The Policies and Politics of Reproductive Justice

Juana Rosa Cavero Reproductive Justice Coalition of Los Angeles

What is Reproductive Justice   …exists when all people have the social, political and

economic power and resources to make healthy decisions about our gender, bodies and sexuality for our selves, our families and our communities.

  Asian Communities for Reproductive Justice, EMERJ- Expanding the Movement for Empowerment and Reproductive Justice

What is Reproductive Justice   Reproductive Justice is based

on a human right’s framework and is defined as “the right to have children, not have children, and to parent the children we have in safe and healthy environments – is based on the human right to make personal decisions about one’s life, and the obligation of government and society to ensure that the conditions are suitable for implementing one’s decisions is important to women of color.

  SisterSong Women of Color Reproductive Justice Collective

Policies and Politics

  There exist factors that affect/influence my ability to make decisions about my reproductive health…

Reproductive Oppressions

  Toxic facilities like power plants and oil refineries are mostly located in poor communities of color, which expose women to reproductive toxins linked to infertility, miscarriage, infant mortality and breast cancer.

Reproductive Oppressions   The increase in criminalization of pregnant women who

use substance in the name of “fetal rights” disproportionately targets poor women of color, who are being incarcerated at extremely high rates rather than receiving treatment.

Reproductive Oppressions   Forced sterilizations of

poor women, women of color and women with disabilities, and coercing women to use dangerous, long-term, provider-controlled contraceptive such as Depo-Provera.

RH, RR, RJ   Reproductive Health – Reproductive Health – a service

delivery model centered around increasing access to reproductive health care

  Reproductive Rights – a legal & policy model centered around choice and privacy

  Reproductive Justice – an organizing and leadership development model centered around the understanding that reproductive oppression is a result of intersecting oppression based on race, class, immigration status, ability, etc. and is a way to control entire communities.

New Vision

Benefit of the RJ Framework

The best way to understand reproductive justice is to look at its core aspects, which helps us understand not only the way we think about the issues our communities face, but also the way we take action around them

History of RJ   Women of color delegation returned from the 1994

International Conference of Population and Development in Cairo, Egypt

  Reproductive rights + social justice   Human right provide more possibilities for our struggles

than the privacy concepts the pro-choice movement claims only using the U.S Constitution.

  It represent shift for women adv for control of their bodies – narrow focus on legal to broader analysis of racial, eco, cultural and structural constraints on our power.

Reproductive Justice Coalition of Los Angeles

  … manifestations of racism, classism, ageism and other oppressive societal assumptions that create reproductive health disparities among women.

  RJCLA works to ensure that women of color, women living in poverty and immigrant women are primarily engaged and mobilized in setting and addressing a reproductive justice agenda for Los Angeles.

Policies and Politics and RJ   Legislation   Regulations   Norms

  cultural, community

  Morals   Religious Directives

Policy set parameters to maintain order

Policies and Politics and RJ   Politics –

  Debate or conflict among individuals having or hoping to achieve power

  POWER – within our work   To deprive the other side of what it wants   To give the other side what it wants   To elect someone who supports your issues.

PLAN B – EC – Morning-After Pill POLICY   2005 -Plan B – has a patent for 7 years   2005 – FDA approves Plan B for 18 and older (without a

Rx) - 17 under must have Rx   2009 – generic is produced; Plan B is patented for 18+, so

generic is OTC for under 17 under; later that year, FDA allows 17 year old to get PlanB OTC

FYI: “Plan C” does not exist. Intended to spark discussion during presentation.

PLAN B – EC – Morning-After Pill POLITICS   2005 – Research finds that EC is not harmful to women

and young woman can and should have access   2005 – FDA restricts access   Susan F. Woods - assistant FDA commissioner for

women's health and director of the Office of Women's Health RESIGNS

PLAN B – EC – Morning-After Pill POLITICS ---

Reduce unwanted pregnancies and abortion

v.s.

Encourage teen promiscuity and encourages abortions as a form of birth control

Organizing   Moved legislation so that Plan could be accessible in

pharmacies with pharmacists Rx no matter age   Created educational campaign for young women and men

to know about Plan B   Focused on the mechanics of EC and not the discussion

of conception vs. fertilization

Religious Hospitals   1 in 6 patients in the United States is cared for in a

Catholic hospital.   8 of the 25 largest health systems in the country are

religiously-owned.   Religiously-affiliated hospitals use religious doctrines as

means to restrict the services they offer to patients, especially reproductive services.

  Religiously affiliated hospitals bill the United States government more than $40 billion a year.

Religious Hospitals

  The largest single group of nonprofit hospitals are Catholic institutions- controlling 622 hospitals nationwide.   5 of the 10 largest healthcare systems, which operate hospitals

and medical centers in the United States, are Catholic.

Religious Hospitals   Ethical and Religious Directives for Catholic

Healthcare Services (Directives),   The Directives prohibit almost all reproductive

health services.   Contraceptives that do not promote “natural family planning”

are prohibited. Most treatments for infertility, sterilizations for men and women, and abortion, even in cases of rape, incest, or to save a pregnant woman's life, are banned.

Religious Hospitals   Special government exemptions known as “refusal clauses”

  Permit hospitals to use religious doctrines as patient care guides,   Remain eligible to receive public funding.   1973 Congress passed the Church Amendment, allowing

healthcare providers to refuse to provide abortions or sterilizations on religious grounds.

  The Balanced Budget Act of 1997 includes a refusal clause that created uniform standards for Medicare managed care. Insurance plans and institutions were allowed to opt out of providing, reimbursing, or referring Medicaid patients services that contradicted the organization’s religious or moral beliefs.

  Almost every state has some sort of refusal clause allowing individual health providers to refuse to provide abortion services.

Real Cases   Cases brought to court

Case I   19 weeks pregnant, temperature of 106, bleeding

excessively.   Had a life-threatening condition that prevents a person’s

blood from clotting normally.   FACT: no chance the fetus could survive,   Ethics committee told the doctor that he could not

perform the abortion until the fetus’s heartbeat stopped.   The patient was in the Intensive Care Unit for ten days.

Case II   15 weeks pregnant with twins, miscarried a fetus at home;

umbilical cord and placenta from the passed fetus remained in her uterus

  ER physician perinatologist determined that nothing could be done to can't pregnancy.

Case II, con’t   She agreed to medical abortion (medication and go

home) or to miscarriage the second fetus.   Hospital refused to start treatment because the remaining

fetus still had a heartbeat   She was delayed by approximately 3 ½ hrs transferred by

ambulance to a hospital 80 miles away.

Case III   11-weeks gravely-ill woman, she had right heart failure;

Dr’s told her if she continued with the pregnancy, she had almost a 100% chance of dying.

  Sister Margaret McBride determined that this was a valid exemption to Directive where in some circumstances, procedures that could kill the fetus to save the mother are acceptable.

Case III   Catholic Bishop Thomas J. Olmsted Declared that

McBride was automatically excommunicated for her decision to allow an abortion in a Catholic hospital.

What can we do: Merger Watch   Providing expert analysis of the potential impact of a

religious/secular hospital merger on community access to reproductive health services and on patients’ ability to have their end-of-life wishes honored.

  Helping form community coalitions to speak on behalf of patients’ concerns and educate the public.

  Pressing hospital officials for changes in the terms of the proposed merger, so that patients’ rights and access to care will be protected.

  Intervening in state hospital oversight proceedings to urge changes in merger plans.

  Merger Watch

Lets talk RJ

What are some issues in your community? - - - -

Resources   THREE applications of the Reproductive Justice Lens.

  EMERJ* Training Curriculum 2009 ACRJ and ACCESS/Women’s Health Rights Coalition

  Asian Communities for Reproductive Justice, www.reproductivejustice.org/

  ACCESS/Women’s Health Rights Coalition, www.whrc-access.org

  SisterSong: Women of Color Collaborative, www.sistersong.net

  MergerWatch -- http://www.mergerwatch.org/   GroundsWell Foundation --

http://groundswellfund.org/resources/what-is-reproductive-justice

  Undivided Rights: Women of Color Organizing for Reproductive Justice by Jael Silliman, Marlene Gerber Fried, Loretta Ross, and Elena Gutierrez