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.
How?
Well, first, you have to have a doctor. A doctor who knows you, and who is looking out for your health as well as your fetus’ health. As we will show in episodes 2 and 3 of this podcast, the U.S. medical system is more focused on the fetus than on the mother - leading to rising maternal mortality rates. Most of those occur after birth - when medical systems seem to shut down.
“You have a healthy baby. Goodbye.”
Women in urban areas - whether they are in poverty or not - have to solve the issue of transportation in order to even see a doctor. Some people live in what Chicago Foundation for Women executive director Felicia Davis Blakley calls “medical deserts,” where the closest OB is three busses away; where people have to take off a day of work, and find childcare, in order to get a monthly checkup.
As Make It Work Nevada executive director Erika Washington points out in episode 1, there is a corner in North Las Vegas that has five fast food restaurants - and a dialysis clinic. She noted they also have a grocery store, but it doesn’t sell healthy food. It sells, as Erika said, “a variety of covered and smothered meats.”
Sounds yummy.
Then there’s the challenge of finding a doctor who will listen to you, and not - as Brenda Zamora shares in episode 4 - yell at you. Or as midwife Jollina Simpson talks about in episode 2, talks down to you. Or just gets medical stuff wrong because they didn’t study your body type in med school.
Here’s a hint: Black skin doesn’t “pink up.” And if you’re a doctor looking for your patient to be “pale,” you’re going to miss “ashy” on your Black patients.
In 1994, a group of Black women had a sidebar meeting at a conference in Chicago. The conference was sponsored by the Ms. Foundation for Women and the Illinois Pro-Choice Alliance. A representative from the Clinton Administration came to talk to the 250 or so attendees about their proposed healthcare plan. Remember that? The one Hillary Clinton was putting together, which outraged members of Congress?
Anyway, there were 12 Black women at this conference, and they were struck by the fact that the Clinton health plan didn’t have anything about reproductive health. So they met, and they created a framework, which they called Reproductive Justice, which not only exists, but is growing as a movement today.
The four principles of Reproductive Justice are:
- The right to have a child
- The right to not have a child (which includes sterilization, which many doctors won’t do)
- The right to have a child in a healthy environment and then raise them safely
- The right to bodily autonomy and sexuality
These principles are repeated throughout this podcast, as well as homages to the 12 founders who “gave birth” to the Reproductive Justice movement.
Let’s look at what these principles mean. The right to have a child encompasses the ability to get pregnant and survive. It also means having a job that pays a living wage so you can take care of the child or children. It means living in a safe space - without mold, without fear of violence - so you can raise your child safely. It means, as many of our interviewees noted, having healthcare professionals examine their internalized biases.
Loretta Ross is one of the founders of the Reproductive Justice movement. Her body of work was recently recognized by the MacArthur Foundation with a “genius” grant. She noted in episode 1 how abortions could be avoided if we as a society cared more about women as whole people rather than as vessels for giving birth.
“If a woman is suffering from economic insecurity or poor housing or lack of health care or violence in her life, that’s going to affect her reproductive decision making. If she has bad answers to those human rights issues 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, health care, the ability to stay in school - then she might turn an unplanned pregnancy into a wanted child. So isolating abortion from the pre-existing conditions in women’s lives did not make sense to us.”
So in a post-Dobbs America, we are exploring what Reproductive Justice means. This means looking at the beginnings of the movement (Episode 1), the injustices people need to overcome (Episode 2) the history and current status of pregnancy criminalization and forced sterilization (Episode 3) women’s experiences with giving birth (Episode 4), the role of midwives and doulas (Episode 5) and the state legislation that affects women’s pregnancy decision making int he U.S. (Episode 6). We’ll end the series with a roundtable of some of the participants.
I would say “enjoy” - and this podcast is definitely enjoyable. But there are some hard things in here, too. People die in childbirth. Hopefully, this series will give people enough knowledge to make that number a rarity.
Each American Dreams: Reproductive Justice episode will drop every Saturday for six weeks starting January 7.
