How Helms Censors Reproductive Healthcare

Anne Keyworth, Resident Blogger (’16, North Carolina Central University)

The Helms Amendment, enacted in 1973, placed restrictions on reproductive health organizations that receive US funding. It is supposed to permit reproductive health organizations to assist women with post-abortion care and abortion services in the instances of rape, incest, and risk of serious harm to the health of the woman. However, it has instead been interpreted by many US aid agencies as a complete ban on abortion services or equipment, and the results of this have been devastating.

Part of what the law has been interpreted to mean is that such agencies and their employees cannot engage in conversations about abortion, despite whether the procedure is legal in the given country or not. This effectively means that such agencies must censor the language they use and the conversations they may engage in with the women and families they serve. Furthermore, it has been so pervasive that it has even been attached as a condition to funding given to foreign country’s governments. For example, the United States granted Afghanistan $4.2 million for building democracy, under the condition that it agrees to the restrictions of the Helms Amendment.

One of the things I learned in my Constitutional Law class was that conditional grants being offered to states cannot be coercive, meaning that the consequences of not meeting the condition cannot be overly harsh and leave the state with no choice in the matter. Clearly, the same standard has not been applied to matters pertaining to international aid. Instead, the United States has continued to impose its political ideologies (specifically, the 1973 ideologies of the Senator who introduced the amendment, Jessie Helms – a man known for his anti-woman and homophobic beliefs) on those who accept US aid, and consequently on the women who approach such agencies when they most need unbiased, uncensored medical information; not American politics.

Censorship of maternal health and rights discussions pertaining to abortion are already pervasive in many countries, and this disproportionately impacts low income women and families in need of safe and legal reproductive health services. But many countries are seeking to expand their approach to maternal healthcare and are being stifled by the demands of the Helms Amendment. Nepal, for example, began implementing a plan to more comprehensively approach abortion care in 2004, and abortion services were made available in every district within the next five years. This was a much less restrictive approach to abortion that it had previously held. However, navigating the unclear requirements of the Helms Amendment led to restrictions on which agencies could fully implement the new law of Nepal.

The political restrictions the US is placing on countries who accept its aid act as a pervasive form of censorship, specifically related to abortion. Until this stops, abortion services will continue to be scattered and rare, and women in need of such services face unnecessary political obstacles in obtaining the medical care of their choice. Our politics has no business interfering with women’s medical decisions.

The Helms Amendment: Facepalm

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

Let’s talk about the late Senator Jesse Helms.  Senator Helms was the national treasure*who proposed at least ten constitutional amendments to ban abortion, voted against a Clinton nominee for assistant housing secretary “because she’s a damn lesbian,” who won reelection with racism, and who pulled a Todd Akin before it was cool when he “told an abortion-rights advocate that he would not allow an exception for rape in his antiabortion legislation because a rape victim could not become pregnant.”  He was basically your racist relative at Thanksgiving who talks about “feminazis.”

Enter the Foreign Assistance Act of 1961.  This act created and funded USAID, with the goal of promoting ‘social and economic development’ abroad.  When the Act was amended in 1973, Senator Helms’ amendment was included, which reads:  “No foreign assistance funds may be used to pay for the performance of abortion as a method of family planning or to motivate or coerce any person to practice abortions.”  Those of you playing along at home might be wondering what the issue is, since “family planning” is defined by the World Health Organization as including “use of contraceptive methods and the treatment of involuntary infertility.”  The most logical interpretation of the phrase is that it covers planning to prevent pregnancy in the first place.  After all, no one is advocating for abortion to be used as first-line contraception or for coerced abortions.  It turns out that the Foreign Assistance Act doesn’t define “family planning” at all, so USAID decided to interpret the Helms Amendment as meaning that “recipients of U.S. family planning assistance [are] legally prohibited from supporting abortion as a method of family planning using U.S. funds.”  In practice, it has operated as a total ban on funding abortion.  Even in cases of incest, rape, and danger to the woman’s life.  Even in parts of the world where rape is used as a tactic of war.  Even where USAID is expending resources to help women who were injured or sickened by botched abortions because they cannot access safe, sanitary procedures.

Is this an interpretation that Jesse Helms probably loved?  Yes.  Does the 1973 Senate vote of 50-48, primarily along party lines, suggest that this was the interpretation all along and the Democrats were not pleased?  Possibly.  But if USAID’s interpretation is what Congress intended, wouldn’t the statute have omitted “family planning” and instead read, ‘No foreign assistance funds may be used to pay for the performance of abortion or to motivate or coerce any person to practice abortions’?

Legislative action to change or omit the Helms Amendment has gotten nowhere.  Perhaps our efforts would be more impactful if we pushed USAID to interpret the Helms Amendment in the most obvious way- as barring use of USAID funds to promote abortion as first line birth control.  Intuitively, if the U.S. is committed to helping the people it serves abroad, it should do what is best for women’s health- and that sometimes includes abortion.

 

 

*NOT a national treasure

Marriage Equality and Reproductive Justice

SJ Chapman, Resident Blogger (’12, Northwestern University Law School)

In light of the news about the Supreme Court rejecting marriage equality cases, it might interest you to know how these cases intertwine with reproductive justice.

When they fought to uphold their bans against gay marriage, Indiana and Wisconsin framed their argument chiefly in terms of reproduction.  Marriage, the states argued, is a regulatory framework meant to incentivize fathers to help raise accidental children.  Since same-sex couples cannot procreate, there is no reason to grant them the right to marry.   The Seventh Circuit Court of Appeals found this approach laughable, reproaching the states’ reasoning in a must-read, highly entertaining opinion.

Notably in the opinion, the Court alluded to a central reproductive justice issue: abortion.  The Court reasoned that due to the likelihood of a married same-sex couple adopting a child, the number of abortions would decrease.  “Carrying a baby to term and putting the baby up for adoption is an alternative to abortion for a pregnant woman who thinks that as a single mother she could not cope with the baby.” (p. 22)

Behind this dictum is the principal that Pro-Life advocates can work towards their goal through marriage equality; rather than placing legislative roadblocks in the way of access to abortion, enacting marriage equality will naturally lead to fewer abortions.

When it comes to granting civil rights or violating reproductive rights to achieve the same effect, let’s hope legislators chose the former.

Politician Advocates Birth Control for Welfare Recipients

Elise Foreman, Resident Blogger (‘16, Emory University School of Law)

Stories depicting the regulation and subsequent criminalization of the poor are far too common, almost mundane, in a country that espouses the virtues of democracy and asserts constitutional rights in the drop of a hat. However, the recent kerfuffle in Arizona points to something even more sinister baked into America’s apple pie coating. Earlier this week, the state’s GOP vice president (rightfully) resigned his post after advocating for sterilization of the state’s Medicaid recipients. This cracker-jack reasoning was punctuated with the statement: “. . . if you want to (reproduce) or use drugs or alcohol, then get a job.” (Full story here). The debate over drug testing for government aid recipients has been dissected ad nauseum, and fortunately been struck down in the courts. (For a review of this issue, see The Huffington Post’s collection).

But this latest call for sterilization should cause hesitation in even the most conservative thinkers. In a political climate that still hotly debates abortion even 40 years following Roe v. Wade, these statements point to a dissonance in the reproductive debate. Certainly there is a difference between birth control and abortion, however the point remains centered over the control one has over his or her reproductive future. Individuals, by virtue of being human, claim the right to exercise complete autonomy over their reproductive choices; this right is not premised on his or her financial situation or employment status. Regulating the reproductive choices of an individual based upon his or her Medicaid status demonstrates that such individual should be disallowed of this inherent human right because he or she is in fact less than human. No person or entity should breach another’s bodily integrity, nor advocate for rules that do so. For once and for all, get the government out of these intimate decisions and focused on topics it should be discussing. I have a list.

Pregnant in a War Zone

Sasha Young, LSRJ Summer Intern (’16, Northwestern School of Law)

A couple of years ago a dear friend of mine had her dream wedding “back home” in Palestine. She’s now battling the Atlanta heat through her first pregnancy, and with the recent surge in violence in the Occupied Territories, I thought for the first time what it would have been like for her to be pregnant “back home.”  The Occupied Palestinian Territories are fraught with human rights situations. I’ve thought about many of the different aspects before, but before I imagined my friend, I had never really taken a reproductive justice lens to the conflict. Immediately, my mind jumped from sexual assault, to access to abortion services, to getting maternity care in a place where sanitary napkins were only recently removed from the list of blockaded items.

The implications for pregnant women are predictably scary. An investigation into the 2008-2009 siege in Gaza revealed horrifying stories of women walking for miles through heavy shelling to find safe places to deliver. Hospitals prioritize the injured, travel is nearly impossible, and physicians are overwhelmed by trauma injuries. One woman, Dalal, recounted her doctor shouting at her for putting the ambulance driver’s life at risk when she should have delivered at home. Another woman, Rula, recounted walking alone for more than an hour in active labor only to be turned away from the hospital because there were too many injured people and not enough staff. Another report found that between 2000 and 2007, ten per cent of pregnant Palestinian women in the Occupied Territories were forced to give birth while stopped at Israeli checkpoints. Of the 69 documented births, 35 babies and 5 mothers died.

Obviously Occupied Palestine is not the only place where women are pregnant and give birth under violent and dangerous conditions. Stories like these are undoubtedly repeated throughout Syria, Congo, Timor, and every conflict zone in between. The immediate trauma of violent conflict leaves practically everything else as “collateral damage” of war, but I suppose this is just a little known bullet point on a long list of reasons we need a sustainable solution to the conflict in Israel and Palestine.

The Changing Abortion Conversation in Latin America and the Caribbean

Sasha Young, LSRJ Summer Intern (’16, Northwestern School of Law)

I recently saw a film that caught me by surprise, “La Espera” (released in the States as images“Expecting”) by Chilean filmmaker Francisca Fuenzalida. The film is devoted to one night, when Natalia and Rodrigo, a teenage couple from Santiago, self-induce an abortion with Misoprostol. The film was released in 2011 to critical praise for great filmmaking and the courage to tackle the subject of abortion in a country with one of the strictest abortion bans in the world.

Earlier this year I traveled to Chile, the skinny country that lines the western coast of South America, with a bit of angst over what I would find. I wondered what a country that in the last 50 years had a socialist president, a revolution, and a dictator [who, despite his human rights violations, brought incredible economic development and one of the most oppressive abortion laws in the world] would actually look like. I’d heard stories from friends about their own botched Misoprostol abortions, and I’d read about little Belén, the 11-year-old girl who was raped by her mother’s partner and then praised by the former president for deciding to continue her pregnancy. What I found was a country where, although it’s not uncommon to see hormonal teens passionately rolling around the manicured lawns of el Cerro Santa Lucía or see street art cursing the bourgeoisie, the conversation about abortion is hard to find.

I worked in an abortion clinic in Bogotá, lived beside an abortion clinic in Mexico City, and marched to stop restrictions on reproductive rights in Atlanta. I’m from a little island where abortion is still illegal, but even there in Aruba, the conversation of abortion happens. So I was really excited a few weeks ago to hear a debate happening around new Chilean president Michelle Bachelet’s plans to introduce therapeutic abortion exceptions to Chile’s abortion law later this year. The controversial president is a physician by profession, a single mother of three children, and possibly made of steel considering the political risk she’s taking with this new initiative. Abortion is a controversial topic, but in a region with one of the highest rates of teenage pregnancy, where bad abortions are the leading killer of young women, and where criminal penalties for abortion disproportionately affect poor women, we have to at least have a conversation about what reproductive justice in our region looks like.  The winds are changing throughout Latin America and the Caribbean, and having an open and honest conversation is the first step to achieving equal access to tools that help us decide when, how, why, and if we want to parent.

 

Birth Control vs. Population Control, and Why it Matters

Grace Ramsay, LSRJ Summer Reproductive Rights Activist Service Corps (RRASC) Intern (’16, Smith College)

Earlier this month, I attended a discussion hosted by Population Action International, NARAL, and the Ibis Foundation, addressing the global gag rule and its effects on reproductive health worldwide.  Basically, the gag rule is a U.S. executive policy that prevents any countries receiving U.S. family planning aid from offering abortion services, even if the country wants to use its own funds to do so.  It was created under the Reagan administration – every Democratic president has since reversed it, and every Republican president has reinstated it.  It’s a clear anti-choice policy that has disastrous effects on family planning initiatives worldwide.

During the talk, the NARAL representative alluded to allying with environmental action groups.  When birth control advocates/family planning initiatives “go abroad” and team up with environmentalists, I tend to get concerned.  The language can quickly move away from the need for universal access to the variety of contraceptive methods and instead focus on how developing nations are “irresponsibly reproducing”.   So often I hear rhetoric like, Lower birth rates will put less strain on our natural resources! Or, We’re reaching our carrying capacity!  Such statements are especially misleading because the U.S. actually consumes more natural resources than developing countries.  I was pleasantly surprised that this talk kept its focus on ensuring the right to family planning for all women.

As a person who cares about RJ, I absolutely support the right to global contraceptive access and I also think it’s really important to take a nuanced look at the way we talk about population control in relationship to birth control access, in the light of the U.S.’s own eugenic history.

Let’s not forget that not one generation ago we were forcing sterilization upon disabled people, incarcerated people, and poor people, in an attempt to create a more “fit” American population.

Let’s not forget that in the 1970s, African American and Puerto Rican women were disproportionately sterilized without their consent.  Meanwhile, white women were campaigning for the right to birth control.

Let’s not forget that the United States knowingly sold the dangerous Dalkon Shield contraceptive to developing countries, after it was removed for sale in America.

Let’s not forget that the reproductive justice movement aims for the freedom to choose when and how to have a family (or not).   When we introduce anything else into the equation – even for the sake of “saving our planet” – it becomes coercive.  If we shift away from this concept for the sake of “saving our planet” we lose the voices that matter most: the people in the population.  And if replacement population rates become the end goal for contraception distribution, rather than enabling women’s agency and autonomy worldwide, we’re at risk of replicating our eugenic past (and present).  Population control efforts and RJ efforts may both create the same result (a lower population), but to me, intent is what matters most.

It’s the World Cup Again! Time to think about RJ.

Gavin Barney, LSRJ Summer Intern (’16, University of California, Berkeley School of Law)

I adore the World Cup.  I try my very best to spare my friends and loved ones, but I could happily talk all their ears off about the tournament all day without it ever getting old. And the fact that this year’s games are taking place in Brazil – the spiritual home of futebol – has made it all the more exciting.

However, given the ludicrous scale of this kind of global sporting event, some of the most important, fascinating, moving, and upsetting stories have taken place outside the newly built stadiums and team base camps. For example, with the collective eyes of the world trained on Rio de Janeiro and São Paulo in the months preceding the games, Brazilian citizens spilled into the streets to protest their government’s allocation of massive funds to stadium building at the expense of transportation, education, healthcare, and other vital services. Events like the World Cup or the Olympics give people around the world a unique opportunity to learn about the internal issues of the host nation because mainstream news outlets give the country more in-depth coverage than they ever would otherwise.

You might be wondering, well what does the World Cup have to do with RJ? Well, several articles have been cropping up about the effects the World Cup has had on sex work in host cities around Brazil. The tone and content of articles have varied widely, and while the influx of tourists and media has created an environment of heightened exploitation, it has also given some Brazilian sex workers an opportunity to be heard on a world stage.

Sex work is legal in Brazil, so long as the worker is over the age of eighteen, but according to the Huffington Post, the World Cup is expected to cause a marked increase in child prostitution in areas near the stadiums. The HuffPo article points out that this type of phenomenon is all too common and cites an expert writing on human trafficking at this year’s Super Bowl who wrote that events that attract huge numbers of (male) fans “could never not be breeding grounds for sexual exploitation.” Apparently, the last two World Cups also saw increases in child exploitation as high as 30-40%, and this year’s tournament will once again juxtapose the vibrant celebration of the games with the tragic reality of human trafficking. As advocates for reproductive justice –or any kind of social justice for that matter – this type of pattern is unacceptable, and the notion that it is just the-way-these-things-are needs to be strongly countered.

Elsewhere, in an altogether different kind of story, RT.com reported on a public pick-up style game of soccer played between professional (adult) sex workers and a group of American Christians on a street in Belo Horizonte. The “naked match” was organized by the Prostitutes’ Association of Minas Gerais to draw attention to sex workers’ rights and to protest prejudice and stigma. Above all else, these members of the “naked Brazilian forces” called for their profession to be treated like any other legal job. In addition to providing a refreshing take on the dignity of sex work, this event has produced some of the most striking images I have seen during the World Cup. I highly recommend that you take the time to look through them.

Ultimately, I’m not entirely sure what to take from these stories or how they should color my enjoyment of the actual soccer matches. Just as the World Cup itself is complex – simultaneously a bloated and exploitative celebration of excess and an event of pure joy – this small sample size of media coverage speaks to many more complicated issues than these journalists have the time or inclination to fully flesh out. But in the end, I suppose it is just more proof that there are very few things in this world that don’t lend themselves to some thoughts on reproductive justice.

Sterilization Abuse Isn’t a Relic of the Past

Candace Gibson, Resident Blogger (’12, University of Utah S.J. Quinney College of Law)

As many scholars have noted, laws that were passed to involuntarily sterilize those who were poor, those with disabilities, those institutionalized, and those deemed “sexually promiscuous” and others during the beginning of the century also impacted women of color.

In 1903, President Theodore Roosevelt began to fear “race suicide” or that “Yankee ‘stock’ …. would be overwhelmed, numerically and hence politically, by immigrants, nonwhites, and the poor.”

Latinas were impacted on the continental United States as well as in Puerto Rico during the first half of the twentieth century. U.S. policy promoted permanent sterilization in Puerto Rico through door to door visits by health workers, financial subsidies, and employers favoring sterilized women in the hiring process.

Things hadn’t changed much by the seventies.  In Madrigal v. Quilligan, it came to light that medical practitioners at Los Angeles County Medical Center coerced low-income, immigrant women into sterilization within hours of giving birth.  One plaintiff, Maria Hurtado, described her situation: “I was told through a Spanish-speaking nurse, that the state of California did not permit a woman to undergo more than three caesarean section operations, and since this was my third, the doctor would have to do something to prevent me from having another caesarean operation.  They did not explain or describe the tubal ligation, and it was later performed on me without my knowledge or consent.” When the case was decided in 1978, the judge ruled that the practitioners had acted in good faith and without intent to harm.

Latinas in California’s mental health facilities were also subjected to sterilization abuse because they were labeled feeble-minded or because their parents could not support them or for other arbitrary reasons.  However, these women shared similar characteristics: they were of Mexican origin, they had little access to education, and their families migrated back and forth to the United States. This story of abuse started in 1909 and lasted until 1979.

To this day, advocates are hearing stories of abuse and coercion when women are in the hands of the state for their care.

During this past summer, it was reported that 132 women incarcerated in the California prison system were forcibly sterilized between 2006 to 2010.  As you can imagine, many of the women were women of color.  In 2010, Latinas and African-American women made up 59% of the California prison system and these numbers are indicative of the national trend of low income women and women of color serving time in prison for non-violent offenses.  The providers who sterilized these women assumed that these women were repeat offenders or believed these women should no longer parent because they had multiple children.  Many of the women went in for various reproductive health care needs and were misled to believe that sterilization was their only option for treatment.  It is disappointing that these women were deemed to have no dignity or autonomy by their providers. It is more distressing that the mainstream reproductive rights movement has forgotten about these women even though correctional institutions are the second largest provider of reproductive health services in this country.

The situation of these women and their families reminds us that we are a long way off from the right to parent and the social supports needed to actualize this right for many persons in this country.

Do you know about the Helms Amendment?

Candace Gibson, Resident Blogger (’12, University of Utah S.J. Quinney College of Law)

Many of us know about the Hyde Amendment, but do you know about the Helms Amendment?  The Helms Amendment was passed in 1973 to the Foreign Assistance Act, restricting abortion funding abroad. Yesterday marked the 40th anniversary – here are the top 5 things you need to know about how it hurts women globally.

  1. Both the Helms Amendment and the Hyde Amendment are restrictions on abortion care that deny women at home and abroad the care they need.  Both were passed soon after Roe v. Wade became law.
  2.  The Helms Amendment attaches restrictions on abortion care to overseas federal funding.  It not only withholds access to safe abortion services but it also denies women information on abortion care.  Millions of women rely on U.S. funded programs in their countries for their reproductive health care.
  3. The Helms Amendment contributes to 47,000 deaths each year because women are forced to seek unsafe abortion services.
  4. Unfortunately, the Helms Amendment has also negatively impacted efforts to increase the use of contraception for women who would like to begin a contraception regimen after seeking abortion services.  Studies show that women are more likely to use contraception following abortion care when family planning services are offered at the same facility where they received abortion services.  Due to the Helms Amendment, women must find family planning counseling and services at another facility, lessening their ability to receive contraception.
  5.  Latinas in the developing world are greatly affected by the Helms Amendment because it deincentivizes efforts to decriminalize or legalize abortion care.  For instance, 18 states in Mexico have passed constitutional amendments that declare the sanctity of life since conception.  In these 18 states, women will not be able to get the care they need because they are less likely to have providers who are not receiving U.S. funding.

For more information, check out this factsheet by our friends at Ipas.