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As 2023 dawns, women in the U.S. look back on the last year and see one glaring issue: 2022 was the year their right to have an abortion was severely curtailed.
But many women did not have access to abortions even before the Dobbs decision. Women on Medicaid, in the same states that are outlawing abortion now. Women who live in rural areas. Women who don’t have access to good doctors, and good advice.
One thing the popular press doesn’t seem to talk about is how many women and trans men (anyone with a uterus) want to have children, but find that the systems as they are set up in this country mitigate against them.
You read that right: women want to have children, but don’t because it is so hard to do so.
Erika Washington (00:00):
Tell me about that. Uh, night of Conception ,
Erika (00:27):
No, we're not talking about that kind of conception. Well, we kind of are. We're talking about the birth of a movement. The birth of a vision that changed the way we looked at healthcare, birthing and women's autonomy. We're talking about reproductive justice.
OPENING MONTAGE
Toni Bond (00:50):
Black women in black pregnant-capable people's bodies have historically and continued to be under surveillance and monitored and controlled.
Loretta Ross (01:00):
I wrote a report called Women's Watch that predicted that there would be overlap between the white supremacist movement and the anti-abortion movement
Felicia Davis Blakely (01:09):
Demanding an anti-racist healthcare system.
Shonda Summers Armstrong (01:12):
What we are looking at is reducing the need for C-sections, which reduces the cost to the citizens of this state.
Ashlee Hernanz (01:26):
When I woke up, I woke up to like the worst pain ever. I wanna say I was like seven centimeters
Paul Koopman (01:31):
At that point. I was, I was afraid of having to go back home with… as, as a single father.
Felicia (01:37):
I trust women and I think that women have an inalienable right to liberty and to decide what happens to their own bodies.
END MONTAGE
Erika (01:46):
This is American Dreams, reproductive Justice, and I'm your host Erika Washington. In June of 1994, 12 women gathered in a Chicago hotel room to talk about how they have been left out of conversations on healthcare. Many of those women had never met before. They were delegates at a meeting the Clinton administration had called with about 150 reproductive healthcare workers, but they were the only black women at the conference, and they were astonished at what they heard. We'll let two of them tell the story.
Loretta Ross (02:21):
My name is Loretta J. Ross, and I'm an associate professor at Smith College in Northampton, Massachusetts. I'm what I call a professional feminist because I've been doing women's rights activism since the 1970s and five years ago, I retired from running a nonprofit called Sister Song, women of Color Reproductive Justice Collective, and began my academic career.
Toni Bond (02:49):
And my name is Dr. Toni Bond. I am one of the mothers, one of the 12 black women who created reproductive justice movement. And I am also a religious scholar. My work is at the intersection of religion and reproductive justice. I'm what's known as a womanist ethicist, and I'm also the board chair and one of the founding members of a national organization called Interfaith Voices for Reproductive Justice.
Erika (03:23):
Were you in that room as well?
Loretta (03:24):
Yes, I was. I was one of the 12 women there.
Toni (03:29):
Interestingly enough, we did not plan to come together. A number of us, we did not know each other. And we happened to be at this conference in '94… in June of '94 in Chicago, a conference that was sponsored by the Ms. Foundation for Women and the Illinois Pro-Choice Alliance. And it was a conference about universal healthcare reform. A representative from the then Clinton administration came to present the Clinton administration's plan for universal healthcare reform. The plan did not include anything, any coverage for reproductive or sexual healthcare. And so we left that plenary and it was, uh, “Able” Mabel Thomas, who is in Georgia, who called us together, who brought us together and, and said, you know, we need to talk about what's wrong with this picture. Why would the Clinton administration develop a plan for universal healthcare and not include reproductive and sexual healthcare? It's like women didn't exist.
Loretta (04:41):
Somehow the architects of the healthcare plan thought if they omitted reproductive healthcare from the proposed healthcare plan, they could lessen Republican opposition to it. Now, not only was that a suspect strategy, cuz the Republicans are implacably opposed to healthcare reform. Mm-hmm.
, I don't, they don't care what's in it. But for us as black feminists at that conference, the proposal simply didn't make sense because reproductive healthcare is the number one driver of all women to the doctor. After you have your period, your second on becoming a woman moment is your feet up in those stirrups. And so we wondered why the Clinton administration thought they could recruit feminists to support such a male-centric healthcare plan.
Toni (05:38):
We gathered, I want to say, I think it was in Cynthia Newbille’s hotel room, we gathered in her hotel room and began to talk about not just what was missing from this plan, but talked about the lived experiences, our own lived experiences around issues of reproductive and sexual healthcare, accessing it, and talked about the Black women who we came in contact with every day and the stories that we heard, and the many times that we had to connect black women and girls to vital services like abortion care, but more importantly, well woman care, access to a gynecological exams. And, and we talked about the high rates of fibroids, for example, for Black women. And we talked about the high rates of fatal fatality from breast cancer for Black women
Erika (06:49):
In the 1970s when most of the women in the room were starting their careers. U.S. breast cancer rates jumped by a stunning 62% and another 36% in the 1980s. And healthcare milestones for women might start usually around the age of 21 with a feet up in the stirrups moment, but there are other markers women should be aware of. The CDC recommends that women should start getting mammograms at the age of 45. They should get pap smears every three years and more frequently if they have HPV or an abnormal result. Today, women can prevent most, but not all cervical cancers with a vaccine when they're preteens. But the Clinton administration didn't want to include women's health in their proposal?
Loretta (07:34):
Well, I think I need to give a little background. [Okay.] Because black women's sexuality and our child rearing and even producing children has always been a deeply politicized project within this white supremacist system. I mean, before the end of slavery, having children enriched the slave masters. After the end of the Civil War, then all of our fertility and our children became problematic. And so we've always been subjected to strategies of population control, or eugenics, or thinking that our children and our fertility are the source of many of America's problems.
Toni (08:21):
We remembered that history of not being able to control our own reproduction and suffering the physical and sexual abuses of slave owners.
Loretta (08:37):
What we did was in response to a public policy initiative. We first analyzed that we overlapped with the pro-choice movement in fighting for the right to use abortion, contraception and abstinence if people believe in that. But we also separate from the pro-choice movement. We have to fight equally as hard to have the children that we want to have because Black women, along with Indigenous and Mexican-American women, have been historically subjected to sterilization abuses.
Toni (09:12):
Loretta, through her international work, brought in more of the human rights framework. And I think all of us contributed some pieces of black feminist thought, black feminist theory,
Loretta (09:28):
And so the right to have children and to have them under the conditions which we preferred - which included using doulas or midwives or having your birth plan respected or even having your, uh, your needs attended to. Like unfortunately, Serena Williams had to deal with after she had a baby, when the doctors didn't believe that she had a, a pulmonary embolism going on due to medical racism.
Toni (09:56):The four principles are the right to have a child; the right not to have a child; the right to parent the children one has with the social and economic supports they need - so that not just the child, but the whole family thrives; and the right to bodily autonomy and sexual pleasure.
Loretta (10:13):
And so that became the foundation of reproductive justice. Now, the term reproductive justice was created when we spliced together the concept of reproductive rights with the concept of social justice. And we spliced, we did that splice because we couldn't understand why abortion was always isolated from the other social justice issues that are implicated in anybody's abortion decision. I mean, if a woman is suffering from economic insecurity or poor housing or lack of healthcare or violence in her life, that's gonna affect her reproductive decision making. If she has bad answers to those human rights issues that are preexisting in her life when she's facing an unplanned pregnancy, she's likely to terminate that pregnancy. If she can. If she has good answers to those issues like housing, healthcare, um, the ability to stay in school, et cetera, then she may even turn an unplanned pregnancy into a wanted child. And so isolating abortion from the preexisting conditions in women's lives did not make sense to us. And that's why we thought the social justice framework was so necessary to be married into the reproductive rights framework.
Erika (11:45):
Interesting what Loretta said about people not having abortions if they have healthcare and a safe place to live and all those other things. But we talked to a woman who runs the Chicago Foundation for Women. Her name is
Felicia (11:56):
Felicia Davis Blakely.
Erika (11:57):
She says the same thing Loretta says, but kind of from a different direction.
Felicia (12:01):
We know that freedom from gender-based violence, domestic violence is associated with decrease economic mobility for women. We also know that access to, um, abortion, abortion care, and holistic reproductive services and holistic healthcare honestly impact a woman's economic mobility as well. And these things kind of are interwoven… like they actually cascade and can impact each other because the decision of when to have a family, how many children to bear has a direct impact on the economic security of a woman and that family. No conversation about abortion is complete without really talking about reproductive justice and what that means in order for a person who may become pregnant or wants to become pregnant or a pregnant person to bear a healthy child. There is a whole environment around that person that needs to be thriving. First and foremost, there needs to be housing support. You can't have a healthy child without having safe, stable housing to support you in that.
There has to be some type of economic security. You can't be able to deliver a healthy child or access the services that you'll need without that. There has to be healthcare access. And this is where there are a lot of problems even in Chicago where we have a city that's a sanctuary city, a state that is, um, protecting a woman's right to choose, but having choices of where you go to have care for the baby and for yourself. There are healthcare deserts in Chicago, which means then low income women have less access to the services that will actually enable them to have a healthy pregnancy and to deliver a healthy baby.
Erika (13:55):
So Loretta is saying not having economic security or social safety keeps people from having children. But Felicia is saying having children keeps people in poverty. Either way, we have been working on these disparities for over half a century, and we're no closer to closing the gap than we were in the 1960s.
Lyndon Johnson (14:25):
Men and women of all races are born with the same range of abilities, but ability is not just the product of birth. Ability is stretched or stunted by the family that you live with and the neighborhoods you live in by the school you go to and the poverty or the richness of your surroundings. It is the product of a hundred unseen forces playing upon the little infant, the child. And finally, the man.
Erika (15:07):
President Lyndon Johnson gave the commencement speech at Howard University in June, 1965, just two months before he would sign the Voting Rights Act. In the speech he talked about what he envisioned racial equality would look like, including reparations, but also including what sounds a lot like reproductive justice.
LBJ (15:27):
It is not enough just to open the gates of opportunity. All our citizens must have the ability to walk through those gates. And this is the next and the more profound stage of the battle for civil rights. We seek not just freedom, but opportunity. We seek not just legal equity, but human ability. Not just equality as a right and a theory, but equality as a fact and equality as a result.
Erika (16:14):
Johnson was also famous for his war on poverty, which we definitely know the U.S. has not won, especially when it comes to women's and pregnant capable peoples choices to have a child. We talked to Mary Leung, who is a nurse midwife in Chicago. Her clinic is in the heart of a low income neighborhood. We'll talk to her more in future episodes, but she echoes the connection of poverty and pregnancy outcomes.
Mary Leung (16:38):
You know, there's been studies done in England that associate specifically your income level with your risk factor in a healthcare sense. But if you think about it in the context of this country, right? In this country, unfortunately, there are things that make your general health a little bit riskier. It doesn't mean that you will be unhealthier, but it means that the potential is there, right? So we have patients who tend to live closer to or at the poverty line, right? And when, when you have a lack of resources, and many of our patients also live in food deserts, right? So they can't just go to the local supermarket and get their pick of fresh vegetables. So that, I mean, you know, if you think about some of the basic things about health that you hear from your doctors, from the internet for it's like, “eat healthy” and what does that mean? Eating healthy is fresh fruits and vegetables. And a lot of times that isn't necessarily even available to everybody depending on where they live. So that's a risk factor.
Erika (17:45):
They're not just studies from England, the Urban Institute, but I report in 2015 that correlates income to health. People who make less than $35,000 a year are 17% more likely to report poor health than people who make a hundred grand or more. They're twice as likely to have heart disease or diabetes. Numerous studies show the same results. And you could see that in Las Vegas specifically. If you go to the historic west side, right next to four fast food restaurants, there's a dialysis location. Literally you can hit it all right there together, . And across the street there is a, grocery store, but they do not offer a plethora of fresh vegetables. But you can get fried fish and other covered and smothered meats and macaroni and cheese and things like that. You can get all of that in that corner and you can go to dialysis.
Mary (18:43):
This whole concept, that concept of reproductive justice, it's a term that was coined by Black women who were looking at this sort of conversation about choice, no choice. And they said, we don't have these choices available to us. And that came to be more inclusive to people who had less choice because of their socioeconomic status, because of their race, because of their identity as not being a woman. You have your child, right? Even if you want to have a child, this child that is very desired, then you have to go and live in your neighborhood, which may or may not be safe. Not just from, you know, somebody breaking in and somebody hurting you on the street, but you have to feel safe from police violence. You have to feel the safety of having financial security. You have to feel the safety of not feeling like you're gonna get kicked out of where you're living. You have to have the safety of knowing that you're gonna have food on the table for your child, right? So reproductive justice isn't just about having a baby or not having a baby or having an abortion, or not having an abortion. It's about having a child and feeling like you can provide a safe living, a safe life for that child and not have to worry about burying your child or traumatizing your child because of the circumstances they live in.
Erika (20:14):
Mary works at the first free-standing birth center in the Chicago area. It's on the west side. Another birth center is being built on the south side. This is being met with high anticipation in the Chicago birthing community. But even with two birth centers, that doesn't mean that everyone who needs a doctor or midwife can get one.
Chi Chi Okwu (20:32):
When we're thinking about access, we have to look at it from a holistic perspective and not just stop with whether or not someone actually has the, the right to make a choice about whether or not they want to get pregnant. But if they do, then what happens? Because if someone decides, okay, I wanna have a baby, but then they don't have the system and the resources to actually experience a safe and healthy birth, have we done our job?
My name is Chichi Okwu and my full name is Chinyere. I am the executive director for EverThrive Illinois. We are a reproductive justice organization. We are working to achieve reproductive justice through community driven partnership, capacity building, and policy action throughout the state.
Chi Chi (21:25):
Most people when they hear anything about reproductive, like they hear that word, they immediately think about abortion, pro-choice, pro-life, which is really more about a lack of education. The conversation we've had about, you know, women's rights, women's health, reproductive health, reproductive rights has been very narrow. And I think one of the reasons, you know, we have just been so drawn to this framework, this reproductive justice framework, is that it brings in the intersectional nature of this topic. The group of women that founded this movement are saying, “okay, you can have all the clinics, you can have all the legal rights, but that doesn't mean that everybody has access to these resources because there are so many other factors.” So like let's say you live in a city and there's like, you know, one clinic that you can go to depending on what part of the city you live in, depending on your access to transportation, where you live. You might be in a shelter and not in a permanent home. You may not have paid sick leave to even take time off to go and access these resources. And also thinking about like the relationship between your doctor that might be different because of the color of your skin. So all of those things, economic security, all of those things play a factor into what is actually available to people.
Erika (22:52):
One of the heartening things about the reproductive justice movement is that everyone who's a part of it idolizes the founders. There wasn't a conversation we had with journalists, practitioners or advocates that didn't mention the 12 founders. I asked Loretta Ross if she was surprised by this.
Erika
I wanna go back a little bit to when you all were discussing this framework and, and adding the social justice piece. What did you think the reaction was going to be? What did you want people to, to think and say, once you all put this out there and said, now this is what it actually needs to look like, this is what healthcare reform needs to include. Did you have an expectation?
Loretta (23:32):
No, we didn't have an expectation. I think our, we had low expectations. We actually thought that this was just something that we would use one time to challenge healthcare reform and then be done with it. So we had very low expectations of it. Plus we did not understand how exhausted mainstream discourse was with the pro-choice, pro-life binary. And so much to our surprise, it not only succeeded in bringing together women of color who wanted a different way to express what they needed from reproductive politics, but the entire left wing of the pro-choice movement glommed on to reproductive justice and started using it as this framing and creating quite a few tensions within the mainstream white movement that wanted to, that, that believed that using reproductive justice was a way to avoid using the term pro-choice or talking about abortion as a whole. And it was not that.
Loretta (24:43):
I've also been a little bit surprised by how many white women assume that reproductive justice doesn't include them, for example. Mm-hmm. . I think it's that fear that our feeling that because it was created by Black women, it only should apply to Black women as if Black women can't create universal theory. I mean, think about intersectionality for example, right? And that that perception is also held by a number of Black women who think that, uh, white women are trying to co-opt it distort it, those kinds of things. I push back on both of those perceptions. ‘Cause reproductive justice is a criteria based framework as opposed to an identity based framework. It doesn't matter what your identity is. Do you believe in the tenets, the criteria, the values of a reproductive justice analysis? That should be the decider for us. And the last thing I'll say that surprised me cuz I hadn't looked that far down the road, was that a lot of people imagined that we created reproductive justice as a way to push back on the whiteness of the pro-choice movement.
Loretta (26:01):
And that's also not true. Um, if we had wanted to critique and push back on the pro cho pro-choice movement, we would've had to center white women in our lens. And instead we centered ourselves as Black women. But I do understand why, um, mostly it's white women that say that it was created to counter the conservatism of the pro-choice movement because that's their standpoint and that's how they most use it. But it was not done as a way to offer a critique of white women. I mean, they were nowhere in, in our discussions and stuff. And so it's kind of interesting how it's played out over the years.
Erika (26:45):
Do you think that is because it, um, some white women don't feel that they were a part of it, that they weren't centered, that that's why they, um, assume that it's not for them because they're not in the center?
Loretta (26:59):
No, I don't think, well, that might be part of it. Um, I think they had a deeper, more existential fear that the framework would be used to avoid, uh, the nastiness and of the abortion debate - that people would use it to avoid dealing with abortion. And in some ways, that has become true, mostly transnationally rather than here in the United States because people in other countries have used the reproductive justice framework as a way to create political space when using pro-choice or abortion rights didn't create that space. But in all cases, no one is using reproductive justice as a way to avoid talking about abortion. It's a way to strategically embed abortion within an overall human rights framework.
Chi Chi (27:59):
Roe v Wade was always the floor. It wasn't meant to be the ceiling. And so taking that conversation, it goes beyond just like, do you have the right to choose and whether or not to have an abortion, but if you do choose to, you know, carry a child, then do you have the right to have a safe and healthy birth? And we know that in the United States, black and brown childbearing people are anywhere from four to six times more likely to die from from childbirth or childbirth complications than their white counterparts. So we know that's not true in our country. And then reproductive justice pushes it even further to say, once you have the baby, we're not done yet. We want to ensure that you have the right to raise your child in a safe and healthy environment. Meaning that, that you have access to high quality healthcare, you have access to healthy food, you have access to a safe home.
You don't have to worry about gun violence if you walk outside your door, or police violence. You know, all of those things matter. So we're looking at it from this really holistic perspective and we can't just stop at is it pro-choice or not? But we have to also look at what are the systems that surround families, parents, children, that allow them to thrive at every stage. The right to to choose is just the floor. We have to look at this all the way to how do we have safe and healthy, thriving families and which lead to then safe and healthy communities as well.
Erika (29:31):
So ROE has been replaced by Dobbs, which has made it almost impossible for women in some states to get an abortion. I asked Loretta Ross what she thought about the decision coming down so quickly.
Erika to Loretta
Even when it, the, the decision, the pre-decision when it was leaked that this was the way it was going to go… There were so many people who were just completely shocked. Were you shocked or did you see it coming?
Loretta (29:56):
Um, I saw it coming and I was surprised. I don't know if shock is the word, because ever since the Reagan years, feminists have been warning that the Republicans were gonna try to overthrow Roe v Wade. I mean, Ronald Reagan promised to insert a human life amendment into the U.S. Constitution. And although he wasn't able to deliver on that, he was very aggressive in his attacks on abortion. And every Republican president since then has been that way. So that's why I wasn't surprised because that's what the Republicans do because of who they are. And the packing of the Supreme Court indicated that that was one of the things that they wanted to do.
Erika (30:41):
Of course, we all know that Dobbs was the end, not the beginning of the attack on abortion. As Dr. Toni Bond points out, the Hyde Amendment passed just a few years after Roe.
Toni (30:51):
The Hyde Amendment precludes the use of government funds, Medicaid, insurance of federal employees, any kind of government funding to be used for abortion only in cases of certain exceptions. Now, you do have some states who have become what we call Medicaid states and decided that they were going to use their own funds, Medicaid funds to cover abortion care. So for instance, California is a Medicaid state, Illinois is a Medicaid state. You can get abortions there. And so you're absolutely right for Black and Indigenous communities of color, the Dobbs decision certainly has a great engraved impact on our lives. But Roe was already out of reach for BIPOC communities because of the Hyde Amendment.
Erika (32:01):
Now that we are at Dobbs, maybe we can talk about reproductive justice in a fuller way. This is what Felicia Davis Blakely of the Chicago Foundation for Women said.
Felicia (32:10):
If you no longer have access to one type of reproductive care, then it stands to reason we would have to actually expand the access for all the other types of reproductive care to be able to provide the additional supply of resources that are needed.
Erika (32:31):
How to expand. That is what we're exploring in this series. But first, we're going to look at the issue of reproductive injustice more closely. Let's end this segment with Dr. Toni Bond, setting the issues out for us.
Toni (32:44):
What I find is that people oftentimes conflate reproductive health and reproductive rights with reproductive justice. And then I also find that people lump them all together as if it's one movement. And in fact, it's three different movements. And we need all three.
Erika (33:09):
The voices you heard on today's program are reproductive justice founders, Dr. Toni Bond and Professor Loretta Ross. Chicago Foundation for Women Executive Director Felicia Davis Blakley. Midwife Mary Leung. And Chi Chi Okwu from EverThrive Illinois.
We also want to pay homage to the 12 women who were in the room int 1994:
• Dr. Toni M. Bond
• Rev. Alma Crawford
• The late Evelyn S. Field
• Terri James
• Bisola Marignay
• Cassandra McConnell
• Cynthia Newbille
• Loretta Ross
• Elizabeth Terry
• Rep. ‘Able’ Mable Thomas
• Winnette P. Willis
• Kim Youngblood
We also want to note that Loretta Ross is one of the 2022 recipients of the MacArthur Foundation “Genius” Award, for “Shaping a visionary paradigm linking social justice, human rights, and reproductive justice.”
American Dreams: Reproductive Justice is produced by Carrie Kaufman with Overthinking Media LLC, and Erika Washington, empowered by the donations to Make It Work Nevada. Music by Wil Black for Black Gypsy Music, with incidental music by the Swinggrowers. Artwork by Brent Holmes.
I’m your host, and Make It Work Nevada Executive Director, Erika Washington.