reproductive rights – UAB Institute for Human Rights Blog

Eugenics: How the Remnants of a Bygone Theory Threaten Personal Liberty Over a Century Later

by Sumaira Quraishi

Trigger warnings: rape, invasive medical procedures, and medical malpractice.

Often, the Supreme Court of the United States is seen as a paragon of the American legal system and the national values it strives to uphold. At least, it used to be. While trust in the sanctity of the Supreme Court has recently been broken over controversial political issues, the Supreme Court is no stranger to making unfavorable and borderline unconstitutional rulings in cases brought before the justices at the time. While this is to be expected, with the court switching from conservative to liberal-dominant every so often, some cases seem to concern unalienable human rights that have been denied by the court, as expected of a supposed higher authority that is ultimately, and always will be, a product of its time. In 1927, Carrie Buck learned just how fallible the highest court in the American legal system could be when infiltrated with an ideology eventually perpetuated by the Nazi party during World War I.

Image shows Jewish prisoners in their barracks at the Nazi concentration camp Auschwitz. — Jewish prisoners at Auschwitz. Source: Yahoo Images.

The Birth of Eugenics

Surprisingly, and perhaps horrifyingly, eugenics was not the child of oppressive or violent regimes, but the culmination of centuries of scientific research and racism woven together and spread through communities worldwide during the early 20th century. Eugenics was a theory created to exterminate certain people who were not considered mentally fit, genetically clean, or conventionally attractive. The ones who decided the people that fit into these categories usually were ones in positions of power or influence in society: doctors, politicians, and scientists. Favored methods for perpetuating eugenics were forced sterilization, societal segregation, and social exclusion, all of which seem to be methods straight out of the time of slavery where eugenicists drew inspiration and justification for eugenics.

In the modern age, there is a laser-like focus on women’s rights to not have a child, and while this pursuit of maintaining women’s rights is justified, for many vulnerable men and women today the fight for the right to have a child is just as in need of attention. An old theory about the superiority of white, able-bodied people may seem like one to be thrown into the history books and mentioned alongside other conventionally shunned snippets of history in the modern discourse, however, eugenics never truly went away.

Eugenics Still Lingers

Overshadowing lives today as a phantom of the eugenics school of thought, a forgotten Supreme Court case in 1927 named Buck v. Bell led to the codification of sterilizing those deemed “feeble-minded” and genetically inferior by people in positions of power into law. Carrie Buck was a woman who resided in a mental institution and became pregnant after being raped, resulting in staff at the asylum taking acute notice of Buck. Doctors and directors at the asylum were firmly entrenched in the eugenics culture sweeping across America and firmly believed Buck should not be allowed to carry to term. These men took the stand that Buck should be forcibly sterilized to prevent her genes from being passed on, and the Supreme Court was in full agreement, with the justification for the ruling against Buck being that she had a history of mental illness back to one of her grandmothers and being sterilized would protect the goodness of society by keeping “feeble-minded” and “promiscuous” people from reproducing.

Not only is Buck v. Bell an appalling ruling that trod on the constitutional rights of Buck, but it also opened the door for forced sterilization procedures to continue without secrecy and, chillingly, has never been overturned. An old legal case from the 1920s may seem like something to be stored away in textbooks and forgotten, yet, eugenics practices in the form of forced sterilizations are happening today

In California between 2006 and 2010, almost 150 women in two different prisons were given hysterectomies without their consent or legal documentation authorized by the state, with 100 suspected cases of sterilization dating back to 1997 uncovered as well. Furthermore, in 2017 a Tennessee judge offered to reduce prison sentences by 30 days for any inmate who signed up to receive a birth control implant or a vasectomy. The latest case of eugenics rearing its head in American practices was in 2020 when it was revealed that hysterectomies were being performed illegally on women in the U.S. Immigration and Customs Enforcement (ICE) detention centers. These cases are not the only ones concerning the continued use of forced sterilizations to prevent incarcerated or institutionalized individuals from having the right to choose to have a child, with many more subject to the archaic practice who have yet to have their story told. These practices are considered morally reprehensible by the general public but can trace their roots to eugenic procedures approved by the Supreme Court in a case that was challenged but never overturned, and some laws approving the use of sterilizations are still in existence in states such as Virginia.

Image shows an empty cell area of a prison. — Prison. Source: Yahoo Images.

What Can Be Done

Fighting a system that has failed a large portion of the American population, and pushing for a Supreme Court ruling to be overturned when the nation’s political climate seems fit to burst with elections on the horizon can seem incredibly intimidating. These thoughts are not unfounded, but what government bodies forget is that their power comes from their people and constituents. Harmful practices can be challenged with public favor and fervor. Staying informed on what influences modern atrocities like Buck v. Bell and knowing that the majority of the population supports upholding the 14th Amendment protecting civil liberties keeps people motivated to improve the lives of their fellow Americans. Leaving Buck v. Bell as a precedent in U.S. law allows for unprotected groups of individuals who are incarcerated or institutionalized to be at heightened risk of human rights abuse, and while forced sterilization is morally reprehensible, the law does not currently outline sterilization as illegal since the Supreme Court ruling remains standing. Reaching out to local or state politicians is an option for those who want to appeal hurtful laws, and a less intimidating option is to join advocacy groups whose views align with your own.

For more information on another situation involving eugenic practices ruining the lives of nonincarcerated individuals, the case of a fertility doctor who artificially inseminated dozens of his clients with his sperm and remains free from jail can be found here.

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?

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.
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.
Research organizations such as SisterSong, Planned Parenthood, and URGE to start your activism and make your impact.

Disability Rights: A Personal Perspective

* This is a repost from summer 2017

“The purpose of the present Convention is to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity.” When I was hired by the UAB Institute for Human Rights, I never dreamed that we would take the trip to the United Nations for the 10^th Convention of States Parties on the Convention on the Rights of Persons with Disabilities. Visiting the United Nations has always been a dream for me, but being able to take part in an international effort to promote disability rights was an unbelievable opportunity to me personally.

Disability has always intersected my life. My sister and I were born with Ehlers-Danlos Syndrome, which is basically a fancy way of saying that all the connective tissue in our bodies are about as stable as a limp noodle. Because of EDS, chronic pain is just a part of my life. I am unable to run, walk, or jump without a joint in my body threatening to dislocate. I suffer from sleep disorders and chronic fatigue along with a host of gastrointestinal issues. It also affects my heart and my autonomic nervous system; I tend to feel like a walking time bomb of anxiety, heart palpitations, and general malaise all wrapped up in a spaghetti-based body. I have lived my whole life without complaining for the most part. Most people in my life don’t know the extent of my disability, or even about it at all. I keep my pain hidden because I do not want anyone’s pity. I continue physically far beyond what my body’s real limits are because I do not want people to think I am lazy or helpless. It takes too much time to explain my disability to everyone I meet, so I deal with my pain with a smile on my face. This is the reality that most people with disabilities face—a life of “oh, I’m so sorry for you!” when they learn of your disability and “why can’t you do this?” when they do not understand your limits. My struggle as a woman with a disability is the reason why the Convention meant so much to me. Before the Convention, I had never in my life been around more than two people with disabilities or ever felt like anyone truly understood what I was going through. Seeing so many other people with disabilities raising their voices, sharing their pain and suffering, and demanding change gave me hope that one day I will no longer feel like I need to hide my disability.

Photo of the team at lunch at the United Nations.

I have always known that having a disability does not mean you cannot be strong and independent. Not being able to walk for long periods does not make me lazy, and my joint instability does not make me weak. I know these things, but sometimes the able-bodied world undermines these beliefs and makes me feel like I will never be good enough. The champions of disability rights who I met gave me such courage to fight those fears. The utter strength and bravery of these people were so encouraging to someone like me. I could see myself in Daniela Bas, the head of DESA and wheelchair user. Ms. Bas has managed to overcome so many obstacles as a woman with a disability yet constantly dazzles people with her charismatic personality and fierce intellect. Ms. Bas gave her knowledge on the importance of international cooperation in dismantling the cross-cutting barriers faced by women with disabilities. Her policy-based approach and political science background gave me hope that one day I could follow in her footsteps. Ms. Mia Farah, of the Lebanese Association for Self-Advocacy, gave me such encouragement from her passion, skills, and independence as a woman with Down Syndrome. Ms. Farah organized one of the most enjoyable and successful side events I attended, despite the challenges that her intellectual disability can bring. Her story of her successes resonated with me because I have always feared my limitations. Mia Farah showed me that limitations that others place on you because of your disability don’t have to define you.

I not only found inspiration during my time at the UN but a wealth of new knowledge as well. Every individual gave new insight on disability rights that I had never considered before. Natalie Draisin spoke on road safety for women and girls with disabilities, and how unsafe roads and transportation can be fatal—an important issue that many ignore when discussing disability rights. I was touched by the story of Flavia Cintra, a Brazilian journalist, whose doctor told her to abort because he believed that tetraplegics should never have children. Ms. Cintra shared how Brazilian mothers with disabilities often lose custody of their children and have their reproductive rights stolen from them through deceptive paperwork. Some wedding officiators even refuse to marry people paralyzed below the waist because they are believed to be unable to bear children. I never knew any of these issues before speaking with Ms. Cintra. As a reproductive rights activist, Ms. Cintra’s story made me understand the importance of including people with disabilities in our activism. All of the stories and experiences that were shared with me hit deeply and gave me such insight into international policies on disability rights.

Audience view during the side event by IHR and IDPPS teams’ “Making Disability Rights Real: Implementing the CRPD through Regional Cooperation with Lessons Learned from ASEAN.”

The global environment for people with disabilities is harsh, whether one is in Brooklyn, Bogota, or Bangkok. All over the world, people with disabilities deal with compound discrimination, lack of adequate healthcare, limited access to resources, sexual abuse and assault, and the negation of their independence. Having this opportunity to partake in the implementation of policies on disability rights was genuinely life changing. Viewing the inner workings of the United Nations made me realize that I wanted to make a career in the international nonprofit organizations that work with the UN to effect change. It was incredible to see people from so many different places, all speaking in different languages. I could be listening to a speaker in Chinese, and put on a headset to have it translated live into French, Russian, English, and several more. Watching the sign language interpreters onstage during meetings was so thrilling— not only was it beautiful to watch, it also was critical in making the events accessible to the deaf and hard of hearing. These events made me realize how necessary sign language is to have a successful career in advocacy, because the inclusion of nonverbal people is vital. I will always look back on this trip to the United Nations as the moment when I found my calling. As I have always tried to ignore my disability, I had never realized until now how central disability rights are to my life. Being around such fearless role models brought to life a passion to fight for the rights of women and girls with disabilities around the world.

America: No Country For New Moms

This repost is in honor of this Sunday: Mother’s Day. Happy Mother’s Day in advance to all every MOM!!

The jarring sound of their discontented newborn’s piercing screams haunt many new mothers’ dreams—that is, if they can find the peace and quiet to fall asleep in the first place. It is an indisputable fact that having a new baby is incredibly difficult, exhausting, and wildly expensive. The costs continually rack up: costly medical care (for mom and baby), cribs, strollers, clothes, pacifiers, toys, mountains of diapers, hygiene products, etc. The list is nearly inexhaustible, and that’s just the bare minimum. Let’s take a look at the average cost of having a young child for the average family.

For families whose income level is at or under the median American income, the average monthly cost of a child under two is about $800. The average income of this group is $24,400 – this means that after expenditures on children, the average low-income family only has about $1,200 left to spend on their own food, healthcare, transportation, and emergency costs per month. The numbers only get more dire from here. For the 60% of single-mother families in poverty, the average monthly income ($1,387) minus costs of one child allows for about $600 a month for all the costs of daily living (Poverty Threshold 2016). This is the bare minimum with no money budgeted for entertainment, self-care, or emergency bills.

Maternity leave appears to be an additional luxury for families with non-working individuals and those who can afford designer diaper bags and color-coordinated nurseries. Often outsiders may conclude businesses or governments should not pay maternity leave; however, for many, every penny is absolutely crucial to maintain the very basic needs of their family. For these families, maternity leave is not a luxury, but a necessity. All those shocking numbers miss a crucial point. These statistics, as appalling as they are, are for the lucky minority of mothers who can secure an income during pregnancy and the period following childbirth.

In America, 88% of mothers are unable to receive pay for maternity leave. Federal law requires that companies larger than 50 employees must provide 12 weeks of maternity leave, but that leave is unpaid. For single mothers in poverty, it is estimated $4,161 in paychecks stop; significant money they could use for diapers, food, medicine, and bills. Over a third of mothers end up taking no formal time off from work, leaving their babies in costly childcare programs and often still suffering from the emotional and physical strain from childbirth when returning. Imagine growing an entire human being inside your womb for nine months, going through the arduous process of childbirth, and then having to return to your exhausting job as a fast food service worker two days later. That situation may seem like an exaggeration, but many mothers have these circumstances. This is a disservice to their humanity.

Baby Toes. Source: Jake Guild, Creative Commons.

It is seemingly simple to ignore the suffering of such a vulnerable part of our population. Legislators seek to refuse abortions to women; however, they, at the very least, owe them the means to provide a safe, healthy, and nurturing environment to raise their baby. America is one of only three countries in the world deny paid maternity leave along with Oman and Papua New Guinea. Some may praise this policy (or lack thereof) for allowing the private sector to be more flexible or for conserving federal tax dollars. After all, why would anyone pay their employees when they are not even working? The truth of the matter is that paid maternity leave has an overwhelmingly positive impact on mothers, their children, and the company itself.

To consider some international policies, Finnish mothers can receive 17.5 weeks of maternity leave with up to 78% of their pay, along with essentials like bedding, clothing, and hygiene supplies. Stunningly, Bulgarian mothers have the option of nearly five years (58.6 weeks) of maternity leave with 90% of their salary. An in-depth study conducted by the University of North Carolina on European maternity leave policies found that paid maternity leave is indeed a cost-effective way for mothers to improve the health and success of their children. Paid-leave programs reduce infant mortality and increase pediatric health due to the ability of mothers to invest more time into their children. A Norwegian study conducted over seventeen years concluded that children whose mothers received paid maternity leave had higher IQs and higher college attendance rates than children of mothers who did not. This conclusively tells us that paid maternity leave is cost-effective, improves the health of children, reduces deaths, and ensures higher rates of success.

What does this lack of protection for new moms say about American culture? Do we not value our women or children? The United States has lagged behind in policies to promote women and children for decades. The policy that mandated twelve weeks of unpaid maternity leave was instituted in 1993. Prior to that, pregnant women and new mothers had no choice but to either lose their jobs or work in dangerous conditions for their health. Additionally, the U.S. has still not signed the Convention on the Rights of the Child (1989) or the Convention to Eliminate All Forms of Discrimination Against Women (CEDAW 1979), though both have been signed by almost all other nations. Even when the legislation and infrastructure is there to offer some assistance to pregnant women, mothers, and children, American society seems resistant to those policies.

New mothers under the Special Supplemental Nutrition Program for Women, Infants, and Children (known as WIC) often face stigma when buying their grocery items. The WIC program has strict limits on the amount and type of products that you can buy, so it’s easy to make mistakes and then hold up the checkout line accidentally. Mothers I personally know who participate in the WIC program have relayed their experiences of other customers scoffing, making rude remarks, and even confronting them while checking out. Participating in any welfare program tends to generate harsh criticism, making welfare users feel ashamed and stigmatized. The Supplemental Nutrition Assistance Program (SNAP) in particular has been characterized as being abused by people who only buy junk food and refuse to work. This is not the case: more than half of SNAP participants are children; data does not back up the rumors that SNAP benefits are disproportionately used to buy junk food; and the program has not been shown to discourage work (Dewey).

As far as benefit programs tailored specifically for new parents go, state policies across the U.S. have not been much better than it is at the national level. Only three states (California, Rhode Island, and New Jersey) currently have paid leave programs, though a fourth, New York, is soon to join in January 2018. Other states have classified pregnancy as a temporary disability, which allows new mothers to receive benefits from disability programs. Though beneficial and certainly needed, this practice is problematic as it reduces funding available for persons with disabilities instead of developing additional funding for new families. Alabama has no law that mandates paid leave or allows any form of additional benefits.

The University of Alabama at Birmingham has a recently instituted program that allows for up to four weeks of paid parental leave, but most other large employers in the state, including the University of Alabama, do not offer any paid leave.

A woman sits on a playground next to her young daughter. — Mom and Daughter. Source: Donnie Ray Jones, Creative Commons.

Why you should care? Basic empathy aside, international declarations and laws set several standards that impact how countries should treat pregnant women and new families. Article 25 of the UDHR states that “motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.” Additionally, according to Article 23, “everyone, without any discrimination, has the right to equal pay for equal work.” American policy violates these globally accepted norms, as it has systematically denied proper care and assistance to mothers and children, as well as furthered the gender pay gap by obstructing mothers from earning income, hindering advancement in their career, and causing many to lose their jobs from sheer inability to work in the little time provided to recover. Though the United States has not ratified CEDAW which would make paid maternity leave a legal right, our nation still has the obligation to improve gender equality and promote the well-being of women and children.