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We looked inside some of the posts by lilou-a and here's what we found interesting.
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Tumblr was created by web developers David Karp and Marco Arment.
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INTRODUCTION
Reproductive Justice is an intersectional and feminist paradigm to advocate for women and LGBTQIA2S+ to protect and carry out their human rights. It was initially created as a political and social movement by a group of Black women activists in 1994 called Women of African Descent for Reproductive Justice.
In June 2022, the Supreme Court struck Roe v Wade based on a lack of Substantive Due Process, which allows Courts to uphold certain rights not expressly enumerated in the Constitution. They declared that the substantive right to abortion was not “deeply rooted in this Nation’s history and tradition.” So, it is safe to assume that the majority position of the Supreme Court, which has been highly politicized as of late, has decided that the right to privacy between a woman and her doctor and abortion is not in line with our traditions or history. One is untrue: Abortions were common practice from 1600 to 1900. The other is an appalling admission that the power over women’s bodies and their healthcare decisions belongs to a patriarchal and sexist group of lawmakers who freely design legal systems of oppression.
The abortion debate is not a debate about choice; it is a debate about who retains control. Reproductive Justice allows us to analyze and understand this issue from an intersectional perspective (Eaton & Stephens, 2020). The post-Dobbs era must represent the undeterred continuity of civil and political activism on behalf of all women, cis and identified, to overcome racial, socio-economic, and gendered systems of oppression. In that spirit, I am interested in identifying the different categories and nomenclature of Reproductive Justice that shape the holistic paradigm of women’s human rights to design an operational definition that represents contemporary social values and the law today.
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Mobilizing for Reproductive Freedom in the Battle Over Bodily Sovereignty
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PHILOSOPHICAL FOUNDATION
“At the core of Reproductive Justice is the belief that all women have
the right to have children; the right to not have children and; the right to nurture the children we have in a safe and healthy environment.”
Rooted in the ‘internationally-accepted human rights framework,” Reproductive Justice is a feminist activist framework in response to the binary debate around reproductive choices narrowly centered around access to abortion and dismissive of the cultural and socio-economic circumstances of women of color and indigenous women in their fight against gendered oppression and for reproductive freedom.
This movement was eager to broaden the scope of the debate toward reproductive justice, including the prominence of socio-economic factors to raise a child in a safe and sustainable environment. The right to decide not to have a child and ultimately regain control over bodily autonomy, decision-making, and the means to do so, which include access to contraceptive means and safe and affordable abortion. And the right to have a child in response to population control, specifically for Black and Native American individuals, and access to natural and safe birthing practices, affordable healthcare, housing, and education.
During a pro-choice conference in 1994, then-president Bill Clinton introduced his new healthcare reform plan. The proposed bill did not include a holistic approach to reproductive issues, shying away from recognizing the singular struggle of Black and Indigenous women with greater socio-economic challenges and fewer healthcare options. It also did not address the systemic discrimination of women of color to access better-paying jobs and opportunities for education, childcare, and support for motherhood. Finally, it failed to address the economic disparity that women suffer compared to men and the lack of support for low-income families to raise children across ethnicities. Twelve women organized an impromptu caucus, discussed the reframing of reproductive rights and social justice, and coined the term “Reproductive Justice.” These twelve activists are Loretta Ross, Toni M. Bond Leonard, Reverend Alma Crawford, Evelyn S. Field, Terri James, Bisola Marignay, Cassandra McConnell, Cynthia Newbille, Elizabeth Terry, “Able” Mable Thomas, Winnette P. Willis, and Kim Youngblood and formed the Women of African Descent for Reproductive Justice.
NewsBlog: the Legacy of the SisterSong Coalition for Reproductive Justice
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KEY STATISTICS & OBSERVATIONS
Roe v Wade was overturned on June 24, 2022, in Dobbs v. Jackson Women's Health Organization, erasing 50 years of precedent.
Following this decision, "14 states have made abortions illegal." [1]
Washington, Oregon, California, Minnesota, Illinois, New York, Vermont, Connecticut, New Jersey, and Maryland are the only states whose constitutional laws protect abortion rights without restrictions and offer a wide range of affordable reproductive services and protections for abortion providers and access to clinics.
Nevada abortion rights are enshrined in the Nevada Constitution and protected by state law but with limitations on access to care. Medicaid does not cover abortions but covers pregnancy and childbirth.
All states cover most forms of contraception under Medicaid. Still, many apply utilization control, such as providing three months' worth of contraceptives instead of a year or requesting pre-approval before granting access. Post-partum IUDs are much more restricted.
Many states require a prescription for Plan B despite it being approved as an OTC medication.
Most states do not cover condoms or sponges OTC without a prescription.
Few states provide coverage for in-mail contraception.
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Medicaid Coverage of Family Planning Benefits
Overall, 9% of the population is uninsured and 20% is covered by Medicaid while the rest are insured through employment and private insurance, ACA marketplaces, and Medicare.
Ensuring Comprehensive Contraceptive Coverage in all U.S.
Obstacles to Contraception
Limits on supply - 3 months instead of 12 -> time constraints.
Detering medical management techniques or gatekeeping -> an individual must get a doctor's appointment or a prescription or pre-approval from their health insurance.
Breach of confidentiality for adolescents and young adults under their parent’s coverage.
Interference or coercion from pharmacists and health care practitioners.
Religious and moral grounds exemptions.
HHS excludes vasectomy and external condoms because it is considered male contraception and does not count as women’s preventive services under the law.
FDA is not kept up to date with approved contraceptive methods.
Individuals may need pre-approval from a family doctor to see and obtain a consultation with a family planning healthcare provider, which creates delays and unnecessary costs.
Exclusion of some providers from network services based on their abortion practices.
Oversight and Future Regulations
Researchers and watchdog organizations must have access to the data.
Courts must have the power to mandate changes.
Congress must create a comprehensive, holistic family planning agenda that positively affirms contraception, family planning, and reproductive health for all individuals everywhere without limitations, coercion, or discrimination - which is another example of positive rights versus negative rights.
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CRITICAL REVIEW #1
“Low-Income Abortion Clients’ Attitudes Toward Public Funding for Abortion”
Key Points
This research study reveals that women interviewed about public funding for abortion had internalized the stigma about lower income individuals who are in need of low-cost abortions or abortions covered by Medicaid.
Based on the moralizing paradigm that abortion procedures are abhorrent, critics often depict such women in need as irresponsible, promiscuous, and illicit substances abusers as a mechanism of oppression.
As a result, these women made sure it was understood their circumstances were different. They made sure the interviewer understood their character was noble as if being in need of a safe and affordable abortion meant you were a low-class citizen.
Nickerson, Adrianne, et al., 2014. “A Qualitative Investigation of Low-Income Abortion Clients' Attitudes Toward Public Funding for Abortion.” Women & Health. Vol. 54(7), pp. 672–86.
“Participants used disparaging language to describe the presumed behavior of women faced with unintended pregnancies. In seeking to discredit “other” women’s abortions, women revealed the complex nature of abortion stigma.”
“We suggest that to minimize experiences of stigma, and to protect women’s health, Medicaid coverage needs to be expanded to cover women under all circumstances; the Hyde Amendment has contributed to high acceptance of limited circumstances surrounding abortion, but in doing so it contributes to the discourse that there are justified and unjustified reasons for having an abortion.”
Today, shaming and oppressive tactics to stigmatize people who need abortions have morphed into legal and incentivized denouncing. In May 2021, Texas passed a law rewarding “deputizing citizens” in denouncing a person who aids another to obtain or provide an abortion after six weeks. If successful in Court, the “snitch” may be awarded $10,000. It is crucial to note that this abhorrent tactic perpetuates culture wars and empowers citizens to destroy individuals’ lives without merit. It creates a climate of surveillance and mistrust that will surely escalate tensions among citizens already living in a divisive society. Instead, we need not empower citizens with destructive capabilities and distill values that promote dialogue, empathy, and a deeper understanding of the issues at stake.
Mobilizing for Reproductive Freedom
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STUDY #1
“Reproductive Rights Without Resources or Recourse.”
“The U.S. Supreme Court declared procreation to be a fundamental right in the early twentieth century in a case involving Oklahoma's Habitual Criminal Sterilization Act, an act that permitted unconsented sterilization of individuals convicted of certain crimes.”
Researcher Kimberly Mutcherson highlights that this declaration is a “negative right,” meaning the courts legally remove the obstacles or burden to achieve procreation in outlawing coerced sterilization.
“The absence of a positive right to procreate reflects not just constitutional tradition but also a governmental and societal commitment to a longstanding set of reproductive hierarchies by which those who fall outside of the traditional framing of family too frequently find their procreative dreams hindered.”
U.S. social norms are a mechanism of prejudice that works jointly with the oppressive legal system of the courts to create a hostile environment for communities who do not have access to the financial and educational means necessary to raise a child in a healthy and safe environment and are not representative of the white hetero normative family unit.
“I argue that a positive legal right is morally necessary in the United States, given the profound significance of procreation, the current barriers to access to care, and the related issues of individual and societal justice.”
All individuals who want to have children and create a family must have access to realistic economic opportunities, affordable healthcare and fertility technologies, affordable childcare, and a safe environment. A favorable legal frame would guarantee proactive solutions to provide the means for children to be conceived and families to flourish. It is time to embrace family planning as a collective responsibility to nurture future generations and give them all the resources necessary for a promising future.
Mutcherson, Kimberly. 2017. “Reproductive Rights without Resources or Recourse.” The Hastings Center Report. Vol. 47 (S3), p. S12-S18.
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THE RIGHT TO HAVE A CHILD
The U.S. Supreme Court declared procreation to be a fundamental right in response to coerced sterilization in the case Skinner v. Oklahoma State in 1942
Thanks to the Affordable Care Act, all insurance plans cover pregnancy, including prenatal care, inpatient services, postnatal care, and newborn care, but plans may vary.
Before ACA, pregnancy was considered a pre-condition and was not covered by most health insurance companies.
However, the U.S. is the only country among rich and developed nations not to provide paid parental leave.
With the over-medicalization of birthing and health insurance restrictions on birthing centers and at-home deliveries, women have to give birth in hospitals, which leads to an increase in non-vaginal births, increased post-cesarian surgery complications, increased difficulty breastfeeding, and higher postpartum depression rate.
Birthing in a hospital setting, which occurs around 95% of the time, increases risks of coercion and manipulation from obstetricians who create artificial conditions for the need for c-sections by inducing labor early and providing pain medicine which prevents individuals from delivering their baby slowly and vaginally.
Assisted Reproductive Technology is not covered by Medicaid, with the exceptions of New York and Illinois, which offer fertility medications and the storage of sperm and eggs for those facing fertility-inducing medical treatment, respectively.
About 35 states lack insurance coverage for some fertility treatments.
Stigma prevents people with disabilities or people at a socio-economic disadvantage from accessing fertility treatments. And reproductive health care
Transgender and non-binary individuals who live with a same-sex partner face even greater stigma and difficulties in accessing reproductive health care.
There is a tremendous lack of sex education for children and adolescents and a lack of free and confidential methods of contraception.
The American social infrastructure is gravely insufficient. It does not provide realistic economic opportunities for all families, equity in education and affordable child care, parental education, and safe and environmentally adequate neighborhoods.
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STUDY #2
“Potential Medicaid Cost Savings from Maternity Care Based at a Freestanding Birth Center.”
Medicaid pays for about half the births in the United States, at very high cost. Compared to usual obstetrical care, care by midwives at a birth center could reduce costs to the Medicaid program. This study draws on information from a previous study of the outcomes of birth center care to determine whether such care reduces Medicaid costs for low-income women.
Methods
The study uses results from a study of maternal and infant outcomes at the Family Health and Birth Center in Washington, D.C. Costs to Medicaid are derived from birth center data and from other national sources of the cost of obstetrical care.
Results
We estimate that birth center care could save an average of $1,163 per birth (2008 constant dollars), or $11.6 million per 10,000 births per year.
Conclusion
Medicaid is the leading payer for maternity services. As Medicaid faces continuing cost increases and budget constraints, policy makers should consider a larger role for midwives and birth centers in maternity care for low-risk Medicaid pregnant women.
Howell, Embry, et al. 2014. “Potential Medicaid Cost Savings from Maternity Care Based at a Freestanding Birth Center.” Medicare & Medicaid Research Review. Vol: 4(3), p. E1–E13.
This is incredibly important as birthing choices are usually much more limited for people with lower financial means. People who qualify for Medicaid are typically forced to give birth at hospitals because Medicaid has stringent guidelines and selective reimbursement modalities for birthing center services and minimal reimbursement for at-home births. Quality of care should not be determined by socioeconomic status, and states should step in to regulate midwifery in an equitable way, such as reimbursing fees for equal services at the same dollar amount.
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Research Study on Potential Medicaid Cost Savings from Maternity Care Based at a Freestanding Birth Center
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Not-For-Profit Birth Center
“Common Sense Childbirth is the nonprofit organization that I founded in 1998. I’m a midwife, but the organization was founded to provide prenatal care, maternity care and support for marginalized women and women of color and for people who were suffering poor birth outcomes.”
“It basically comes down, in my opinion at least, to decolonizing every institution and finding a way in that we can be at the table, that we can be a part of the decision making. That we can have power in policies and in advocacy.”
“We work with women across the entire spectrum. A majority of my patients and clients actually are Medicaid eligible or have Medicaid or on managed care Medicaid, depending on how they get signed up. And then I have quite a large number of undocumented women who are not able to apply or to receive Medicaid or government support. And then we have self-pay patients who are earning too much to be Medicaid eligible but not enough or not in jobs where they’re getting insurance through their work and so they are uninsured.”
Full Interview of Jennie Joseph Founder of Commonsense Childbirth
Commonsense Childbirth - Equitable Perinatal Care Website
Commonsense Childbirth serves people in perinatal care regardless of their ability to pay.
The clinic and its mission are partly funded by the Groundswell Fund, one of the largest funding organizations for women of color enterprises and the Reproductive Justice movement.
Groundswell Fund Website
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