Decolonizing Medicine: Honoring Non-clinical Medicine in RJ

Erika Bleyl, LSRJ Summer Intern, (University of Washington School of Law)

My mother was raised in a rural town in Japan, and my father works for an international pharmaceuticals company. Growing up as a child who was frequently ill, I have always been acutely aware of the dichotomy of Western and alternative medicine. So when the current media sparked a dialogue around Purvi Patel and home abortions, I conceptualized this first as an example of how immigrant communities and Western medicine have always clashed.

In the struggle for access to abortions, much of the language has been centered around the goal that abortions in the medical context should be widespread and economically feasible. And I agree – we should be concerned that legal reproductive healthcare continues to become less and less accessible. I am not advocating for the destruction of conventional medicine. However, I am calling for the acknowledgement that a history of racism, sexism, and colonization has shaped Western medicine. I believe that we as RJ advocates need to fight not only to eradicate the criminalization of pregnancy outcomes, but also allow for the availability of a wide range of reproductive healthcare – clinical or not.

First, it is important to realize that it is easy for people with access to great medical professionals to believe that medical clinics are the gold standard for abortion access. While access to clinics is essential, Western medicine has a history of condoning coercive, non-consensual medical procedures that have left people with marginalized identities skeptical of conventional medicine. Western medicine frequently relies on a dichotomy of “normal” versus “pathological” – and as we know, a very narrow subset of people get to be considered “normal” in a world where systemic oppression is alive and well. Medical racism was used to legitimize colonial expansion via Manifest Destiny, and supported slavery through the “science” of phrenology. Medical sexism pathologized women’s sexuality and bodies through diagnoses such as female hysteria. There is scholarship that suggests that the European witch-hunts not only criminalized women’s bodies, but also did so specifically to target folk healers and midwives. So when Western medicine has a history of conducting oppressive medical procedures on primarily the bodies of women of color, poor women, disabled people, and gender variant people, is it surprising when people with these identities are skeptical of conventional medicine?

Furthermore, the Western world’s questioning of the legitimacy of alternative medicine is itself a product of colonization. We see over and over in history that colonizers ridicule and demonize indigenous medicine, only to turn around and capitalize on it (also see: columbusing).

It is not only crucial to anti-racist organizing, but also healthy for the field of science, to resist dialogue where Western medicine is immune to criticism and alternative medicine is, well, alternative.

The Case for Queering Sex Education

Travis Noddings, LSRJ Summer Intern, (’15, University of Florida)

June 26th has been a decent day for marriage equality—the Obergefell v. Hodges decision striking down state bans on same-sex marriage came exactly two years after DOMA’s definition of marriage was held unconstitutional in United States v. Windsor, and twelve years after Lawrence v. Texas negated state bans on consensual sex acts (read: sodomy). The victories are small, yet momentous.

Despite greater legal blind spots towards gender and non-marital relationships in general, one would hope that our nation’s education system might reflect such progress. Unfortunately, Sex education in schools is still often mute—or worse, malicious—when it comes to discussing sexual orientation, gender, and HIV.

From 1996 to 2014, we’ve spent over $1.75 billion state and federal dollars funding abstinence-only education programs that teach that the only normal, safe, and acceptable sexual activity is between two, heterosexual, married people. Worse, eight states currently have laws that expressly prohibit teachers from discussing gay sex (including topics of sexual health and HIV awareness) positively, if at all. Some explicitly require that gay sex only be discussed in the context of sexually transmitted diseases or presented as illegal under outdated state sodomy laws. Other non-heteronormative sexual configurations are completely ignored.

This alienation of queer students undermines their safety, obfuscates safe sex practices outside of a heteronormative context, and leaves them at heightened risk for STIs (especially for trans* folks) and unintended pregnancies.

The way our education system approaches queer sex—or doesn’t— is failing to provide care for the sexual health and agency of queer students. The choice to parent is a fundamental right, but when we see such disparities in education and health outcomes we have to ask if the same tools and knowledge are being made accessible to everyone.

Organizations like Gender Spectrum work to bring nuanced discussions of gender identity and expression to schools, preparing students and educators for more encompassing and accurate curriculum. A 2015 study of over two decades worth of sex education curriculum found that programs that addressed gender norms or power in relationships were five times as likely to be effective as those that did not. They were also 63% more likely to yield a significantly lower rate of STIs or unintended pregnancy. Researchers also found that sexually active LGB students who received highly inclusive HIV education reported significantly lower rates of pregnancy than those whose education was not inclusive (8.8% vs. 38.6%). They were also more likely to be instructed on condom usage and to have used one the last time they had sex.

Comprehensive and inclusive sex education benefits all students—it won’t solve circumstances of homelessness, violence, or other compounding factors that put LGBTQ students at risk, but it will hopefully bring them into the lesson plan so they can begin to exercise equal and informed judgement in their reproductive decisions.

Maintaining momentum: Applying an Intersectional Lens to Recent SCOTUS Decisions

Jacque Patton, LSRJ Summer Intern, (University of Kansas School of Law)

The Supreme Court of the United States had some landmark decisions in June: the ACA was upheld once again in King v. Burwell, SCOTUS also upheld an important provision of the Fair Housing Act in Texas Department of Housing and Community Affairs v. Inclusive Communities Project, and SCOTUS announced its decision that same-sex marriage is a fundamental right protected under the 14th amendment in Obergefell v. Hodges. Although the excitement from these important decisions is undeniable, it does not mean that the fights for the causes SCOTUS addressed are over. In fact, many states have already responded to the ruling by putting obstacles in front of same-sex couples seeking marriage licenses. The governor of my home state in Kansas issued an executive order to prohibit the state from taking action against religious organizations or clergy that continue to discriminate against same-sex couples.

I recently moved to the Bay Area for the summer for my internship here at Law Students for Reproductive Justice. I had the opportunity to attend one of the oldest pride festivals in the world in San Francisco that started on the day the decision from Obergefell came out. I attended all three days, from the Trans March to the party and parade on Sunday. I was told by many people that the parade and party on Sunday had become commercialized and was being capitalized on, and in contrast to the Trans March on Friday night, I agree. The Trans March was inspiring to be around; people had signs in support of other movements, including Black Lives Matter. It made me see clearly something I’ve been thinking for a long time: through solidarity, through these different movements coming together, this is how change will happen. This is the power of intersectional movements.

The power of intersectionality may be obvious to some, but coming from a conservative state like Kansas where I felt like a radical thinker, to a place where people are freely saying thoughts I had only began to conceptualize in my head, has transformed me. The exposure I’ve had to intersectional theory reminds me that, while the decision in Obergefell is important, it is not a win for all people in LGBTQ communities. Basic human rights violations other communities face daily in this country—like the rate at which transgender people of color experience police brutality—continue to be ignored by our government. Decisions made by SCOTUS in June should not be analyzed separately from each other, but analyzed together to see whether they are moving us towards a more inclusive and equal society. These decisions should be heavily criticized because some of the language and levels of scrutiny applied are problematic for the advancement of civil rights issues. To not address all forms of oppression damages any movement that is fighting for equality—none of us are equal until all of us are equal.

Revolution Over Rights: On Jennicet Gutiérrez, the legal system, and the fight for the liberation of all queer people

Erika Bleyl, LSRJ Summer Intern, (University of Washington School of Law)

On Wednesday June 24, 2015, Jennicet Gutiérrez, an undocumented trans Latina leader at Familia: TQLM and GetEqual, was removed from the White House after she interrupted Obama’s speech during a reception commemorating Pride Month. Gutiérrez, pled for the release of LGBTQ people in detention centers and called for an end to state violence against queer and trans people of color (“QTPOC”). Obama responded by saying, “this is my house, you’re eating my h’ors d’oeuvres,” and shamed her for interrupting him. Many in the room cheered for Obama, and booed at Gutiérrez until she was escorted out.

While there are some who would argue that President Obama probably could not hear what Gutiérrez was saying, the President – either by purposefully dismissing Gutiérrez’s mission or by not apologizing for misunderstanding the situation – has sent the message that he would rather give a speech about trans women than actually listen to a trans woman.

Every time something like this happens where a mainstream entity silences QTPOC resistance, I harken back to the first law school event I ever attended during my last quarter of undergrad. I was disappointed to see that despite significant resistance from audience members and other panelists, one panelist claimed that all forms of LGBTQ equality had been obtained with the passing of gay marriage. Sadly, he was not the only person I had heard this sentiment from, and this event now represents for me the ways that law school perpetuates the harmful notion that laws are the best (or only) tool for obtaining equality and that lawyers are leaders in movements that have always been truly transformed by community organizers.

Like many law students, I came to law school hoping to acquire tools that I could use to uplift my community. Yet as a law student, I have only been provided tools that reinforce the legal system. I am taught to celebrate laws that maintain systems I don’t believe in, and when I am critical of things such as the SCOTUS opinion and problems with the pursuit of marriage equality, I am told that I am ungrateful or unrealistic.

Yet Dean Spade writes in his book Normal Life how recognition-and-inclusion focused law reforms do not actually produce changes that enhance safety for queer and trans people. Even during a time when Laverne Cox and Caitlin Jenner have gained massive public attention, I agree with the sentiment that visibility is not enough. Laws themselves have produced systems that make being trans administratively impossible. Laws that simply “add” to current laws, such as the criminal justice system, are actually contributing to the most significant source of violence against QTPOC.

It is past the time that the voices of trans women of color should be heard rather than shushed. Isn’t Gutiérrez justified in being concerned that trans immigrants make up one out of every 500 people in detention, but account for one of five confirmed sexual abuse cases in ICE custody? Why did the City of Seattle spend $100,000 on painting their sidewalks rainbow, when King County is estimated to have 4,000 homeless queer youth? What are mainstream LGBT organizations doing to support the activists from #BlackOutPride, 6 of whom were detained in Chicago for protesting ongoing state violence against QTPOC? Will you rise up for the liberation of all queer and trans people?

Texas makes it harder for young people to access abortion care

Abbey Marr is a Law Students for Reproductive Justice Fellow at Advocates for Youth

(Andrea Grimes/ RH Reality Check)

(Andrea Grimes/ RH Reality Check)

You may remember that last fall Alabama enacted a new parental involvement law that puts some young people on trial simply for seeking abortion care. Texas has decided — on top of the many harmful restrictions it has put in place for all people who seek abortion care in its state — that it would like to join Alabama in making it a degrading, next to impossible task for young people under 18 to obtain abortion care if they cannot get a parent’s consent.

State parental involvement laws are nothing new, but they are getting worse. Even at their least harmful, the laws – which generally require that when people under eighteen seek abortion care, they notify or get consent from one or both parents first, or get a special waiver, called a “bypass” from a judge – delay access to abortion, endanger health and safety, and fundamentally disrespect young people’s ability to make their own decisions. This harm disproportionately falls on young people in foster care, young people who face abuse or assault from their parents, and other young people that already face significant barriers to obtaining care. And some states are making it worse: this week Texas is poised to pass HB 3994, which would make it virtually impossible for some young people to obtain abortions. Like many states, for the past 15 years Texas has forced people under 18 seeking abortion care to get the signed consent of a parent or legal guardian, or seek a judicial bypass.

HB 3994, which has passed the Senate and the House and will likely be signed by the Governor, would make this judicial bypass process much, much harder. First, it would require doctors to presume that anyone seeking an abortion is under 18 and thus subject to judicial bypass requirements, unless she can present proof of identification, or the doctor determines after “due diligence” that she is over 18.  For people under 18, the judicial bypass procedure has requirements so stringent that almost no one will be able to meet them, including requiring most people seeking a bypass to do so only in their counties of residence or the counties where they intend to obtain care, requiring them to meet an extremely high burden of proof that they are “mature” enough to obtain bypasses, that abortion is in their best interest, and that they are in some form of danger if they were to tell parents or guardian they were seeking abortion care, and allowing judges to force applicants to undergo a mental health evaluation. The law would also add significant delays into the process of obtaining a bypass: applications are no longer required to be considered within two business days. Instead, courts may take five business days. If the courts do not rule in five days, the law would no longer presume her application is granted. Instead, the law is silent, possibly putting an applicant in an indefinite purgatory. And finally, the law compromises anonymity: if a person seeking a bypass says she is being abused, the court must report it to the Department of Family and Protective Services.

Even without these additional hurdles, young people are more likely to face barriers to accessing safe abortion care and may be forced to delay an abortion because they need time to assemble the funds, or lack transportation or access to a provider. These new requirements add logistical nightmares that push some young people through the cracks. They are demeaning, onerous, and stand in the way of young people’s access to safe abortion care.

It is best for young people who find themselves pregnant to be able to seek the advice of a trained medical professional rather than face the situation alone and afraid. Further, young people should have the same right to access the full range of reproductive and sexual health services that other people have. That right includes the ability to access reproductive and sexual health services confidentially and with dignity. With the expected passage of HB 3994 this week, the Texas legislature has decided to put politics ahead of the rights of the young people across its state.

This blog is a cross-post from Advocates for Youth’s youth activist site amplifyyourvoice.org

Infertility Treatment for the Rest of Us

Jamille Fields, Resident Blogger (Law Students for Reproductive Justice Fellow at the National Health Law Program)

Reproductive Justice is defined as the right to have children, the right to not have children, and the right to parent those children in a safe and healthy environment. The Repro community is most often associated with the right to not have children, but I would like to focus today on the first right listed—the right to have children. Recently, Domenico Dolce (the Dolce in Dolce and Gabana) made news with his derogatory comments about in vitro fertilization.  I won’t warrant them with the dignity of repeating them here. But, as celebrities—rightfully–sounded off rebuking his comments, I was reminded that infertility treatment is something that many everyday women and men don’t even consider as an option. As usual, money has a lot to do with it.

Only fifteen states require insurance companies to either cover or offer coverage of infertility diagnosis or treatment. Even among these states the level of coverage varies. Among these states, thirteen have laws that require insurance companies to cover infertility treatment, but three of these states—California, Louisiana, and New York– specifically exclude in vitro fertilization. According to a recent Kaiser study, 22 states Medicaid programs cover infertility testing and only 16 states cover some level of infertility treatment. And, even in those states, the treatment and testing is only covered in limited circumstances.

More attention needs to be paid to the issue of infertility. Around 12% of women of reproductive age had difficulty getting pregnant or carrying a pregnancy to term and about 9% of men between the ages of 15 to 44 reported some form of infertility. These estimates are likely underestimated given infertility isn’t often discovered until individuals are attempting to get pregnant. The information available notes that Latino, black, and white women had similar rates of difficulty getting pregnant, and Asian women had a lower rate. Due to lack of documentation on infertility, it is largely unknown if racial and ethnic disparities exists between those able to get pregnant.

What is known, however, is that there are racial and ethnic, as well as income, disparities in the conditions that have a causal relationship with impaired fertility. For instance, environmental and occupational hazards are suspected to decrease sperm quality, and communities of color are more likely to work in strenuous jobs and live in neighborhoods with polluted and unsafe environments. Communities of color, also, often have higher rates of chronic illnesses, such as cancer and HIV, and the treatment for these illnesses can cause infertility. Untreated STI infections, such as chlamydia, can also lead to infertility and there are higher rates of chlamydia among people of color.

There are also racial and ethnic differences in those who are seeking infertility treatment. According to the CDC, 12% of women or their partners have ever used some form of infertility treatment. Assisted reproductive technologies (ARTs such as in vitro fertilization or IVF) were used in 1.6% of total births in the U.S., however, one study published in 2008 found that 84.6% of ART cycles involved white women.  This is largely contributed to the economic access to infertility treatment.

As for next steps, more research needs to be done to understand the causes of infertility. And, more states need to require insurance, both public and private, to cover infertility testing and treatment. This will give more women and men who want to have children the tools to do so.

The Washington Area Clinic Defense Task Force- Past, Present, and Future

Emily Gillingham, Resident Blogger (’15, Michigan State University College of Law)

The Washington Area Clinic Defense Task Force is an all-volunteer, anti-violence group founded in the 1980s to promote peaceful and safe access to women’s health clinics in the Washington, DC metropolitan area. WACDTF sends volunteers to abortion clinics that are being harassed by “pro-life” protestors (or as they call them, “antis”). WACDTF volunteers are not counter-protestors and aren’t there to engage with the antis; rather, their goal is to de-escalate the situation, deter antis from trespassing, help patients get safely inside the clinic, and provide a calming presence for patients, their companions, and clinic staff.

I’m studying in DC this semester and have been volunteering as a clinic escort with WACDTF. As law students, a lot of our reproductive justice advocacy is more high-level and nebulous, on the policy side; I have found volunteering with WACDTF to be really rewarding and enjoyable because I feel the impact I’m making right away. Plus, check out these fly shirts (pictured below)!

Gillingham blog

The coalition became WACDTF and made their role to be a calming presence at clinics. “At the beginning some people would hold signs and do chants, but the understanding was always to keep things calm,” said Alicia.

Alicia said that in response to the blockades, “Clinic Defense would throw a monkey wrench in the antis’ plans. They would take advantage of the fact that they organized very hierarchically. They wanted it to be a surprise what clinic they would blockade or else Clinic Defense would be there, so they didn’t tell anyone until that morning.”

Once, a WACDTF member determined where the antis’ rendezvous point would be ahead of time, arrived there before the anti with the maps, and gave out fake maps that led somewhere else entirely, thus leading the antis to a random shopping center instead of the clinic. Another time, a WACDTF member’s car “happened to break down” at the entrance to the parking lot where the antis were meeting, preventing them from going to the clinic. Alicia also recalled, “one time we were in a long line of cars [antis on their way to protest at a clinic] and we turned left and they followed us.” As Alicia pointed out, “these were not official WACDTF decisions.  Rather they were done thoughtfully by smaller groups of people in WACDTF but working on their own.”

Gradually, the antis’ tactics began to evolve. Alicia explained, “In the mid to late 90s, the blockades were tapering down because of a number of things. A number of injunctions, bubble laws, ordinances, that made it more difficult for them to do it.” There were also changes in how the police enforced trespassing and other existing laws, and the things WACDTF did to protect the clinics which made it harder for the antis. The antis fell in numbers and smaller groups began to do more extreme things. They would disable a car in front of the clinic entrance to block access; they engaged in “lock and blocks,” locking themselves with chains and locks to things like the bar of the front door.

I asked Alicia whether the Freedom of Access to Clinic Entrances Act (FACE) impacted WACDTF’s work. She said that FACE is “about the penalties you can get. It doesn’t do anything right there in the moment. Joe Anti may still block. It may be a deterrent, but it doesn’t do anything except that we can say that you could be charged with a FACE violation.”

Although the large blockades and lock and blocks are largely a thing of the past, current anti-choice tactics at clinics, while different, are still deeply problematic. “The harassment is every week, directly accosting and harassing women seeking reproductive health care including abortion and many other services,” Alicia said. “Some anti groups also try to turn landlords against the clinics, harass them in other ways.  Week in and week out.” So, WACDTF’s work is still needed in front of the clinics. This is still needed, this is about basic access to healthcare.”

I agree!

Do you want to learn more about WACDTF? Visit their website at http://www.wacdtf.org/

 

 

 

Can you design a Teen Pregnancy Prevention Campaign that does not shame Young Mothers, Insult Low-Income people . . . And Oh yeah, and is not Racist?

Jamille Fields, Resident Blogger (Law Students for Reproductive Justice Fellow at the National Health Law Program)

May is Teen Pregnancy Prevention Month–a month that Gloria Malone, a young mother, described as “the month of getting it wrong.” Malone was referring to the problematic teen pregnancy prevention campaigns that are displayed throughout the year, but are really touted during May.

Such campaigns include a Milwaukee campaign launched earlier this year that includes young parents as huge toys, such as a jack-in the box, puppet, or pull toy, with the message “Have a Baby too Young and it will Control Your Life.” In 2013, the Candies Foundation launched and continued an ad campaign, complete with celebrity endorsements (all women from what I can tell), with such messages as “You’re supposed to be changing the world, not changing diapers.” With taxpayer funding that same year, New York City launched an even more offensive campaign. One of the campaign ads featured a black toddler with the words “Honestly, Mom, chances are he won’t stay with you. What happens to me?” and another that read “Got a job? I cost thousands.”

These campaigns are problematic on so many levels that I don’t know where to begin. The Milwaukee campaign conveys to young parents a message of hopelessness. The Candies Foundation continues to place all responsibility for reproductive decision-making on young women, excluding men from any role in the matter. The New York City campaign ads, which featured mostly people of color, suggests that it is these communities that need to have their reproductive activities monitored and contained. Also, the message that the child will somehow be lost if Daddy doesn’t stay in a relationship with Mommy is insulting to all of the single parents who have raised and continue to raise healthy and happy children. Further, intertwined throughout many of these campaigns and others is the message that poverty is solely attributed to a person’s decision to have children. In addition to shaming teen mothers generally, the overall problem presented is that she is poor—and it is poor people of color who should not have children.

There are public health benefits of individuals of all ages having the resources and ability to plan births. According to the Guttmacher Institute, unplanned pregnancy is associated with delayed prenatal care, premature birth, and adverse physical and mental health effects for children. Eighty-two percent of teen births are unplanned. But, it is worth noting that teens are not alone in unplanned pregnancies given that around 50% of pregnancies in the United States are unplanned.

There are equally important public health concerns created from the societal shaming of young adults, particularly, mothers to whom the stigma is usually attached.  Such shaming, often makes young parents feel isolated and prevents them from seeking the assistance these young people and their children need.

It is important to empower – not shame – all young adults to take charge of their reproductive decision-making. This can be done by providing teens with evidence-based and comprehensive sexuality education in schools and creating a space for one-on-one discussions about sexual health in medical providers’ offices. Teens should be made aware that their health insurance plan may have to cover contraceptives with no out of pocket cost to them, even if they are a dependent on their parents plan.  Further, any discussions around sexual health and pregnancy prevention should be addressed to young men, just as equally as it does to women. This education should include LGBT youth who are often overlooked in these discussions with the assumption that they will not get pregnant. A recent study of New York City high school published in the American Journal of Public Health found that among sexually active teens, those who identified as lesbian, gay, or bisexual were almost twice as likely to report becoming pregnant or getting someone else pregnant.

Malone (mentioned above) is one of seven mothers spearheading the #NoTeenShame Campaign, which is designed to push back against Teen Pregnancy Prevention campaigns that are based on shame, and to offer messages of support and hope for young parents. There should be more campaigns like this. Instead of shame, we could equip adolescents with the education and resources they need to make decisions about their sexual health. Further, we can offer already parenting teens support that their life will go on; they can lead healthy and productive lives; and they can be good parents.

A Proposal to Preserve Reproductive Autonomy in the Face of Refusal Clauses

Emily Gillingham, Resident Blogger (’15, Michigan State University College of Law)

If a pharmacy or pharmacist won’t dispense medications related to reproductive healthcare, there is a public health interest in that information being publicly available.

Stories keep popping up in the news of women going to a pharmacist and being denied birth control, Plan B, or medications associated with abortion on the basis of the pharmacist’s moral beliefs. So-called “conscience clauses” that allow pharmacists to refuse to provide medicines to customers threaten lives, violate reproductive autonomy, and delay time-sensitive reproductive health decisions that women are legally entitled to make for themselves. NARAL has a great breakdown of refusal clauses in the U.S. here.

The idea that a pharmacist is permitted to inject his or her beliefs into others’ lives in such a momentous way is absolutely horrifying to me. In this context, I do not care what a pharmacist’s moral beliefs are.  The fact is, an enormous part of a pharmacist’s job is dispensing medications associated with reproductive healthcare. If a pharmacist’s moral system prohibits him from providing medicine to someone, either 1) he shouldn’t be a pharmacist, or 2) there needs to be an expedient way for the customer to work with a different pharmacist on-site to access that medicine. The status quo, where women can be denied access to medications that in some circumstances are life-saving because the pharmacist won’t do his job, is unacceptable.

A woman has a limited window to take Plan B, and she doesn’t necessarily have the luxury to spend her day going from pharmacy to pharmacy in search of one that will dispense it to her. The status quo assumes that she has access to transportation to get her to not just one, but potentially several pharmacies, and that she has the freedom to shirk responsibilities of work and home to do so.

If refusal clauses remain on the books, I propose the following in the interest of promoting women’s access to prescription and over-the-counter medicines that impact their reproductive health:

  1. Creation of a federally mandated online registry, open to the public, where all pharmacies register what medications they refuse to dispense on moral grounds, and whether the objection is pharmacy-wide or confined to one or more pharmacists.
  2. If a pharmacy refuses to dispense a medication on moral grounds, it must inform the woman where the nearest pharmacy is that will dispense it.
  3. Any pharmacist that refuses to dispense any medicine on moral grounds cannot be the only pharmacist on duty at that time if the entire pharmacy is not registered as a moral objector.
  4. Pharmacies that do not have any pharmacists on staff who have a conscientious objection to dispensing medication related to reproductive healthcare must post a sticker on the front door of the store noting that they will dispense all reproductive healthcare medications.
  5. Creation of an alternative distribution system for “refusal clause” medications where only one pharmacy is near the woman and that pharmacy refuses to fill them.

2 State Bars Have Done the Right Thing for New Moms Needing to Pump. We’re Making Sure the 48 Left Do Too.

Galen Sherwin, ACLU Women’s Rights Project & Lauren Hall, Legal Intern, ACLU Women’s Rights Project

When Kristin Pagano came to the ACLU after being denied accommodations to pump breast milk during the Illinois bar exam, we decided to take action on her behalf. After the ACLU of Illinois sent a letter to the Illinois Board of Admissions to the Bar, the board agreed to make nursing moms eligible for accommodations – such as breaks and a private room for pumping.

Then another new mom-to-be, Shahzeen Karim, came forward with the same problem — this time in Texas. After over 25,000 people signed a petition, the Texas board also agreed to change its policies.

Now a third case has popped up in Kentucky, where the Office of Bar Admissions has told Jacquelyn Bryant-Hayes that the single lunch break in the 8-hour test day should be sufficient for her, even though she informed the board that her baby will be just four weeks old on the day of the test and her doctor estimated she would need breaks every 1.5 hours. (Setting aside the law, something is just wrong with their math!)

The ACLU of Kentucky is appealing that decision. But obviously, this isn’t an isolated problem. That is why the ACLU and Law Students for Reproductive Justice are today announcing a nation-wide initiative to ensure that all nursing mothers who need testing accommodations during the bar exam are eligible to receive them, no matter where they are taking the exam.

Why does this matter?

The ACLU has long fought against discrimination based on pregnancy and breastfeeding in education and career advancement. Standardized tests and licensing exams, such as the LSAT, bar exam, medical boards, serve as important gateways to the professions, and they should be administered in a way that is fair to all test takers, including women who need some extra time and a place to pump.

Failure to pump on a regular schedule (typically every 2-3 hours) can lead to serious consequences, like pain and infection. If women are not allowed enough time to pump during these marathon tests, they will be forced take the exam through pain and distraction, risking their health, or will have to put off taking the exam altogether. Women should not have to choose between pursuing their career goals and their own health or that of their babies.

Thanks to the bravery of Kristin, Shahzeen, and Jacquelyn, we’ve already won changes in two states — and hope to win in a third. Now we need to win this for everyone. The ACLU and LSRJ volunteers are researching the accommodation policies in all 48 states left and will follow up with action against state legal licensing boards whose policies penalize nursing moms.

Here’s how you can help! If you (or someone you know) are planning on taking the bar (or another similar entrance or licensing examination) and need testing accommodations, or if you have already been denied those accommodations, we want to hear from you. Tell us your story!

And stay tuned for more opportunities to get involved as the campaign kicks into full swing.

This blog is a cross post from the ACLU website.