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.

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.

Reproductive Justice as Self-Determination

Ruth Dawson, Resident Blogger (’12, Emory University School of Law)

A report recently came out about the conditions of women members of the Revolutionary Armed Forces of Colombia (FARC), the country’s biggest rebel group.  Though there is a “veneer of [gender] equality” in the organization, the report tells horrific stories of women, including young teenagers, forced to receive contraceptive shots and forbidden from having children.  Perhaps most sickening are the accounts of FARC women being forced to have abortions, or losing their infants to infanticide, in the instances when they did become pregnant.

But I am not disgusted by the bare fact that the women had abortions or used contraception.  Instead, as a reproductive justice advocate, I am most deeply troubled by the way these women were stripped of agency.  Forced contraception, forced abortion, and – not unlikely – forced sex, all strip women of self-determination.

Reproductive justice encompasses far more than the affirmative right to access birth control or abortion, as many opponents seem to believe.  Instead, RJ is about all people deciding if they want to have children, and if so, when and how to have and raise them.  Reproductive justice represents a broad universe of control over one’s own body, and over one’s self.  And that control goes in both directions.  The key to reproductive justice, then, is not just that people are using birth control, or that people are having abortions.  Rather, it is that individuals are making these decisions, unforced and uncoerced, for themselves.

Channeling Human Trafficking Survivors

Amanda Shapiro, Resident Blogger (’15, Brooklyn Law School)

New York announced that it will be among the first to create specialized courts for human trafficking and prostitution.  This move is indeed a step in the right direction.  Human trafficking has achieved celebrity status in human rights reform – likely because there aren’t many sympathetic defenses to “modern slavery” (e.g.,“Oh, whoops, I just forgot to pay my cleaning lady while I kept her in my basement for the past eight years” doesn’t fly too well in federal court).

However, the path to justice for victims of sex trafficking is complex.  We know (as The West Wing aptly noted) that no little girl says, “I want to be a prostitute when I grow up.”  And yet, the way the criminal justice system treats prostitutes would lead anyone to improperly deduce this motive.  This inference is so strong that it trickles into punishing children who are forced into sexual exploitation for money (most or all of which they don’t get).  Somehow, states find no problem in punishing children for prostitution, while contemporaneously declaring their inability to consent to sex (in statutory rape), their inability to enter into a contract (in contracts), and their inability to work (in child labor).

Proving that human trafficking is afoot requires “force, fraud, or coercion” – this burden does not seem high, but in practicality can be insurmountable.  “Pimps” use a grooming process (like that of pedophiles) for both children and women.  This tactic can even lead to victims defending their trafficker.  Despite New York’s laudable step, the trafficking courts will continue processing prostitutes through the criminal system (aka prosecuting them). Courts would do well to remind themselves, in considering “force,” that girls grow up wanting to be doctors, lawyers, teachers, etc., rather than an object of commercial sexual exploitation.

Ahoy, ladies!

Ash Moore, Resident Blogger (’14, University of Oklahoma College of Law)

If you had three tries to guess “closest place to get an abortion,” I bet “Dutch boat” wouldn’t fly out of your mouth. But that’s exactly where Moroccan women can turn starting this week. The “abortion ship” will dock in international waters, keeping it legal despite the fact that abortion is outlawed in the Muslim-majority country.

With all the bad news coming from the American abortion front, it’s nice to see a shining beacon of hope bobbing in water. Last year, 92 restrictions on abortion were passed in the U.S. and with a new state Department of Health report revealing that abortions in Ohio dropped 12% in the wake of new, restrictive laws, there may only be more to come.

In the same study, we learn that most women who had abortions were unmarried, poorly educated, and under 25. I don’t know about you, but it sounds like a raw deal for a kid to me. All these people hollering about “best interests of the child” should really look at the mother’s situation and ask themselves what kind of chance for success a baby would have if the mother brought it to term.

I’ve known several women who had abortions not because they wanted to, but because they felt it was in the best interests of the fetus. Not just because they didn’t have the resources to take care of the baby once it was born, but also because they didn’t have the resources to care for the fetus. I don’t know what I would want to do if I turned up pregnant tomorrow (other than repent because it’s obviously the second coming). I do know I have a personal objection to abortion despite my unwillingness to deprive another grown woman of the option. But I also know that if I tried to have a baby now, it would hurt me and the baby.

All these right-to-lifers go up in arms and yell about adoption. Ok. How many kids have you adopted? How many have the people you know adopted? Now do you think that’s enough to cover all the kids already waiting for a family? I’m a law student, not a mathematician, but even I think the numbers don’t add up.

The organization running this abortion ship gives me hope. Hope that rationality and compassion will win out in the end. Hope that every woman will one day have access to all the reproductive health care she needs, no matter how controversial it is. Hope that America will stop passing draconian laws and nominating political candidates who believe women’s’ bodies can protect themselves from pregnancy after “legitimate rape.” This is my hope. Even if modern day pirates of the Robin Hood tradition have to take to the high seas to fight for what’s right.

The Repro Rundown

In the state with the highest infant mortality rates in the country, a star OB/GYN loses his position on the Mississippi state board of health because he is pro-choice.

Another double standard in support of Viagra by anti-choice legislators, and they’ve even got a catchphrase lined up: “Viagra, that wonderful drug that helps create life.

In Texas, there is a legislative struggle to keep Planned Parenthood in the state’s Women’s Health Program, more on the current developments here.

A trans-gender woman of color is charged with second degree manslaughter after her attacker died in the physical altercation.

Blogger Shark-Fu weighs in on Missouri’s Don’t Say Gay house bill that could bar schools from discussing lgbt issues and also keep student orgs like the  Gay-Straight Alliance from being recognized.

Have you heard of Chen Guangcheng?” a Chinese Human Rights attorney escapes from house arrest when imprisoned for his activism against forced abortions and sterilizations.

Working for RJ in a Long-Term Conflict Setting

Questions and answers on International Women’s Day with LSRJ’s founding executive director, Cari Sietstra, JD, Stanford ’02.

What do you do?

Since leaving my post as the founding executive director at LSRJ – a great job, if ever there was one – I’ve been an “independent consultant specializing in reproductive health and justice.”  Over time I’ve developed expertise in long-term conflict and crisis settings. 

Wait, what does “consultant in reproductive health and justice” mean, exactly?

While it could mean a number of different things, for me it means that for the past six years I’ve pitched potential projects to donors and then partnered with non-profits so the donor’s money is tax deductible and my work is done under an institutional umbrella.  I have a great deal of autonomy and flexibility.  I am based in the US but spend time each year in Thailand and sometimes Burma.

Most of my projects are located on the Thai/Burma border and focus on refugees, undocumented migrants, or internally displaced persons.  My colleagues and I are particularly interested in reducing harm from unsafe abortion, expanding access to emergency contraception and long acting reversible contraceptives like IUDS, and promoting adolescent reproductive health.

What does reproductive health look like where you work?

Basically, eastern Burma has been a conflict zone for more than sixty years.  So reproductive health indicators and maternal mortality rates are by far the worst in Asia and among the worst anywhere in the world.  Unsafe abortion and post-partum hemorrhage are the leading causes of maternal mortality.  There are extensive barriers to achieving reproductive justice including lack of family planning supplies and education, legal barriers to safe abortion, a lack of trained medical providers, early marriage (sometimes coerced or forced), and lack of access to basic healthcare and adequate nutrition.

For an in-depth discussion of reproductive heath in this area of the world, please check out the report Separated by Borders: united in need that our team just published with Ibis Reproductive Health.

You mentioned a “team” – who do you work with?

I am lucky to work with a team of exceptional women who include a doctor-researcher, a nurse, and the wonderful Maggie Hobstetter, another LSRJ alum. Maggie first came out to the border as an international legal intern for LSRJ in 2007.

Maggie and I have led a safe referral pilot project to connect undocumented Burmese migrants in Thailand with a safe, legal abortion.  (Abortion is legal in some cases in Thailand.)

Do you use your law degree in your work?

I do, especially on projects like the safe referral pilot, where we’ve trained Burmese and Thai health care providers on Thai law – what it is, how it’s interpreted and implemented, how to recognize women who qualify for legal abortions, etc.

But I don’t use most of the “hard” advocacy skills I practiced in law school.  My colleagues and I try hard to avoid any direct advocacy or persuasion.

We don’t tell the Burmese medics we work with that they “should” support legal abortion or that they “should” give unmarried couples family planning.  What we do is give them information that legal abortion is very safe (this is often absolutely new to them).  We share human rights documents that uphold the rights of both married and unmarried people to access reproductive healthcare.  But when folks say things like, “I think abortion is a sin,” or “unmarried couples should not have sex,” we don’t push back.  As outsiders, that isn’t our role.  Our role is facilitate difficult conversations about controversial issues in reproductive health and to empower local advocates with information and support.

Do you feel like that attitude reflects a reproductive justice framework?

I do.  I think the best way I can do work in a long-term crisis setting as a well-educated foreigner is to respect the values and priorities of the people I work with while still offering up information on a full-range of reproductive health technologies and rights.

You can’t just walk into an isolated, conflict-affected area and be all, “Hi, I’d like to give you some EC, IUDs and safe abortions. And can I talk to your teenagers too?”  People would be like, “Hi, crazy white lady.  Thanks but no thanks.”

It’s taken years of work to build the strong trust we have with our local partners.  And to do so we’ve tried to be clear that while we are very willing to push boundaries in terms of the work we do, we will always try to meet people where they are on these issues and respect profound differences of opinion.  It’s been an amazing way to create what we hope will be lasting social change.  Our motto is: “Baby steps.  It’s all about baby steps.”

We understand that in a long-term conflict setting we will not be able to fix the overall health situation until the core issue of the conflict itself is resolved.  But small interventions can make huge differences in the lives of women, families, and communities.