Workfare is a governmental plan under which welfare recipients
are required to accept public-service jobs or to participate in job
training.
Many countries around the world have adopted workfare (sometimes
implemented as "work-first" policies) to reduce poverty among
able-bodied adults, however their approaches to execution vary. The United States and United Kingdom are two such countries utilizing workfare, albeit with different backgrounds.
Background
Workfare was first introduced by civil rights leader James Charles Evers in 1968; however, it was popularized by Richard Nixon in a televised speech August 1969. An early model of workfare had been pioneered in 1961 by Joseph Mitchell in Newburgh, New York.
Traditional welfare benefits systems are usually awarded based on
certain conditions, such as searching for work, or based on meeting
criteria that would position the recipient as unavailable to seek
employment or be employed. Under workfare, recipients have to meet
certain participation requirements to continue to receive their welfare
benefits. These requirements are often a combination of activities that
are intended to improve the recipient's job prospects (such as training,
rehabilitation, and work experience)
and those designated as contributing to society (such as unpaid or
low-paid work). These programs, now common in Australia (known as
"mutual obligation"), Canada, and the United Kingdom, have generated considerable debate and controversy. In the Netherlands workfare is known as Work First, based on the Wisconsin Works program from the United States.
Role of the Welfare State
Workfare approaches to welfare are examples of Active Labor Market Policy (ALMP) that differ based on country, welfare state, and time period. Active labor market policies
are utilized to counteract capitalistic market failure that prevent
full employment in an economy. Four types of active labor market
policies are incentive reinforcement, employment assistance, maintaining
occupation, and human (social) capital investment. Workfare/work-first
approaches have been identified as more coercive forms of welfare to
work regimes.
The US and the UK are both examples of liberal welfare regimes that
prioritize the market's role in mitigating poverty, hence adopting
workfare.
There are two main types of workfare scheme: those that encourage
direct employment to get individuals off the welfare roll and directly
into the workforce, and those that are intended to increase human
capital by providing training and education to those currently in the
welfare system.
In less developed countries, similar schemes are designed to alleviate rural poverty among day-labourers by providing state-subsidised temporary work during those periods of the year when little agricultural work is available. For example, the National Rural Employment Guarantee Act (NREGA)
in India offers 100 days' paid employment per year for those eligible,
rather than unemployment benefits on the Western model. However, a
workfare model typically not only focuses on provision of social
protection through a wage-income transfer, but also supports workers to
get into work.
Goals
The
purported main goal of workfare is to generate a "net contribution" to
society from welfare recipients. Most commonly, it means getting
unemployed people into paid work, reducing or eliminating welfare
payments to them and creating an income that generates taxes. Workfare
participants may retain certain employee rights throughout the process,
however, often workfare programs are determined to be "outside
employment relationships" and therefore the rights of beneficiaries can
be different.
Some workfare systems also aim to derive a contribution from
welfare recipients by more direct means. Such systems obligate
unemployed people to undertake work that is considered beneficial to
their community.
The United States
The history of workfare in the United States dates back to before the American Revolution, during which land grants and military pensions were distributed sub-nationally and based on means-testing. The disbursement of the "first" social benefits set precedents for the development of the US welfare state. In the early days of the United States, most Americans were deeply connected to the Protestant
religion that favored literacy and hard work as a means of going to
Heaven. Therefore, education was promoted and poor relief/cash
assistance was discouraged in addressing poverty. In addition, the
United States never had a history of feudalism
to leave a residue of distinct social classes. Feudalism discouraged
education to preserve social order; instead the United States
immediately embraced Capitalism,
an economic system in full support of public education. As such, the
United States from its early beginnings placed greater importance on
education to decrease poverty.
This history gave rise to colonial poor relief methodology that
supported work, as a means of increasing self-reliance. Impoverished and
destitute community members were forced into labor at poorhouses and workhouses
to enable individuals to provide for themselves while completing a task
for the community. Workhouses were designed for the "unworthy" poor, or
those who were unemployed but able to work.
During this time, women were disproportionately found in workhouses, as
they were unable to own property or run a household after a man had
abandoned her or died. People of color were unable to receive any poor
relief at all. This "deservingness" discrepancy impacting women and
people of color set the stage for disproportionate assistance to date.
Poorhouses and workhouses existed as a main method of poor relief
through the 19th century, particularly growing in popularity as immigration increased in the United States and leading to the narrative that poverty equates to laziness.
Throughout the 20th century, narratives about laziness morphed into stereotypes such as the welfare queen
that aimed to paint black, single mothers as abusers of the welfare
system. Under this stereotype, black mothers refused to get jobs, had
numerous children, and lived exclusively off of taxpayer dollars. While
applying only to a small percentage of the population, rhetoric such as
this laid the ground work for welfare reform in the 90s.
In 1996, President Bill Clinton passed the Personal Responsibility and Work Opportunity Reconciliation Act (also known as welfare reform), which created Temporary Assistance for Needy Families (TANF),
shortened welfare stays, and mandated intensive job training and work
requirements for individuals in need of assistance. The Personal
Responsibility and Work Opportunity Reconciliation Act mandated work
requirements after two years of assistance, instituted a five-year
limit, created state controlled funding, rewarded work with performance
bonuses, and required participation in paid or unpaid work. Welfare reform made workfare the official social welfare ideology of the United States.
The effort to decrease the number of people on the welfare roll was
successful, although some argue that this did not translate to a
decrease in poverty.
The criticism related to workfare in the United States is most
notably about the tight restrictions and opportunities for low-skilled
workers. Loic Wacquant
theorizes that the United States and other Western, Liberal states have
shifted towards more punitive governance under the guise of neoliberalism. Supplemented by welfare reform and the 1994 Crime Bill,
he argues that workfare has shrunk (via stricter restrictions) and
prisonfare has expanded, ultimately locking the same vulnerable
population in a viscous cycle in which low wage work, decreased
benefits, and low social mobility lead to increased crime and
punishment. He also argues that the institutional racism inherent in the United States has led to the underdevelopment of public aid.
In all welfare states, there is a constant need to address
inclusion and exclusion (i.e., who Is able to access policies and who is
not). Race discrimination
has placed a central role in this struggle, particularly in the United
States as a diverse nation. Typically, people of color have struggled
entering the workforce due to narratives related to high crime and
low-skilled levels. This discrimination is a leading cause for the
higher rates of poverty of people of color in the United States. Jeff Manza
argues that people of color, particularly African Americans, are more
likely to utilize social benefits because they are more likely to be
poor.
Since workfare decreases the emphasis on education and increases the
emphasis on work, scholars like Manza assert that work-first policies
trap people of color in a cycle of low-wage work and poverty.
Gender inequality arises in workfare as well, particularly related to equal pay and dependent care work.
Welfare states can adopt different models related to the main
breadwinner: male-breadwinner model, dual breadwinner model, or
dual-earner-dual carer model.
Workfare in the United States is focused on the financial self-reliance
of families through work, and tends to lean towards a male-breadwinner
model.
A male-breadwinner model assumes that men participate in the labor
market and women complete domestic and caregiving tasks unpaid.
Welfare policies designed and structured based on the assumption and
support of marriage significantly disadvantage single mothers. For
example, in some states, work-first policies may not consider the
childcare responsibilities of women receiving benefits when requiring
them to participate in workfare. Single mothers are 33% more likely than married parents to be in poverty in the United States also in part due to the stagnant minimum wage and gender pay gap.
In the
UK, critics point out that the type of work offered by workfare
providers is generally unskilled and is comparable to community work
carried out by criminal offenders being punished on community service schemes.
Many charities and workers' unions have criticized workfare schemes for
undermining the work done by actual charity volunteers, and acting as a
threat to low paid unskilled workers.
Reproductive justice is "the human right to maintain personal
bodily autonomy, have children, not have children, and parent the
children we have in safe and sustainable communities," according to SisterSong Women of Color Reproductive Justice Collective, the first organization founded to build a reproductive justice movement.
In 1997, 16 women-of-color-led organizations representing four
communities of color – Native American, Latin American, African
American, and Asian American – launched the nonprofit SisterSong to
build a national reproductive justice movement.
Additional organizations began to form or reorganize themselves as
reproductive justice organizations starting in the early 2000s.
abortion rights sign. women's right sign that promotes equal and safe access.
Reproductive justice, distinct from the reproductive rights movements of the 1970s, emerged as a movement because women with low incomes, women of color, women with disabilities, and LGBTQ+
people felt marginalized in the reproductive rights movement. Women
felt that the reproductive rights movement focused primarily on pro-choice versus pro-life debates. In contrast, the reproductive justice movement acknowledges the ways in which intersecting factors, such as race and social class, limit the freedom of marginalized women to make informed choices about pregnancy by imposing oppressive circumstances or restricting access to services, including but not limited to abortion, Plan B pills, and affordable care and education. Reproductive justice focuses on practical access to abortion rather than abortion rights,
asserting that the legal right to abortion is meaningless for women who
cannot access it due to the cost, the distance to the nearest provider,
or other such obstacles.
The reproductive justice framework encompasses a wide range of
issues affecting the reproductive lives of marginalized women, including
access to: contraception, comprehensive sex education, prevention and care for sexually transmitted infections, alternative birth options, adequate prenatal and pregnancy care, domestic violence assistance, adequate wages to support families, and safe homes. Reproductive justice is based on the international human rights framework, which views reproductive rights as human rights.
Framework
Origin
The term reproductive justice combines reproductive rights and social justice.
It was coined and formulated as an organizing framework by a group of
Black women who came together for that purpose in 1994 and called
themselves Women of African Descent for Reproductive Justice.
They gathered in Chicago for a conference sponsored by the Illinois
Pro-Choice Alliance and the Ms. Foundation for Women with the intention
of creating a statement in response the Clinton administration's
proposed plan for universal health care. The conference was intentionally planned just before the attendees would be going to the International Conference on Population and Development
in Cairo, which reached the decision that the individual right to plan
one's own family must be central to global development. The women
developed the term as a combination of reproductive rights and social
justice, and dubbed themselves Women of African Descent for Reproductive
Justice. They launched the framework by publishing full-page statement titled "Black Women on Universal Health Care Reform" with 800+ signatures in The Washington Post and Roll Call addressing reproductive justice in a criticism of the Clinton health care plan.
The women who created the reproductive justice framework were: Toni M.
Bond Leonard, Reverend Alma Crawford, Evelyn S. Field, Terri James,
Bisola Marignay, Cassandra McConnell, Cynthia Newbille, Loretta Ross,
Elizabeth Terry, ‘Able’ Mable Thomas, Winnette P. Willis, and Kim Youngblood.
Definition
Loretta Ross, co-founder and National Coordinator of the SisterSong Women of Color Reproductive Justice Collective
from 2005 to 2012, defines reproductive justice as a framework created
by activist women of color to address how race, gender, class, ability,
nationality, and sexuality intersect.
The concept of reproductive justice was created by these activist women
of color due to frustrations with the dominant "pro-choice" paradigm.
These women felt that despite having the legal access to options such as
abortion, they were not able to exercise reproductive choices as easily
as their more privileged counterparts. For them, reproductive politics
was not about choice, but about justice.
Abortion discourse in the United States is often explained in
terms of being "pro-choice", i.e. in favor of abortion rights, or
"pro-life", i.e. favoring fetal development and protection of the life
of the "unborn child" and opposing abortion. Reproductive justice
challenges the pro-choice/pro-life dichotomy. Reproductive justice
understands "choice" as something that divides women in policy and
practice because it assumes that all women have an equal ability to make
the same choices. Therefore, "choice" ignores structural factors such
as economic status, race, immigration state, etc. Some women's studies scholars like Greta Gaard
argue that "choice" is a "scheme of omission" which means that it
leaves many women out of the conversation, particular women of color,
immigrant women, queer women, transgender women, etc. Structurally,
these identities do not have the same degrees of choice when it comes to
accessing reproductive care. Gaard argues that this further divides
women according to class and race. This creates a need for a new frame that is more inclusive, and reproductive justice was created to be that frame.
Reproductive justice is a critical, theoretical framework that
was invented as a response to United States reproductive politics. The
three core values of reproductive justice are the right to have a child,
the right to not have a child, and the right to parent a child or
children in safe and healthy environments. The framework moves women's reproductive rights past a legal and
political debate to incorporate the economic, social, and health factors
that impact women's reproductive choices and decision-making ability.
When defining reproductive justice, activists often reference the concept intersectionality,
a broader framework used to analyze the various life experiences
individuals may have as a result of the ways in which their identity
categories, such as race, class, gender, and sexuality, interact with
each other. Reproductive justice advocates use this framework to
highlight how people who face greater societal oppression in their
everyday lives as a result of their intersectional identities also face
higher levels of oppression in their reproductive lives. This means that
it is often harder for oppressed people to access healthcare due to
factors such as education, income, geographic location, immigration
status, and potential language barriers, among others.
There are three frameworks that focus on women's reproductive needs:
Reproductive health: Addresses inequalities in health services by advocating for the provision of services to historically underserved communities.
Reproductive rights: Emphasizes the protection of an individual
woman's legal right to reproductive health services, focusing on
increasing access to contraception, and keeping abortion legal.
Reproductive justice: Encompasses reproductive health and
reproductive rights, while also using an intersectional analysis to
emphasize and address the social, political, and economic systemic
inequalities that affect women's reproductive health and their ability
to control their reproductive lives.
The founders of the reproductive justice framework also defined it as
being "purposefully controversial" because it centralizes communities
of color. Advocates state that centering these communities pushes back
against the "dehumanizing status quo of reproductive politics."
By centering the needs and leadership of the most oppressed people
instead of the majority, reproductive justice seeks to ensure that all
people can create self-determined reproductive lives.
The reproductive justice lens is therefore used to address issues
related to abortion, contraception, immigration, welfare, HIV/AIDS,
environmental justice, racism, indigenous communities, education, LGBTQ+
rights, and disability, among other issues impacting people's
reproductive lives.
Unlike the pro-choice reproductive rights or reproductive health
movements, reproductive justice includes community safety, violence, and
the government's role in reproduction. For example, the right to parent
in safe environments would encompass issues such as police brutality and the water crisis in Flint,
Michigan. These issues are largely absent from pro-choice advocacy.
Asian Communities for Reproductive Justice, recently renamed Forward
Together, defines the concept as follows:
Reproductive Justice is the complete physical, mental, spiritual,
political, economic, and social well-being of women and girls, and will
be achieved when women and girls have the economic, social, and
political power and resources to make healthy decisions about our
bodies, sexuality, and reproduction for ourselves, our families, and our
communities in all areas of our lives.
The reproductive justice movement, in its efforts to illuminate these issues, challenges the right to privacy framework established by Roe v. Wade that was predicated on the notion of choice
in reproductive decision-making. Essentially, the reproductive justice
framework turns the focus from civil rights to human rights. The human rights approach of reproductive justice advocates the right
of reproductive decision-making as inalienable for all marginalized
women, regardless of their circumstances. In contrast, reproductive
justice advocates argue that the civil rights-based, pro-choice
framework centers on the legal right to choose abortions without
addressing how socioeconomic status impacts the choices one has. Rickie Solinger said "the term rights often refers to the privileges or benefits a person is entitled to and can exercise without special resources," whereas the privacy framework established by Roe and interpreted by the Supreme Court in Maher v. Roe,
holds that "the state is not obligated to provide the means for women
to realize their constitutionally protected rights, but only to refrain
from putting any 'obstacles' in their 'path'".
The reproductive justice movement seeks to secure women's
reproductive rights by attempting to abolish the civil rights foundation
created by Roe, which has not addressed issues of abortion
access or reproductive oppression, and replace it with a human rights
foundation that would require the state to ensure every person's access
to free reproductive decision-making.
The definition of reproductive justice and the issues the movement
focuses on will continue to evolve with the challenges to reproductive
freedom that marginalized women face.
Reproductive oppression
The organization Asian Communities for Reproductive Justice, one of the
original groups to define and promote reproductive justice, defines the challenges to reproductive health, rights, and justice as "reproductive oppression". They explain,
The control and exploitation of women and girls through our bodies,
sexuality, and reproduction is a strategic pathway to regulating entire
populations that is implemented by families, communities, institutions,
and society. Thus, the regulation of reproduction and exploitation of
women's bodies and labor is both a tool and a result of systems of
oppression based on race, class, gender, sexuality, ability, age and
immigration status. This is reproductive oppression as we use the term.
This definition is relevant because the reproductive justice movement
is defined in part by its opposition to reproductive oppression. By
establishing reproductive justice as a counter to this form of
oppression, advocacy groups like Asian Communities for Reproductive
Justice highlight the movement's focus on broadening the reproductive
rights and health frameworks to include the impact of socioeconomic
conditions.
Rhetoric
Using the term reproductive justice instead of pro-choice, reproductive rights, or reproductive health, is a rhetorical choice. Robin West,
professor of law and philosophy at Georgetown, says that "pro-choice"
court cases may have been lost because of how the issue was framed. For
instance, she argues that "rights" rhetoric gives courts, specifically
the Supreme Court, immense rhetorical power. Reproductive health often places power in the hands of doctors, medical professionals, and the ability to access clinics. In this view, rights and health both refer to power being given to the people from a top-down perspective. As a response, the term justice is meant to put power back into the hands of the people.
Although distinct from pro-choice frameworks, reproductive justice advocates typically rely on narrative
as a rhetorical strategy to mobilize consensus. These narratives
centralize women's stories and decision-making. Narratives relying on
public memory of feminist movements link women's stories across time and
space, and help people to understand the movement's reasons for
organizing. This facilitates personal connection with otherwise abstract policy decisions, and puts a human face on political issues.
While feminist narratives emphasize women's stories and experiences,
reproductive justice narratives focus on the stories specifically of
women of color, treating those with lived experience as experts on the
challenges they face.
For social justice issues, narratives operate on two levels: individual
narratives as a rights-gaining strategy and narratives about social
justice or activist movements.
Digital rhetoric
Technology-based tactics used by activist groups to speak out against reproductive oppression can be referred to as digital rhetoric. For example, women used social media to gather their forces in an attack against abortion bill HEA 1337 in 2016. Through their planning on an online announcement portal, participants would systematically call Mike Pence's office to offer information about their periods to prove the bill's problematic requirements.
As a digital form of rhetoric, media can become more than just a way to
exchange messages and can emerge as infrastructures in our lives.
As a concept that falls under digital rhetoric, technofeminism complements the framework and goals of reproductive justice. Both technofeminism and reproductive justice are centered on intersectionality
and its emphasis on recognizing the existence of multiple, unique
identities. Technofeminism reinforces the presence of digital spaces as
useful for feminist activism, but these spaces can also empower the
wrong groups in a given situation; this can be problematic
intersectionally.
Reproductive justice is at odds with such an issue because online
spaces can empower both feminist activists and pro-life groups
simultaneously, for example. Addressing the existence of power
formations through notions of intersectionality will ensure that there
is no indirect compliance with the behaviors these groups exhibit.
In addition, recognizing the connection between identity and power
allows for more attentiveness toward technofeminist changes and
diversity.
In the United States
Origins
Different ethnic gender norms
Early
notions of women's liberation focused largely on freedom from the
Victorian Era gender roles. These roles placed white women in the cult
of domesticity, confining them to the expectations of motherhood and home-maker,
void of any autonomy separate from their husbands or families. Early
notions of women's liberation focused largely on freedom from the
Victorian Era gender roles. These roles placed white women in the cult
of domesticity, confining them to the expectations of motherhood and home-maker,
void of any autonomy separate from their husbands or families. Women
whose partners or family members are opposed to abortion tend to have a
negative impact. It may cause women to not seek the care that they want
and need, and cause women to seek care in unconventional ways.
The feminine norms and restrictions did not apply the same exact
way for Black women and other women of color. Black women were
considered to be outside the cult of domesticity and many of its gender
norms that were perceived by white people; as Stephanie Flores wrote in The Undergraduate Journal of the Athena Center for Leadership Studies at Barnard College, "Blacks were not perceived as feminine, but rather as less than human" but contraception
was still socially unacceptable for Black women because it was their
perceived duty to produce more slaves. The social stigmas in place
greatly impact how Black women are perceived from abortion. Women of
color having more trouble finding supportive communities or people they
can turn to for help or advice. Women of color tend to also have a more
difficult time finding a good environment to raise their children, where
they will be safe, cared for, and well educated.
The feminine norms and restrictions did not apply the same exact
way for Black women and other women of color. Black women were
considered to be outside the cult of domesticity and many of its gender
norms that were perceived by white people; as Stephanie Flores wrote in The Undergraduate Journal of the Athena Center for Leadership Studies at Barnard College,
"Blacks were not perceived as feminine, but rather as less than human"
but contraception was still socially unacceptable for Black women
because it was their perceived duty to produce more slaves.
Neither Black nor white women had been historically granted full bodily
autonomy with regards to their reproductive health, but they
experienced this lack of freedom differently, and thus emerged the need
for a movement that was able to cater specifically to the unique
experiences and challenges faced by Black women. Similarly, Latinx,
Arab/Middle Eastern, Indigenous, and Asian/Pacific Islander women have
all faced different gender norms based on their race/ethnicity. However,
the gap in the US has always been widest between white women, who are
the most privileged group, and Black women, who have been the most
maligned.
Forced and coerced sterilization and birth control
At
the dawn of the mainstream women's rights movements in the United
States, reproductive rights were understood to be the legal rights that
concerned abortion and contraceptive measures like birth control. The
predominantly white advocates and organizations fighting for
reproductive rights during this era focused almost exclusively on these
goals. This resulted in the widespread, long-lasting exclusion of Black
women from mainstream women's rights movements.
The beginning of the birth control movement in the United States alienated Black women in many ways.
With mostly white leadership, advocates in this movement catered
mainly to the needs of white women. Additionally, in the early 20th
century, white nationalists spread the concept of "race suicide",
the fear that white women using birth control would reduce the number
of white babies being born, thus limiting the power and control of white
people in the United States.
This concept has been a driving force behind the history of forced and
coerced sterilization of women of color around the world, including in
the US. The most recent cases of non-consensual sterilization in the US
occurred throughout the 20th century, targeting "women living with HIV,
women who are ethnic and racial minorities, women with disabilities, and
poor women, among others."
Often, the "consent" for sterilization was obtained from women under
distressing circumstances (i.e. during childbirth) or obtained without
providing all of the necessary information regarding the sterilization.
Other times, a woman's consent was not given, and the procedure was done
when the woman thought she was receiving only a cesarean section. In
many states, these sterilizations were publicly funded. Such sterilization efforts resulted in the near-elimination of some Native American tribes. According to Flores,
The
mainstream feminist movement recognized coerced sterilization as a
problem for black women, but continued to argue for easier access to
sterilizations and abortions for themselves. Their demands directly and
negatively impacted black women as they failed to take into account the
needs of black women for protection from hospitals and government
officials who would otherwise force black women to limit their
reproduction.
The
genocidal connotations and lack of consideration for forced
sterilization in the birth control movement contributed to
intersectional challenges faced by women of color. They also resulted in
a movement of Black people against Black women's choice to use birth
control or abortion, rather than producing more Black babies to build
the community. This effectively divided the Black community.
The birth control movement essentially espoused the idea that women
could attain freedom and equality by receiving legal access to family
planning services, which could help lift them out of poverty. While this
may have been partially true for white women who were free of racist or
classist discrimination, black women faced many more barriers that were
blocking their way to liberation, by nature of being Black in such a
racially unequal society. Margaret Sanger,
a prominent contraceptive advocate and the first to coin the term
"birth control" in the late nineteenth century, has been criticized for
aligning with eugenicists in ways that perpetuated birth control as a
method of population control. There are varying levels of agreement/disagreement with this criticism within the reproductive justice movement.
In Killing the Black Body, Author Dorothy Roberts asserts that Sanger
ultimately contributed significantly in the fight for contraception
access but did so in a way that often shifted the focus away from
reproductive autonomy and utilized eugenic ideas that were prominent at
the time.
There is also a history of coercive promotion of birth control
among women of color in the United States. Before their approval by the FDA,
birth control pills were tested on Puerto Rican women who were not told
they were participating in a clinical trial of little-tested
medication, nor were they told about side effects that were occurring
among their peers in the trial. Some women were not even told that the
pills were meant to prevent pregnancy, and those who were told this were
told it was 100% effective. Women in the trials were given doses ten
times higher than what is actually needed to prevent pregnancy. Although
a few trial participants died, they were not autopsied to discover if
the drug was related to their deaths.
More recently, women of color, women with low incomes, women in
conflict with the law, and women who have used illicit drugs have been
coerced into using long-acting reversible contraceptives
(LARCs). Women have been given the choice between LARCs and jail, or
have been told that they would lose their public benefits if they did
not use LARCs. Medicaid
has covered the implantation of LARCs, but not their removal, which has
disproportionately affected women of color, who often experience
poverty and rely on Medicaid. LARCS have also been disproportionately
promoted to women of color. Many criticize these efforts as based in eugenics and seeking to curtail population growth among communities of color.
Anti-abortion advocates have used the history of forced and coerced
sterilization and birth control to claim that abortion itself represents
a eugenics conspiracy. The movement cites the high abortion rates among
Black women and the presence of abortion clinics in predominantly Black
neighborhoods as evidence. Its methods center on erecting billboards
across the country with messages like "Black children are an endangered
species" and "The most dangerous place for an African American is in the
womb."
Reproductive justice advocates respond by showing that Black women have
higher abortion rates because they have higher unplanned pregnancy
rates due to factors like disparities in healthcare and sex education.
The fertility rate among Black communities is the same as among white
communities, showing that Black populations are not in decline. Abortion
clinics are intentionally cited in low-income neighborhoods to increase
access, and economic disparities mean that many of these neighborhoods
are predominantly Black. Author Dorothy Roberts says:
Black
women’s wombs are not the main enemy of black children ... Racism and
sexism and poverty are the main enemy of black children. [The billboard]
doesn’t highlight the issues behind why women are having so many
abortions, it just blames them for doing it ... [These billboards] are
essentially blaming black women for their reproductive decisions and
then the solution is to restrict and regulate black women’s decisions
about their bodies.
Redefining reproductive rights
Women of color
Even
when topics of racial genocide were no longer at the forefront of the
birth control conversation, reproductive freedom for Black women was
still not a priority of the mainstream civil rights movement in
America.While reproductive politics were central to the mainstream
feminist movement, they were often not addressed in ways that
represented the needs of women of color as well as white women. These
gaps in both the civil rights movement and the women's rights movement
shed light on the need for Black women's organizations that would be
separate from the existing movements focused only on racial equality
without addressing women's specific needs or only on gender equality
without addressing Black women's specific needs.
The committee to End Sterilization Abuse (CESA) was an
organization formed in 1977 that was specifically dedicated to
addressing the forced sterilization of Black women in the US. CESA
created a "working paper" that essentially served as an open letter to
mainstream feminist activists called Sterilization Abuse: A task for the Women’s Movement.
This paper highlighted one of the biggest intersectional challenges
Black women faced in their fight for reproductive rights. It explained
how despite not being addressed in mainstream feminism's fight for
reproductive freedom, forced sterilization is indeed an infringement on
one's reproductive rights, and one that disproportionately affected
black women over white women.
Calling attention to this infringement on the reproductive freedom of
Black women was an important step in leading to the expansion of
reproductive politics in the US.
Many new reproductive health organizations for women of color were created in the 1980s and 1990s, including the National Black Women's Health Project,
and they objected to the rhetoric employed by the mainstream
reproductive rights movement to define the issue of abortion along the pro-choice and pro-life lines that figured in abortion disputes since the 1973 Roe v. Wade Supreme Court decision legalizing abortion in the US.
These new women-of-color-led organizations felt that the term "choice"
excluded minority women and "masked the ways that laws, policies and
public officials punish or reward the reproductive activity of different
groups of women differently." Activists for the rights of women of color subsequently expanded their attentions from a focus on unfair sterilization practices and high rates of teen pregnancy among women of color to include the promotion of a more inclusive platform to advance the rights and choices of all women.
The concept of reproductive justice was first articulated in June
1994 at a national pro-choice conference by an informal Black Women's
Caucus that met at the Illinois Pro-Choice Alliance in Chicago. This caucus preceded the 1994 International Conference on Population and Development (ICPD) that took place two months later and produced the Cairo Programme of Action, which identified reproductive health as a human right.
After Cairo, the Black women promoting the reproductive justice
framework sought to adapt the human rights framework outlined by the
ICPD to the United States' reproductive rights
movement. They coined the term "reproductive justice," defining it at
first as "reproductive health integrated into social justice" by using
the moral, legal, and political language of human rights.
In 1997, 16 organizations representing and led by Indigenous,
Asian/Pacific Islander, Black, and Latinx women, including women who had
been involved in the Black Women's Caucus, came together to form the SisterSong Women of Color Reproductive Justice Collective
in order to create a national movement for reproductive justice. Their
website states that reproductive justice is a human right, is about
access (not choice), and is about more than just abortion. They argue
that reproductive justice can be achieved by examining power structures
and intersectionality, joining across identities and issues, and putting
the most marginalized groups at the center of advocacy.
SisterSong spearheaded the push for a new, comprehensive reproductive
justice movement as a more inclusive alternative to the "divisive"
argument for women's rights that primarily emphasized access to
contraception and the right to an abortion.
The founders of SisterSong also felt that some of the pro-choice
activists "seemed to be more interested in population restrictions than
in women's empowerment".
As SisterSong spread the concept of reproductive justice, the
framework gradually won increasing support and prominence in the
discussion of women's rights and empowerment. The 2003 SisterSong
National Women of Color Reproductive Health and Sexual Rights Conference
popularized the term and identified the concept as "a unifying and
popular framework" among the various organizations that attended. In 2004, Jael Silliman and coauthors published the first book on reproductive justice, Undivided Rights: Women of Color Organizing for Reproductive Justice. Moving forward, reproductive justice groups modeled some of their rhetoric after Dr. George Tiller,
a late-term abortion provider who was assassinated in his church in
Wichita, Kansas, in 2009. He coined the phrase "Trust Women", which was
used to promote abortion rights by arguing that women should be trusted
to make their own decisions. "Trust Women" became the name of an
organization and conference based on women's reproductive rights.
Building on his legacy and the popularity of this phrase, SisterSong
and reproductive justice advocates adopted Trust Black Women
as an organizing slogan and the name of a national coalition of
Black-women-led organizations led by SisterSong and devoted to advancing
reproductive justice for the Black community (TrustBlackWomen.org).
Over the decades since SisterSong's birth, the group has inspired
and mentored the creation of dozens of women-of-color-led reproductive
justice organizations across the country. Groups that promote women's
rights such as the National Organization for Women and Planned Parenthood
have increasingly adopted the language of reproductive justice in their
advocacy work. The movement has increasingly entered mainstream spaces,
as organizations such as Law Students for Reproductive Justice have
arisen to promote women's human rights using the reproductive justice
framework. In 2016, Hillary Clinton used the term reproductive justice during her campaign for the presidency.
Asian and Pacific Islander women were a part of the reproductive
justice movement through organizing and advocating for the ending of
oppressive practices against them. Their movement included ending the
sexualized stereotypes of API women which resulted in them being treated
as commodities. On the other hand, API communities asexualized API
women and force them into conformity in the private sphere. The "model
minority" myth painted API immigrants as wealthy and resourceful, while
many API women worked low-wage jobs with no health insurance.
In response, API women formed many successful organizations such as
Asian Immigrant Women Advocates (AIWA), The Committee on South Asian
Women, and Asian and Pacific Islanders for Choice (APIC).
Women in digital spaces
Reproductive
rights have also been redefined digitally. Moving beyond contradictions
about women and technology and exploring the ways these contradictions
can be challenged allows for better opportunities to take action.
On March 28, 2016, "Periods for Pence" pages were created on Facebook and Twitter to combat HEA 1337.
Organizers like Laura Shanley rallied women online to contact Pence's
office and provide information on their reproductive health.
Women were ultimately using digital means to represent their bodies and
band together as a team of multiple identities with unique, individual
experiences.
Sites like the National Abortion and Reproductive Rights Action
League help to engage women with political activism. For example, some
sites share petitions and links for voting/contacting political leaders
so women can get involved despite their busy lives.
Issues
Sex education
Throughout
the world, many people lack a quality understanding of sex education.
Health Organizations should provide sex education including information
and easy access services that can be used. This should include knowledge
of choice about partners, choice about the timing, possible marriage,
and knowledge of consent. According to The Pro-Choice Public Education Project, the US provides more funding towards abstinence-only sex education programs rather than comprehensive sex education programs. From 1996 through 2007, the US Congress committed over $1.5 billion to abstinence-only programs.
When funding is not provided towards comprehensive sex education,
students are not taught about how to prevent pregnancy and sexually
transmitted diseases from occurring. Advocates for Youth
discusses how abstinence-only education programs are not effective at
delaying the initiation of sexual activity or reducing teen pregnancy.
Instead, graduates of abstinence-only programs are more prone to engage
sexual activities without know how to prevent pregnancy and disease
transmission. Reproductive justice advocates call for comprehensive sex
education to be available to all young people.
Birth control
Reproductive
justice advocates promote every individual's right to be informed about
all birth control options and to have access to choosing whether to use
birth control and what method to use. This includes advocacy against
programs that push women of color, women on welfare, and women involved
with the justice system to use LARCs. By providing women and trans
people with knowledge about and access to contraception, the
reproductive justice movement hopes to lower unwanted pregnancies and help people take control over their bodies.
Federal programs supported by reproductive justice activists date back to the Title X
Family Planning program, which was enacted in the 1970s to provide
low-income individuals with reproductive health services. Title X gives
funding for clinics to provide health services such as breast and pelvic
examinations, STD and cancer testing, and HIV counseling and education.
These clinics are vital to low-income and uninsured individuals.
Advocates for reproductive justice also aim to increase funding for
these programs and increase the number of services that are funded.
Abortion access
Advocates
for reproductive justice such as SisterSong and Planned Parenthood
believe that all women should be able to obtain a safe and affordable
abortion if they desire one. Having safe, local, and affordable access
to abortion services is a crucial part of ensuring high-quality
healthcare for women (and for trans and gender non-conforming people who
can get pregnant). Access to abortion services without restrictive
barriers is believed to be a vital part of healthcare because "…induced
abortion is among the most common medical procedures in the US…Nearly
half of American women will have one or more in their lifetimes."
These organizations point to studies that show that when access to
abortion is prohibitive or difficult, abortions will inevitably be
delayed, and performing an abortion 12 weeks or longer into the
pregnancy increases the risks to women's health and raises the cost of
procedures.
The American Medical Association echoes the importance of removing
barriers to obtaining an early abortion, concluding that these barriers
increase the gestational age at which the induced pregnancy termination
occurs, thereby also increasing the risk associated with the procedure.Minority groups experience poverty and high rates of pregnancy
due to a lack of available sex education and contraception. In addition,
women from low income households are more likely to turn to unsafe
abortion providers, and as a result, they are more likely to be
hospitalized for complications related to the procedure than
higher-income women are.
Although abortions were made legal in the Roe v.s. Wade Supreme Court
decision of 1973, many obstacles to women's access remain. Young,
low-income, LGBTQ, rural, and non-white women experience the greatest
hurdles in their efforts to obtain an abortion in many parts of the U.S.
Obstacles to obtaining an abortion in the US include a lack of Medicaid
coverage for abortions (except in the case of certain circumstances,
such as life endangerment), restrictive state laws (such as those
requiring parental consent for a minor seeking an abortion), and
conscience clauses allowing medical professionals to refuse to provide
women with abortions, related information, or proper referrals.
Additional obstacles to access include a lack of safety for providers
and patients at abortion facilities, the conservative, anti-abortion
political legislators and the citizens that support them, and a lack of
qualified abortion providers, especially in rural states.
Abortion access is especially challenging for women in prisons,
jails, and immigrant detention centers. Proponents of reproductive
justice argue that withholding access to abortion in these facilities
can be seen as a violation of the 8th Amendment preventing cruel and
unusual punishments. A survey presented in Contraception found a correlation between Republican-dominated
state legislatures and severely restricted coverage for abortion. Many
anti-abortion groups are actively working to chip away at abortion by
enacting restrictions that prevent more and women from obtaining the
procedure. The research concludes that full access is not available in
all settings, and correctional settings should increase the
accessibility of services for women.
Organizations that promote reproductive justice such as NOW and
Planned Parenthood aim to provide increased access to safe abortions at a
low cost and without external pressure. They advocate increasing
insurance coverage for abortions, decreasing the stigma and danger
attached to receiving an abortion, eliminating parental notification for
teens, training more physicians and clinics to provide safe abortions,
and creating awareness about abortion.
Maternity care
Researchers
have found that women of color face substantial racial disparities in
birth outcomes. This is worst for black women. For example, black women
are 3-4 times more likely to die from pregnancy-related causes than
white women.
While part of the issue is the prevalence of poverty and lack of
healthcare access among women of color, researchers have found
disparities across all economic classes. A black woman with an advanced
degree is more likely to lose her baby than a white woman with less than
a high school education.
This is partially due to racial bias in the healthcare system; studies
have found medical personnel less likely to believe black people's
perceptions about their own pain, and many stories have surfaced of
black women experiencing medical neglect within hospitals and dying from pregnancy complications that could have been treated.
Researchers have also found that the stress of living as a person of
color in a racist society takes a toll on physical health, a phenomenon
that has been coined weathering. The extra stresses of pregnancy and labor on a weathered body can have fatal consequences.
Reproductive justice advocates assert the need to correct racial
disparities in maternal health through systemic change within health
care systems, and they also particularly advocate for access to midwifery
model care. Midwifery care has strong roots in the ancient traditions
of communities of color and is usually administered by fellow women,
rather than doctors. Midwifery practitioners treat the individual as a whole person rather than an objectified body. Midwifery care involves trained professionals including midwives (who are medically trained to monitor and safeguard maternal, fetal, and infant health and deliver babies), doulas
(who provide emotional and practical support and advocacy to mothers
during pregnancy, labor, and postpartum, but do not have any medical
training), and lactation consultants (who train and support mothers with lactation). Midwifery model care has been shown to improve birth outcomes,
but is often not covered by health insurance and therefore only
accessible to wealthier people. Reproductive justice groups advocate for
access to midwifery model care not only to correct racial disparities
in birth outcomes, but because they believe that every woman has the
human right to give birth in any way she wishes, including a home birth
or a midwifery model birth at a birthing center or hospital.
Sexual coercion
Reproductive justice also focuses on providing protection against sexual coercion, unwanted sexual activity that happens when a person is pressured, tricked, threatened or forced in a non-physical way, when it comes to domestic partners.
Sexual coercion consists of, but is not limited, to: continuously
asking for sexual favors until the desired answer is achieved, making a
sexual partner think it is to late to change their mind, manipulation,
threats that can jeopardize one's safety based on sexual preference or
orientation, and stealthing.
Sexual coercion between domestic partners has become a bigger issue in
the United States. Sexual coercion has become a national problem. In
2014, there was research done by Susan Leahy that focuses on nonviolent
nonconsensual sexual assault.
Black women are victimized at an alarmingly higher rate than their
counterparts. "17 percent of black women experienced some form of sexual
coercion by their domestic partners. This has been a known issue since
The Civil Rights, which women used this spotlight to fight for their
rights over their bodies and fight against sexual misconduct against
them.
Incarceration, immigrant detention, and reproductive justice.
Pregnancy, birth, and postpartum during incarceration
Women of color are disproportionately targeted by the criminal justice
and immigrant detention systems, particularly women with low incomes or
from other sectors of society with limited access to healthcare. A
Rhode Island report showed that 84% of women in prison had been sexually
active within 3 months of their arrest, but only 28% had used contraception. Newly incarcerated women are therefore at a higher risk of unintended pregnancy.
Many of these pregnancies also become high risk due to substance use
before incarceration and lack of prenatal care services both before and
during incarceration, leading to preterm deliveries, spontaneous
abortions, low-birthweight infants, preeclampsia, or fetal alcohol syndrome.
During incarceration, many women report challenges in accessing
appropriate prenatal, birthing, and postpartum care, sometimes with
disastrous and even life-threatening results. Women have been denied
medical attention when in labor, shackled during labor even against the
requests of medical professionals, and refused postpartum doctors'
visits after high-risk births. Shackling in five-point restraints (both
wrists, both ankles, and across the belly) during pregnancy and
postpartum has been known to cause issues like a miscarriage (if a woman
trips and cannot break her fall with her hands) and can reopen stitches
from a cesarean. Women also reported being automatically confined to
isolation after birthing and separation from newborns, which increases
the risk of postpartum depression. Breastfeeding and pumping milk have
also been prohibited, which is detrimental to maternal and infant health
and to mother-baby bonding. Advocates in several states have been
fighting these policies, often using a reproductive justice framework,
and several have won policy changes. Doula groups have also formed to provide care to incarcerated and detained women, often using a reproductive justice framework.
Diseases and other health conditions
Since 1980, the number of women in prison has tripled, leading to a high incidence of serious health concerns, including HIV, hepatitis C,
and reproductive diseases. The rate of HIV is higher among incarcerated
women than among incarcerated men, and it can be as much as one hundred
times higher among incarcerated people than in the general population.
The trend towards longer and heavier sentences has also led to greater
health concerns, as many prisons, jails, and detention centers offer
little accessibility to adequate medical care. Due to stigma, when
incarcerated and detained people are given healthcare, it is often lower
quality. Additionally, prisons and detention centers are increasingly
being built on rural land, isolated from major resources for medical
care.
Two major areas of concern for reproductive justice in prisons are
medical neglect and non-consensual prison intervention on a woman's
right to reproduce.
Forced sterilization and contraceptions
Prisons have demonstrated high incidents of human rights violations. These include cases of medical neglect and forced sterilization.
Acts of forced sterilizations have often been used to justify
punishments for imprisoned women. These violations continue to occur due
to limited public attention towards cases of prisoner dehumanization
and injustice. This leads to greater helplessness as imprisoned women
lose say in the treatment of their bodies. For example, prisons often
perform forced hysterectomies on imprisoned women. Article 7 of the International Covenant on Civil and Political Rights established by the United Nations
prohibits cruel, degrading, inhumane torture. The lifelong effects of
forced sterilization as well as the unnecessary suffering due to
untreated disease violates these treaties.
Women with disabilities are one of the minorities that are
greatly impacted by the deprivation of reproductive rights. They often
experience discrimination, limitations to the type of contraception they
are given, and forms of sterilizations. Many women with disabilities
are coerced into sterilizations that they never gave consent to, and
many doctors oftentimes make this decision for women or even family
members that give consent to proceed with the sterilization process for
them.
This is seen as a violation, torture, or abuse to many women around the
world who are deprived from their right to make their own choice for
their body.
Women with disabilities are also deprived from the right to choose what
kind of contraception they use. When women with disabilities are
compared to women without disabilities, the type of contraception they
are given in clinics are quite different. Women with disabilities are
mostly given a contraception that is long acting and reversible, while
those with no disabilities are given moderately effective methods. This is in part a result of lack of knowledge and experience with patients with disabilities.
When taking into account the many forced sterilizations and
discriminations against minority women, eugenics can also be a part of
the reason why these discriminations occur against women with
disabilities and others. In the United States, forced sterilizations
have occurred for eugenic purposes since after World War II.
California being one of the states that allowed forced sterilizations
in the 1940s, especially on minority groups of women that had prominent
unfavored genes. Institutions in California reported to have sterilized
about 381 people, but later the sterilizations ceased due to little
scientific proof to decrease the unfavored genetics. However, disabled
women were still one of the few groups in 1954 to have sterilizations be
performed after no proof of effectiveness was found.
Forced sterilizations have been performed on people of color, immigrant
Latino women, mentally disabled women, physically disabled women, women
from low income, and many more in the United States. These women are
all a part of one or more minority groups that were targeted for not
having the ideal genes or to limit the population growth.
Separation of families
The
criminal justice, child welfare, and immigrant detention systems
frequently target and separate families with marginalized identities,
which advocates say is a reproductive justice issue. The cash bail
system incarcerates only people who have low incomes and cannot afford
bail, which often means people of color. Due to the Adoption and Safe Families Act,
parents can then lose all legal rights to their children if they have
been incarcerated for 15 of the last 22 months, even if they are still
awaiting trial. Both incarceration and immigrant detention separate
children from competent parents who want them, which is often deeply
traumatic
and can result in children being placed in the foster care system,
where the likelihood of poor healthcare and educational outcomes
increases, as does the likelihood of future criminal justice
involvement, and these outcomes are worst for children of color.
LGBTQ+ people
Access to reproductive health
services is more limited among the LGBTQ community than among
heterosexuals. This is evident from the lower number of training hours
that students going into the medical field receive on health problems
faced by LGBTQ persons.
Evidence also shows that once students complete training and become
healthcare providers, they often adopt heteronormative attitudes towards
their patients.
In addition to lower educational standards and evident clinical
prejudice against LGBTQ patients, there is also limited health research
that is specifically applicable to LGBTQ community.
Like cisgender
heterosexual people, LGBTQ people still need access to sex education,
sexual and reproductive healthcare such as testing and treatment for
sexually transmitted diseases, birth control, and abortion. Despite
myths to the contrary, LGBTQ people can still face unintended
pregnancies. Many face increased risk for certain sexually transmitted
diseases, such as HIV. Access to fertility treatment and adoption is
also a reproductive justice issue for many LGBTQ people who want to
raise children. Likewise, prejudice against LGBTQ people is a
reproductive justice issue impacting their personal bodily autonomy,
safety, and ability to create and support healthy families.
Self-determined family creation is a human right for all people,
according to reproductive justice. Trans
people share all of these reproductive justice issues; in addition,
access to gender-affirming hormones is considered a reproductive issue
necessary to their personal bodily autonomy.
Trans people in the US, especially trans people of color, face the most
severe prejudice and violence directed toward the LGBTQ community.
Black trans women in particular are being murdered at alarming rates.
Economic justice
Due to systemic racism,
women of color in the US earn considerably less than white men and also
substantially less than white women or men of color. This impacts their
ability to afford birth control, reproductive healthcare, and abortion,
as well as their ability to have as many children as they want and
raise their families with adequate resources. Due to economic
constraints, women of color are more likely than other women to feel
they need to abort pregnancies they want. They are also more likely to
live in poverty because they have more children than they can easily
afford to care for. Women with low incomes are more likely to rely on
state social supports, which often further limit their access to birth
control, reproductive health services, abortion, and high-quality
maternity care such as midwifery services.
In 1977, the United States federal government passed the Hyde Amendment,
which eliminated federal Medicaid which funded abortions and
reproductive services to low-income women. This caused low-income women
further barriers in accessing reproductive health services, and meant
that they would have to "forgo other basic necessities in order to pay
for their abortion, or they must carry their unplanned pregnancy to
term". The amendment results in the discrimination of poor women who "often need abortion services the most" and have "reduced access to family planning, and experience higher rates of sexual victimization".
Due to systemic racism in the United States, women of color
"disproportionately rely on public sources of health care", so the Hyde
amendment impacted these women substantially.
Environmental justice
Because reproductive justice is tied to community well-being, Kathleen M. de Onı's 2012 article in Environmental Communication argues that reproductive justice should be understood alongside environmental justice and climate change.
Reproductive justice advocates organize for environmental justice
causes because issues like unhealthy drinking water and toxins in beauty
products can impact physical and reproductive health and children's
health.
The Flint Michigan water crisis is often cited as an example of this
because a low-income community primarily composed of people of color was
forced to use toxic drinking water, a situation that advocates say
likely would not have been inflicted upon a wealthier, whiter community.
Environmental reproductive justice was built on the premise to ensure
that women's reproductive health and capabilities are not limited by
environmental pollution.
Environmental justice is a response to environmental racism.
"Environmental racism refers to environmental policies, practices, or
directives that differentially affect or disadvantage (whether
intentionally or unintentionally) individuals, groups, or communities
based on race or colour". The Environmental justice movement began in 1982, in Warren County, North Carolina. It was born out of protests that occurred in response to a polychlorinated biphenyls
landfill, which was located in Warren County, "a rural area in
northeastern North Carolina with a majority of poor, African-American
residents".
Due to the potential for groundwater contamination, there was an
immense backlash from residents and "protesters argued that Warren
County was chosen, in part, because the residents were primarily poor
and African-American". The protests resulted in 500 arrests, but the landfill was unable to be stopped.
An example of environmental racism that shows the enactment of
environmental justice and reproductive justice is the Dakota access
pipeline and protests at Standing Rock. The Standing Rock Sioux and
other indigenous tribes have been protesting the construction of the
Dakota access pipeline and subsequent contamination of the surrounding
waters since April 2016.
Immigration and reproductive justice
Reproductive justice includes the right to exercise autonomy over
family structures and the right to reproduce. Oftentimes, deportation
and immigration policy can affect family planning and structure in a
fundamental way - if one parent is deported, it can lead to the
restriction of a family's income and place an increased burden on a
single parent. Additionally, being separated from a parent can lead to
the traumatization of children.
Additionally, Immigration Customs Enforcement (ICE) has been
criticized for the practice of forced sterilization of immigrant women
in the custody of private detention facilities.
Nurse Dawn Wooton, the whistleblower who brought attention to the lack
of informed consent of immigrant patients at Irwin Country Detention
Center, observed that "these immigrant women, I don’t think they really,
totally, all the way understand this is what’s going to happen
depending on who explains it to them."
Immigrant Latina women are often stereotyped as taking advantage
of the opportunity to bear children in the U.S. to benefit from their
children's citizenship.
This leads to the infringement of many health care benefits and
reproductive health care rights. Latina Immigrant women also often have
to face poverty since without legal status, they do not have many work
opportunities here in the U.S which can interfere with child caregiving
and the reproductive health of the mother.
Furthermore, the immigration system in the United States infringes
reproductive rights from women that are detained in immigration
facilities. Women are either separated from their children by force,
denied access to reproductive health care, or denied abortions.
Immigrant women with legal status also face discrimination and fear,
they live with fear that if they apply for government assistance to
properly care for their children, their legal status will be negatively
impacted.
Worldwide, women with disabilities are sterilized significantly higher than the general population.
The United States has a history of forced sterilization of people with
disabilities - in the 1900s, more than 60,000 people were forcibly
sterilized across the US due to a widespread belief in eugenics.
In recent history, several practices in the US aimed at the
sterilization of people with disabilities have been regarded with
controversy. In 2007, "The Ashley Treatment" referred to a medical
procedure in which parents of a disabled child elected for their
daughter to undergo a hysterectomy and the removal of breast bud tissue,
as well as hormone treatment that stunted her development.
Racial Justice and Reproductive Justice
Racism in the medical field can play a large role in determining a
patient's access to safe and quality medical care. Within the US, a CDC
report found that black women and American Indian/Alaskan Native women
had a higher pregnancy-related mortality ratio (PRMR) than their white
counterparts, at 3.2 and 2.3 percent respectively.
Additionally, this study revealed that the PRMR for college-educated
black women is over five times higher than the PRMR for white women with
the same level of educational attainment. A national survey of five
common causes of maternal mortality found that black women were more
likely than white women to die as a result of the same medical
conditions.
Reagan McDonald-Mosley, chief medical officer for Planned Parenthood
Federation of America, discussed the extent to which racial inequity
contribute to black women's experience with maternal mortality.
“It
tells you that you can’t educate your way out of this problem. You
can’t health-care-access your way out of this problem. There’s something
inherently wrong with the system that’s not valuing the lives of black
women equally to white women."
Black women face both the consequences of medical professionals dismissing pain and health concerns based on gender and race.
One study found that 50% of white medical students believed myths such
as that black individuals had a higher level of pain tolerance than
white individuals, or that African-American patients skin is thicker
than white patients skin.
These myths lead to false diagnoses and dismissal of patient pain.
Additionally, studies show that women's health concerns are often
dismissed in medical offices - one study found that women who went to
the emergency room for abdominal pain had an average wait time 33%
longer than their male counterparts.
One study suggested that women are 50% less likely to receive pain
medication after surgery compared to their male counterparts.
Black women fall at the intersection of biases against both black and
female patients, which can result in reproductive health issues being
taken less seriously.
Socioeconomic issues and reproductive oppression
It
is not possible to describe every reproductive justice issue on this
webpage, as reproductive justice includes and encompasses many other
movements across the globe. The organization Asian Communities for
Reproductive Justice, one of the key groups to define and promote
reproductive justice,
says that advocates of reproductive justice support a diversity of
issues they consider necessary for women and trans people to make
reproductive decisions free of constraint or coercion. These enabling
conditions include access to reliable transportation, health services,
education, childcare, and positions of power; adequate housing and
income; elimination of health hazardous environments; and freedom from
violence and discrimination.
Because of the broad scope of the reproductive justice framework,
reproductive justice activists are involved in organizing for immigrant rights, labor rights, disability rights, LGBTQ rights, sex workers' rights, economic justice, environmental justice, an end to violence against women and human trafficking, and more.
International
United Nations involvement
Under the umbrella of the United Nations, there are several entities whose objectives relate to or promote reproductive justice. Among them, the Convention on the Elimination of All Forms of Discrimination Against Women
emphasizes the rights of women to reproductive health and to choose
"the number and spacing" of their children, in addition to access to the
resources that would allow them to do so. The Convention Against Torture and Other Cruel, Inhuman, or Degrading Treatment "has been interpreted to include denial of family planning services to women." The United Nations Committee on the Elimination of Racial Discrimination
has also been involved with the reproductive justice movement, such as
when SisterSong's Executive Director presented them with a shadow report
written by SisterSong, the Center for Reproductive Rights, and the
National Latina Institute for Reproductive Health in 2014. It described
the US crisis in maternal mortality among mothers of color as a human
rights issue, and the UN committee adopted all of the report's
recommendations.
The United Nations also sponsors conferences and summits with the
subject of the empowerment of women, and these events have historically
advanced the reproductive justice movement. The International Conference on Population and Development is the primary example.
Conferences in Cairo and Beijing
The
United Nations International Conference on Population and Development
(ICPD) that took place in Cairo, Egypt in 1994 marked a "paradigm shift"
to a set of policies on population that placed a high priority on the
sexual and reproductive rights of women. Prior to the ICPD,
international efforts to gauge population growth and to produce
approaches that addressed its challenges focused on "strict and
coercive" policy that included compulsory birth control and preferential
access to health services by people who had been sterilized.
The Programme of Action produced at the 1994 Cairo conference has been
"heralded a departure from coercive fertility strategies" by insisting
on the "fundamental rights of reproductive self determination and
reproductive health care"
and provided the ideological inspiration for grassroots organizations
such as SisterSong in the United States to launch a movement for
reproductive justice.
The United Nations Fourth World Conference on Women in Beijing followed the ICPD a year later, taking place in 1995, and producing a Platform for Action that advocated for the complete empowerment of all women.
It charged states with the duty of ensuring the human rights of all
women, among them the right to sexual and reproductive healthcare. The
Beijing Platform for Action also promoted reproductive justice by
calling on nations to reexamine laws that punished women for undergoing
abortions.
Millennium Development Goals
The Millennium Declaration of September, 2000 and the eight Millennium Development Goals
(MDGs) that emerged as a result of the declaration built on the
framework for sexual and reproductive health rights the ICPD had put
forth five years earlier. The third and fifth MDGs, to promote gender equality and empower women and to improve maternal health,
respectively, embody the principles of reproductive justice through
"the promotion of healthy, voluntary, and safe sexual and reproductive
choices for individuals and couples, including such decisions as those
on family size and timing of marriage." Indeed, the Outcome Document of
the 2005 World Summit
reiterates the connection between the Millennium Development Goals and
their support of the many social factors that promote reproductive
justice by committing the participating countries to reproductive health
as related to the fulfillment of all eight Millennium Development
Goals. Advocates of reproductive justice have noted that by extension,
reproductive justice is critical to include in strategies to meet the
MDGs.
U.S. foreign policy
Organizations
that promote reproductive justice have criticized several United States
policies that aim to remedy international issues of reproductive
health. Below are just a few examples:
The Mexico City Policy, also known by some critics as the Global Gag Rule, and the related Helms Amendment to the Foreign Assistance Act,
are controversial US foreign policies that pertain to reproductive
justice outside the US. The Helms Amendment prevents the expenditure of
United States foreign aid funds on services related to abortion, while
the Mexico City Policy prevents any NGOs funded by the United States from using their resources, even independently raised funds, for services related to abortion.
This means that any organization which provide surgical or chemical
abortions, counsel individuals that abortion is a choice available to
them, or participate in advocacy for the expansion of abortion rights
would be ineligible for financial assistance from the United States.
The Mexico City Policy in particular has been so controversial that
since its establishment in President Reagan's second term, it has been
rescinded by every Democratic president to take office at the end of a
Republican president's term, only to be reinstated by each Republican
president to take office at the end of a Democratic president's term.
With each policy change, NGOs have to reevaluate how to best support
the reproductive health of marginalized women around the world in terms
of both resources and bodily autonomy. Although the Mexico City Policy
and Helms Amendment each only affect the right to abortion in theory,
reproductive justice advocates argue that these policies have the side
effect of crippling organizations that address other important issues
such as prenatal healthcare, access to other forms of contraception, and
STD screening and treatment.
The President's Emergency Plan for AIDS Relief
(PEPFAR) is another contentious American program related to funding
initiatives for global reproductive health. The purpose of the program
is to combat the global HIV/AIDS
pandemic, but agencies such as the Center for Health and Gender Equity
(CHANGE) have called its methods and effectiveness into question.
Critics say that it gives higher priority in funding distribution to
faith-based organizations, including some "with little or no relevant
international development experience" and some which promote abstinence
instead of utilizing effective prevention methods.
This policy approach, which has been nicknamed the ABC—Abstinence, Be
faithful, Condom-use— poses a challenge to reproductive justice.
Advocates hold that such policies marginalize groups of people such as LGBTQ persons who may be discriminated against, as well as women who have been raped, for whom "abstention is not an option."
Although these organizations recognize the gains made by US aid as a
whole, they argue that the rigid structure of the PEPFAR funding hinders
a holistic, community-appropriate strategy to reduce HIV/AIDS
infections, and they contend that the program is "laden with earmarks
and restrictions from Washington that eliminate discretion for making
funding decisions based on local realities and restrict alignment with
European counterparts."
Another policy that has been condemned by reproductive justice advocates is the Anti-Prostitution Loyalty Oath (APLO) produced in 2003.
Required by the United States to grant funding to non-governmental
organizations that work to reduce the burden of HIV/AIDS
internationally, this oath pledges to oppose sex trafficking and
prostitution. Organizations that promote the empowerment of women, such
as the International Women's Health Coalition, maintain that the oath is
"stigmatizing and discriminatory" and that the groups of people opposed
by the policy are precisely those who need help combating HIV/AIDS.
North America
Canada
Coerced sterilizations of Indigenous women in Canada
In
the early 20th century, it was legal in Alberta (1928-1972) and British
Columbia (1933-1973) to perform reproductive sterilizations under the Sexual Sterilization Act. It was not until the 1970s that this legislation was repealed. However, the damage done towards Indigenous women is irreversible and has continued in the decades after the 1970s.
The start of coerced sterilization began with the eugenics movement in
the early 20th century and many Canadians, at the time, were in favour
of this act.
In Canada, it began with the idea of population control, however, it
was disproportionally targeting Indigenous people, specifically
Indigenous women and their right to reproduction. Many Indigenous women were not clearly informed of the tubal ligation procedure and believed it was a reversible form of birth control, when in fact, it was permanent.
A report was released in 2017 which highlighted the coerced tubal ligations inflicted on Indigenous women at the Saskatoon Health Region.
In the report, Indigenous women who underwent tubal ligation surgery
described the experience as making them feel, "invisible, profiled, and
powerless".
Many Indigenous women also stated that they felt pressured into signing
consent forms for the procedure while they were still in labour or in
operating rooms.
This report recommended a nationwide study be conducted in order to
accurately understand how many Indigenous women were affected by this.
However, within the scope of the original study, the class, region, and
race of the individual was found to play a role in the incidence of
coerced sterilization.
In 2017, the Saskatoon Health Region issued a formal apology for its
involvement in the coerced sterilization of Indigenous women, and
acknowledged that racism was a factor in said involvement. Coerced sterilizations were still occurring in Canada, as recently as 2018.
Additionally, lawsuits have been filed against multiple provincial
governments by Indigenous women who underwent coerced sterilizations.
Migrant Women and Temporary Farm Workers in Canada
Thousands of temporary farm workers, including many women, migrate to Canada through the Seasonal Agricultural Workers Program (SAWP). This program is part of Canada's Temporary Foreign Worker Program (TFWP).
Researchers studying migrant women who enter into British Columbia,
Canada through this program found that they face unique barriers that
inhibit their bodily autonomy and freedom to make choices surrounding
their sexual health through "state-level policies and practices,
employer coercion and control, and circumstances related to the
structure of the SAWP".
These women are impacted by many factors that contribute to their
marginalization, including precarious legal status, lack of access to
health care services, poverty, knowledge and language barriers, and job
insecurity.
Utilizing a reproductive justice framework to analyze this issue,
researchers shift the focus from "abortion rights and sexual freedom"
to governmental processes that inhibit access for women to be able to
make choices that are "safe, affordable, and accessible".
Women in SAWP are highly vulnerable due to the program's legal
restrictions, which results in a limited access to social programs or
services, labour rights and health care services.
As a result, migrant women in SAWP take part in "everyday" forms
of resistance to injustices and oppression. Rather than large scale
forms of protest or objection, tactics to resist these forms of
oppression are more subtle. Forms of resistance for these women often
involve private disobedience of restrictive regulations, informing the
media anonymously of injustices, finding and accessing forms of birth
control or reproductive health services even when discouraged from doing
so, forging relationships, and building a community as well as seeking
the aid of advocacy groups.
South America
Restriction on abortion access and birth control
South
America has some of the rates of unsafe abortions in the world - for
every 100 live births, 39 unsafe abortions take place. Additionally, 45% of the women who die from complications due to an unsafe abortion are under the age of 24.
Reproductive healthcare in South America has become a heated political
issue, with a rise in conservative and religious leadership contributing
to a restriction in access to healthcare and reproductive health
education. Restricted access to both contraceptives and abortion
services leads to a high maternal mortality rate, while limited education leads to high rates of teen pregnancy.
Safe Abortion Information Hotlines
Access
to abortion in South America ranges between individual countries and
within cities. Some places - such as Uruguay, Cuba, and Puerto Rico -
allow abortion access before the 12th-14th week of pregnancy. Other
locations restrict abortion completely, such as Chile, El Salvador, and
Honduras. Throughout the rest of Latin America access to abortion is
permitted only under restricted circumstances, which can result in women
undergoing unsafe procedures to terminate pregnancies.
One study examined the impact of a safe abortion information hotlines
(SAIH) in 5 countries (Chile, Argentina, Ecuador, Peru, and Venezuela).
These hotlines, founded by reproductive rights activists, emphasized the
facilitation of accurate, factual information regarding pregnancy
termination and how to safely seek an abortion.
Africa
Maternal Mortality Rates and Healthcare
Sub-saharan Africa has high rates of unsafe abortions - around 6.2 million each year, which result in 15,000 preventable deaths.
Religious values can sometimes create social barriers to accessing
abortion, particularly in African countries that practice Islam or
Christianity.
Additionally, even in countries that do not entirely restrict abortion,
laws that permit access to abortion under specific circumstances can
increase health complications and women seeking unsafe abortions.
Female Genital Mutilation (FGM) refers to the "partial or total removal
of external female genitalia or other injury to the female genital
organs for non-medical reasons." This procedure is practiced in 27
countries in Africa, and can lead to long-lasting health impacts for
individuals who undergo cutting. FGM can result in negative health
consequences in the long run, which can impact daily function and
reproductive health. The World Health Organization (WHO) mentions the inherent inequality with FGM below:
"FGM
is recognized internationally as a violation of the human rights of
girls and women. It reflects deep-rooted inequality between the sexes,
and constitutes an extreme form of discrimination against women. It is
nearly always carried out on minors and is a violation of the rights of
children. The practice also violates a person's rights to health,
security and physical integrity, the right to be free from torture and
cruel, inhuman or degrading treatment, and the right to life when the
procedure results in death."
China's one-child policy was part of a program to regulate population
growth. This policy, which was implemented in 1979, placed fees on
parents seeking to have children, and resulted in forced use of
contraceptive devices by 80% of Chinese women in the 1980s. The
One-child policy also discouraged single motherhood due to the
associated high fees placed on a single person.
As a result of the one-child policy, researchers have noted a
significant difference in the ratio of male children versus female
children born. The Canadian Broadcasting Corporation describes potential ramifications of this increased ratio:
"Because
of a traditional preference for baby boys over girls, the one-child
policy is often cited as the cause of China's skewed sex ratio [...]
Even the government acknowledges the problem and has expressed concern
about the tens of millions of young men who won't be able to find brides
and may turn to kidnapping women, sex trafficking, other forms of crime
or social unrest."
Asia: In Southeast Asia,
Timorese women still face many struggles, they are still fighting for
quality and equal reproductive rights. There is still a lot of violence
against women, meaning they are still fighting for gender equality. Many
Timorese citizens identify as Catholic, almost ninety-five percent,
which may have an impact on their rights and sexual health choices.
Research has shown that in this town, many women are having sex in
order to become pregnant, however many of the men were partaking in
sexual relations in order to fulfill their sexual desires. Both genders
hardly acknowledged pleasure for the women. The women do as they are
told, and if their husband wants sex, it is their job to fulfill his
needs.
Interventions addressing reproductive injustice
Women on Waves
Women
on Waves is a Dutch non-profit organization that utilizes the principal
of intentional waters to combat restrictive abortion laws around the
globe. Women on Waves travels to different countries with strict
abortion restrictions and brings patients 12 miles off shore, the
distance required to avoid penal restrictions in a country.
This organization utilizes international waters as a loophole to
provide reproductive autonomy to women who would otherwise be unable to
access safe abortion.
Comprehensive Sex Education Policy
Many
reproductive justice organizations advocate for standardized and
informative sexual health education in schools around the world. In the
US, sexual health education can often be a controversial and politicized
topic; this can result in some students in conservative states
receiving misinformation or in the deliberate exclusion of curriculum
that addresses key aspects of sexuality and reproductive health.
Ensuring that sexual health curriculum is standardized and medically
accurate would likely result in fewer unwanted pregnancies, STI rates,
and overall provide individuals with the resources necessary to make
informed decisions about their reproductive health.
