Reproductive Rights filed a complaint for her) and found that her human rights were being violated under articles 7, 17, and 26 of the International Covenant on Civil and Political Rights. I commend Ireland on accepting marriage equality, but it is now time to recognize the rights of women. Women have been denied certain rights for so long and although we have gained many, the good fight is not over. The same government who says that it is okay for same sex couples to marry should be the same government that allows women the right to terminate a pregnancy.

 

 

The Controversy of Healthcare Rights

a picture of a sign that reads A Women's Place is in the Resistance
Women’s March. Source: Alan Sandercock, Creative Commons.

The promotion and focus on public health is in some sense evolutionary. As our world continues to globalize, a byproduct is the development and discovery of new technology and information that aid in the improvement of a nation’s health care system. Public health development relies on the accessibility of an efficient and feasible health care system that provides a range from prevention services, like vaccinations and screenings, and treatment services. Therefore, a lack of access to healthcare services and facilities could result in increased illness, disability, and death. Many people do not have access to reliable healthcare, for a variety of reasons, including poverty and high cost of insurance, raising the question of whether or not healthcare can remain simply public health concern, or if it is both a public health and human rights issue. The answer ultimately depends upon the implementation and exercise of a nation’s law.

The international community, through various declarations, recognizes the right to healthcare as a fundamental and universal right for every human being. Article 25 of the United Declaration of Human Rights (UDHR) states that “everyone has the right to medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, and old age.” The social, cultural, and economic rights enshrined in the 1952 UDHR coalesced into legally binding responsibilities with the adoption of International Covenant on Economic, Social and Cultural Rights (ICESCR) in 1966. Article 12 of the ICESCR directly addresses health care stating, “the States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. The full realization of this right shall include: The prevention, treatment and control of epidemic, endemic, occupational and other diseases; and the creation of conditions which would assure to all medical service and medical attention in the event of sickness.”  Both of documents thoroughly defend our rights to healthcare. In this blog, I will argue that all individuals have a right to healthcare without discrimination based on desired services.

According to the UDHR and ICESCR, every individual has a right to health care. Unfortunately, the access to healthcare, for women, is often discriminatory and limited. Males and females are biologically different and require dissimilar healthcare services, particularly different preventative screenings and reproductive health necessities, throughout different stages of life. That being said, one statement that really caught my eye during 2017’s presidency election is the possible defunding of Planned Parenthood.

Planned Parenthood (PP) is a non-government organization that provides crucial reproductive health care, sex education, and information to millions of women, men, and young individuals globally. 2.5 million women and men in the United States annually visit Planned Parenthood, and an estimated one in five women in the U.S. has visited a Planned Parenthood health center at least once in her life. Annually, this organization provides 270,000 Pap tests, more than 360,000 breast exams, more than 4.2 million tests and treatments for sexually transmitted infections, and lastly provides educational programs to 1.5 million young adults annually. Consequently, the reason why PP gets funded by the government is because PP provides free services such as pap tests, breast cancer screenings without any co-pay, thus the government is basically reimbursing the organization. From a public health perspective, PP is essential in maintaining and promoting population health due to preventative screening measures, controlling sexually transmitted infections (STI), and educating the community on positive and healthy behavior change.

a pic of a sticker that reads I Stand With Planned Parenthood
I Stand With Planned Parenthood. Source: Women’s News, Creative Commons.

The most controversial service offered by PP is pregnancy contraceptives and abortions. Overall, 80% of PP patients receive services to prevent unintended pregnancy, yet only 3% of PP healthcare services are abortion services. Abortions are controversial, yet regardless of what your personal views on abortion, PP helps millions of people and the general public stay healthy. In fact, in 2015 PP detected breast cancer in 71, 717 women and treated 171, 882 for STI’s, and without these prevention services, rates of cancer, and the spread of STI’s will increase.

Given that women make up more than half of the US population, is it truly just of the government to defund Planned Parenthood just because it provides abortions? The answer is technically no. The laws governing Medicaid prevent states from excluding certain providers solely because of other medical services they provide, like abortions. Specifically, the Freedom of Choice Act which states it is the policy of the United States that every woman has the fundamental right to choose to bear a child, to terminate a pregnancy prior to fetal viability, or to terminate a pregnancy after fetal viability when necessary to protect the life or health of the woman. The act also prohibits the interference of “discriminate against the exercise of the rights set forth in paragraph (1) in the regulation or provision of benefits, facilities, services, or information.” Defunding Planned Parenthood because the organization provide abortion services is technically illegal and defies the act. Another document that supports women rights to family planning health care services in the Convention on the Elimination of all Forms of Discrimination against Women (CEDAW). According to Article 12 in the Convention on the Elimination of all Forms of Discrimination against Women, State Parties will ensure women have equal access to health care services, including those related to family planning. In modern times, family planning includes services such as contraceptives like birth control and abortions, and according to CEDAW, access to these services are women rights.

As of right now, there is no alternative health care system or health care facilities in place to provide care for people covered by Planned Parenthood. According to the Congressional Budget Office, if Planned Parenthood were to be defunded, there would be increased direct spending for Medicaid by $20 million in 2016, by $130 million in 2017, and by $650 million over the 2016-2025 period. Also, as little as 5% or as much as 25% of the projected 2.5 million patients aided by Planned Parenthood would face reduced access to care. Ultimately, the Constitution of the United States establishes the government’s responsibility to promote general welfare. The potential lack of access to health care due to defunding Planned Parenthood means a failure to provide basic human rights for women, but also a failure to promote general welfare.

Americans need a health care system that works for all patients and providers. This is a turning point for the women in our nation. Many women are worried we are going back in time. The Women’s March on Washington showed the passion, respect, and trust American women have for their rights, their need for government support, and the gravity of the issue around the world. The Women’s March started in Washington, but inspired women all over the world to march for women rights in their own country, and demand their governments recognize women rights are human rights. Just like the thousands of men and women who marched in Washington and all over the world, don’t forget that the US government works for the people, and we need to start learning how to engage in our democracy to ensure our voices our heard. The Unites States of America is the only developed country who doesn’t offer health care to all citizens, and it is time for a change.