2017 has been a year of major transition for many of us—environmentally, economically, and politically. We live in a time of blaring polarization and uncertainty. Despite an increase in awareness and connection via technology, one import factor that binds us all has been forgotten—our humanity. Outcomes that are caused by inhumane conditions being reduced to mere statistics can breed apathy and further disconnect us from the reality of daily suffering experienced by many Americans. Violence, discrimination, and the lack of access to basic human rights such as safety and quality healthcare usurp our humanity.
As a Registered Nurse and Doula, I witness daily how the most vulnerable among us are impacted by inhumane conditions. With over a decade of experience, my service has taken me overseas, into community clinics, classrooms, and right into the homes of many families. I never imagined that my work with women would lead me into the world of Reproductive Justice. However, I have learned that women’s choices regarding pregnancy, parenting, and contraception are all inseparably tied to human rights.
UP CLOSE AND PERSONAL
Recently, I had the honor of meeting Loretta Ross, a founding mother of the Reproductive Justice movement. Over the past two months, hundreds of healthcare leaders, birth workers, activists and academics who have been inspired by Loretta convened here in New Orleans. Using various platforms, they have followed in her footsteps by advocating for reproductive rights and justice for women in our community and beyond.
Loretta is one of millions of Americans who has lived through reproductive atrocities. Possessing inestimable resilience, her life’s work has been to co-create a movement that centers human rights and challenges systems and policies that diminish them. Loretta’s keen intellect and affinity for academics set her apart from her peers at an early age. Born in the early 1950s, she split her time between a military base and public schools, both of which were integrated. An honors student through primary school, she was skipped twice. By the age of 16, she was offered a scholarship to attend Radcliffe College. Despite her countless achievements, it would be the abuses she suffered that would shape the direction of her pursuits.
At the tender age of 11, she was beaten and raped by a stranger. At 15, an older distant cousin committed incest and impregnated her. Due to her parents’ religious upbringing and the hyper-conservative culture of our country at the time, Loretta was not taught about sexuality or reproductive health. She did not possess the language or a safe space to express and process the repeated violations she experienced. Because she chose to keep and parent her son Howard, her scholarship to Radcliffe was withdrawn and she was expelled from her high school. Her academic counselor told her if other girls saw her pregnant and parenting that she would be a negative influence. She was advised to “go away to a home for unwed mothers.” Instead of heeding her counselor’s advice, she filed a lawsuit against the local school district, won, and was able to complete her high school studies.
Her enrollment at Howard University in 1970 yielded expertise in community and political organizing, as she supported various organizations and co-founded the National Black United Front. Loretta was one of the first women to win a lawsuit against the Dalkon Corporation. At 23, she was sterilized from the placement of the intrauterine device known as the Dalkon Shield. Nearly 300,000 women nationwide subsequently filed lawsuits against the company, claiming they had experienced spontaneous abortions, sepsis, pelvic inflammatory disease, and other injuries. After extensive damages and public outcry, this led to legislation requiring FDA regulation and approval of all medical devices.
In 1979, Loretta became the director of the DC Rape Crisis Center—one of the only such agencies run by and for women of color at that time. Throughout the years, she has helped create numerous councils, organizations, and boards that all operate in the realm of reproductive and human rights. It would be the culmination of her personal experiences and progressive work that would lead her to co-create and define what we now know as “Reproductive Justice” and to cofound SisterSong, the largest multi-ethnic Reproductive Justice organization in the country.
REPRODUCTIVE RIGHTS ARE HUMAN RIGHTS
According to SisterSong, Reproductive Justice is defined as “the human right to maintain personal bodily autonomy to: not have children, have children, and parent the children we have in safe and sustainable communities.”
Abortion has been a controversial topic in the U.S. for decades. Currently, it is legal in all 50 states. However, due to many regulations and the conservative (and sometimes hostile) environment of the Deep South when it comes to abortion, access continues to be a barrier. In their most recent study, The Guttmacher Institute—a leader in global reproductive health research and policy—listed “drastic life change, financial strain, and relationship instability” as the primary reasons women seek abortion in the U.S. Mandatory counseling, 48 to 72 hour waiting periods, and traveling 50 or more miles (due to a scarcity of providers) to receive termination services are obstacles women throughout Louisiana encounter.
One physician who literally puts his life on the line to circumvent barriers to reproductive health access in the South is Dr. Willie Parker. Dr. Parker is a nationally known OBGYN, abortion provider, and reproductive health advocate. Raised as a fundamentalist Christian who viewed abortion as a taboo subject he willfully dismissed, it was not until he encountered a teen who was molested repeatedly and impregnated by her father that he shifted his perspective.
In September I had the pleasure of meeting him at a “Power to the Provider” dinner convening in the Central Business District. The event hosts healthcare leaders and Reproductive Justice advocates from across the United States. As the keynote speaker of the evening, his message to attendees was simply “the time to act is now.” He stated that choosing positive intentional action over acquiescence and apathy is the best way to challenge injustice.
In his newly published book, Life’s Work: A Moral Argument for Choice, Dr. Parker gives detailed accounts of his struggles growing up as the product of a single-parent home in the Deep South, the death threats and harassment he experiences being an abortion provider, the countless women he has served, and how their stories have transformed his life. He not only advocates for reproductive choice but boldly uses his platform to speak out against the physical and sexual abuse of women.
The right to not have children extends beyond abortion access to cover contraceptive access as well. I currently serve as the RN Coordinator for Adolescent Sexual Health for one of the few adolescent reproductive health providers here in New Orleans. Many families seek our services to provide hormone therapy in the form of contraception to their daughters who suffer from PCOS (polycystic ovarian syndrome) and irregular, heavy, or painful menstrual cycles. Some adolescent girls with intellectual and developmental disabilities (such as autism for example) experience distress during their cycle. Women and girls with disabilities are also at higher risk for encountering predators and sexual abuse.
[pullquote]According to SisterSong, Reproductive Justice is defined as “the human right to maintain personal bodily autonomy to: not have children, have children, and parent the children we have in safe and sustainable communities.”[/pullquote]
Providing contraception to teens with special needs was an uncomfortable dynamic I willingly separated myself from until being faced with it personally. The lessening of discomfort related to heavy bleeding and cramping and easing the concern of possible pregnancy can be achieved through hormone regulation. The Trump administration recently passed legislation that will allow employers to opt out of providing contraception as a part of covered health care benefits to their employees. Women should have the right to voice their needs and access services that will best suit their individual and family circumstances. Being able to exercise that right is Reproductive Justice.
The second portion of reproductive justice—the right to have children in humane conditions—is another area that needs major improvement in the United States. But how could birthing in humane conditions be a concern when we have access to electricity, plumbing, advanced technology, and spend more on healthcare than any other country in the world?
In May of this year, ProPublica and NPR co-published a major investigative report, “Lost Mothers: Maternal Mortality In The U.S.” that meticulously answered this question. The United States has the worst maternal death rates in the developed world. Every year in the U.S., 700 to 900 women die from pregnancy or childbirth-related causes, and some 65,000 nearly die. Despite a steady decline in infant mortality, we are the only developed nation that continues to see a rise in the rate of maternal death. The misallocation of federal and state funding (only 6% of block grants for maternal and child health actually goes to the health of the mothers) and hospital staff ill-prepared to manage maternal emergencies were listed as two of the primary driving forces behind these dire statistics.
What this report demonstrated was the need for a major culture shift in how maternity services are delivered. Our maternal services mirror abortion access in some aspects, as more emphasis is placed upon ensuring the survival and well-being of the fetus and infant, instead of placing the same amount of emphasis on the mother’s well-being. Providing education and resources to mothers and the staff that serve them can make a world of difference.
MOTHERING OUR MOTHERS
September is Infant Mortality Awareness Month. Nicole Deggins, CNM, MSN, MPH, and founder of Sista Midwife Productions, hosts a series of annual local events every September called “The Art of Birthing” to raise community awareness and to educate pregnant and parenting women. Several of her featured events include a birth advocacy film fest and panel discussion, Watoto Children’s Festival, and Painting With A Purpose day party. A portion of the proceeds raised from her events this year were donated to midwives in Texas who were displaced by Hurricane Harvey.
Nicole founded Sista Midwife Productions as a platform to “bring transparency to childbirth education in order to help women understand their rights as they navigate the medical obstetrical system.” She serves as a birth advocate, educator, and has trained over 100 women nationwide to serve families as doulas and community birth sisters. While in attendance at her Painting With A Purpose day party, I was able to speak with one of her clients, Ashley. “As a 30-something mother of three, I was repeatedly told I was at higher risk for complications due to my age. Nicole gave me so much reassurance. With her support not only was I able to have a non-induced vaginal birth, but I regained my confidence. With proper nutrition, prenatal care, and birth support I had an empowered birthing experience with my third child that I was unable to with my first two.”
A great example of educating providers would be to implement “trauma-informed care” training for all physicians, nurses, and other staff that work with pregnant women. Assessing pregnant women for previous sexual trauma and instituting measures to support their emotional safety should be mandatory for all healthcare personnel. Along with several of my colleagues from Birthmark Doula Collective, I attended the Decolonize Birth Conference in Brooklyn in late September. One of the opening sessions we attended was entitled, “The Body Keeps Score: Survivors of Sexual Violence and Birth Justice.” This session reviewed how to properly support women who are survivors of CSA (childhood sexual assault).
Sangeet Raj Kaur—a NYC-based doula, yoga instructor, and founder of Royal Mothering—explained how the process of giving birth can traumatize mothers who have survived abuse. “Birth forces women to surrender. Survivors attempt to control everything in their lives in an effort to protect themselves,” she said. As a survivor of sexual assault, she explained how having multiple unknown people coming in and out of the room during labor and the use of repeated vaginal checks to measure the progression of labor can be very emotionally triggering. By providers showing more compassion, maintaining good bedside manner, and helping the mothers feel safe during labor, they can ease maternal stress and contribute to healthier outcomes. We all have the right to receive progressive and compassionate care.
COMMUNITY IS KEY
The final component of Reproductive Justice—the right to raise children in safe and healthy environments—bridges the gap between individuals, families, and all of the systems in society that serve us. Housing, environmental justice, education, the criminal justice system, and everything in between all have a major impact on how our families are created and how they sustain and thrive. With major threats to the Affordable Care Act, national and state budget cuts to education, and a marked increase in policing and military spending, we must question what type of communities will nurture and shape the families we create.
“My answer to sustaining family is community,” says Latona Giwa, BSN, RN, IBCLC, and co-founder of Birthmark Doula Collective. Seeing the need for increased maternal education, advocacy and birth support for low income, Black, and Spanish-speaking mothers here in New Orleans, she helped found Birthmark in 2011. The organization has since grown from 2 women to a member-owned co-op of 12.
The collective provides birth services, prenatal and postpartum support, and childbirth education to about 250 families every year. “We serve as a network, resource and community for each other as well,” Giwa states. During family crises and emergencies, the collective rallies around its members. One member had a distant friend who was pregnant and left all she owned behind to escape an abusive partner. She arrived in New Orleans with nothing but the clothes on her back. Within a few weeks, collective members were able to help her find safe housing and contribute ample clothing and food donations for her and her unborn child. It is through connection and support that individuals and families thrive. In these times of angst and uncertainty, it is community that is needed most.
Since launching Birthmark, Latona has co-founded multiple community resources to serve parenting women, including: Cafe Au Lait Breastfeeding Support Group for Women of Color, The Queer Pregnancy and Parenting Project, the Women’s Health and Justice Initiative, and most recently, Community Breastfeeding “Grand Rounds”—a quarterly convening of local breastfeeding experts and birth workers. Like Loretta, Latona has taken her experience as a woman of color, daughter of an immigrant, and mother to provide outlets and resources that are desperately needed by women in her community. By choosing action, we can create the communities we desire.
ACTION OVER APATHY
During an interview, Loretta Ross stated, “I had to decide that my trauma did not define me. Although it grooved deep crevices in my mind into which it can be too easy to slip into depression, I fight these patterns daily and grow stronger with each victory.” Repeatedly, her resilience has created pathways for women to have a voice and agency over their reproductive health and rights. It is my hope that readers will be inspired by everyday citizens in our community and afar who are using their voice and influence to recenter and reclaim our reproductive rights, human rights, and humanity.
For more information on the aforementioned experts and organizations, please visit:
Cover photo by Paris Hatcher; illustration by Erin K. Wilson