Candace Gibson, University of Utah College of Law

*This post is part of a series written in support of Trust Women Week Silver Ribbon Campaign and the online virtual march from January 20-27. LSRJ is proud to partner with numerous orgs across the country – join the march by sending a message to your lawmakers today! And check back here throughout the week for more posts.

In May 2009, a 17-year-old girl in Naples, Utah, was pregnant.  She was charged with second-degree felony criminal solicitation to commit murder.  Why was she charged? She solicited a man to punch her in the stomach so that she would miscarry.  He accepted $150 from her, took her to the basement of his parent’s house, and kicked her in the stomach five times.  According to the young girl, who is now a young adult, she solicited the assault because her boyfriend threatened to break up with her if she did not terminate her pregnancy.  A juvenile court dismissed her case in 2009, but the Utah Supreme Court this past December reversed their decision.  They reasoned that an assault does not meet the statutory definition of abortion and now this young woman may face criminal penalties for this tragic incident in her life.

I don’t disagree with the Utah Supreme Court in saying that abortion as imagined by our state’s legislators is a medical procedure, although the term “medical” will most likely be co-opted by the Anti-Choice movement to exclude abortions achieved through pharmaceuticals (see the case of an Idaho woman who terminated her own pregnancy by ordering RU486 online and was charged  with a felony).  What I do disagree with is the numerous laws passed by state legislatures to restrict abortion services to the point that Roe v. Wade doesn’t make any impact in the lives of women who need it the most.  Remember what Justice Ginsburg said at the Aspen Institute in 2010, “If the court were to change its mind . . . the only women who would be truly affected are poor women. Because even at the time before Roe, women who wanted abortions could have a safe, legal abortion.”  The problem is, this great Justice has forgotten that most poor women still can’t have abortions because of the Hyde Amendment.

This young woman in Utah should have had the right to decide to be a parent, to give her born child up for adoption, or to have an abortion without emotional abuse from her boyfriend or having to deal with the heinous consequences and obstacles of laws that ultimately regulate abortions out of existence.  As the Guttmacher Institute said in their awesome video, “There will always be women who need abortions.”

Susy Prochazka, Thomas Jefferson School of Law

Thomas Jefferson LSRJ regularly hosts a “Dinner and a Movie” night once a month, where we indulge in pizza, nachos, and popcorn, watch RJ-related films, and have a faculty-led discussion where we delve into the issues raised in the film.  In the past, we have watched such heavy films as “If These Walls Could Talk,” “Losing Isaiah,” and “Vera Drake.”  In the spirit of Halloween, we are planning to show a “scary” RJ movie, showing the dire social consequences of the lack of access to education about contraceptives and STIs.

Last week, ten of us watched “Citizen Ruth,” a 1996 film that satirizes the conflict between the Pro-Choice and the Pro-Life camps. The film opens with Ruth getting arrested for huffing spray-paint in an alley.  Ruth is an addict, makes regular appearances in jail, and has been declared an unfit mother by the state four times over. Upon her arrest, Ruth learns that she is pregnant again; the judge threatens to charge Ruth with “felony fetal endangerment” unless Ruth obtains an abortion.  Ruth is unsure of what decision to make when faced with this puzzling offer – she is portrayed as a hapless drug addict, uneducated about the politics of the abortion debate, yet very quickly she gets thrust right in the middle. Ruth encounters Pro-Choice and Pro-Life individuals, inadvertently becoming the symbolic center of the struggle between the two groups, as they both vie for Ruth to act according to their particular beliefs.  Both sides attempt to sway Ruth with monetary incentives, both offering $15,000 to secure Ruth’s promise to either continue or terminate the pregnancy.

Ruth is learning about her right to freely govern her body, but she is simultaneously tempted by the money, which is more than she has ever seen. However, before a decision can be made, Ruth suffers a miscarriage. The movie ends shortly after, with Ruth securing $15,000 and sneaking away from oblivious protestors of both camps, who do not even notice that the subject of their vehement shouting has absconded the scene.

Following the movie, our faculty advisor started off a great discussion, asking us to think about what it means to truly believe in an individual’s right to parent, a central tenet to the RJ movement. In the film, the State has declared Ruth to be an unfit mother, thereby intervening in a woman’s right to raise her children. This presents a “slippery-slope” dilemma: at what point may the State intervene and tell a woman she may not have any more children? May the State order a woman to terminate her pregnancy when she has proven to be incapable of raising the children she already has? When has a woman reached such a point – what standards must be met?

We also discussed the paradox presented by the judge’s threat to charge Ruth with felony fetal endangerment, which he later offered to retract if Ruth obtained an abortion: why is endangering a fetus illegal when the potential harm is caused by illegal acts such as drug use, but is legal when the woman is exercising her right to have an abortion? Should there even be a legal or noticeable difference?

And what about the politics of it all? What are the moral implications of Pro-Choice and Anti-Choice members actively attempting to buy Ruth’s choice? Does Ruth lose her freedom to choose when money enters the picture? What does Ruth’s lack of education about the politics of the abortion debate and her right to choose say about the struggle between the two camps? What are the ramifications of this depiction of lack of education say about the movement? Is the debate limited only to the socially elite who can afford to participate? Do the uneducated and the poor have any say in the debate – or is it restricted to the stereotypical rich, white woman?

While we were not able to reach any clear, defining answers to these questions raised by the film, it was a great discussion that allowed everyone to express their opinions on relevant RJ issues. I highly recommend other chapters do such an event, as new and old members can comfortably debate and express themselves in a casual environment. It’s a fun and low-key event that is great for education, building cohesion and friendships between chapter members, and of course, there are nachos!

This is the second in a series of reflection posts by our outgoing (and inaugural) class of Reproductive Justice Fellows. Click here for the first entry and visit the RJFP page for more information about the program.

Has it already been a year?  Although the bar exam seems like ages ago, it feels like I just moved to D.C. to start my LSRJ fellowship.  My placement was with the National Health Law Program (NHeLP), an organization that works to further access to quality health care for low-income individuals and underserved populations, primarily by providing legal expertise on Medicaid.

Looking back over the year, I am amazed at how much I learned.  When I started at NHeLP, I knew next to nothing about Medicaid.  There was so much to learn – and I was almost certain I would never be able to grasp the complexities in this area of law by the end of my fellowship.

Then, at around six months in, things began to click.  For the remainder of my fellowship, I actively contributed to policy strategy, and I finished research in almost half the time than when I started.  It was also around this time that I began feeling comfortable training and presenting on Medicaid coverage of reproductive health care.  Better yet, others at outside organizations began calling me for advice and input on issues around Medicaid and health care reform.

Now as my fellowship comes to an end and I prepare to transition into my new role as staff attorney, I am looking forward to helping the new LSRJ fellow learn the ropes.  I am incredibly grateful to LSRJ and am proud to have been part of the inaugural fellowship class.  Thank you LSRJ!

Davida Silverman (’10, CUNY School of Law)

2010-2011 RJ Fellow at the National Health Law Program

Last week, the Speaker of the House announced plans to introduce legislation that further restricts abortion access in the new health care plan. Last week, the Philadelphia District Attorney, Seth Williams, indicted Dr. Kermit Gosnell on eight counts of murder in the deaths of seven infants and a Bhutanese refugee. These deaths occurred in a clinic that provided abortions to mostly impoverished women, women of color, and immigrant women. The incredibly unsanitary conditions of the clinic, and the horrendous way the women seeking abortions were treated (or more accurately, not treated at all) are described here.

I believe (as do many others) these two events are connected. The events demonstrate that when abortion is used as a pawn in a political (democratic v. republican) chess game, the health and lives of impoverished women, women of color, and immigrant women are put at risk. Even if the “No Taxpayer Funding for Abortion Act” goes no further, abortion has been more deeply entrenched in the political discourse as a “sacrificial lamb” that can be used to appease a specific group of people.

Reproductive justice activists and lawyers must not only fight against the many barriers women in marginalized communities face in accessing reproductive health care, but also must focus on ensuring that the reproductive health care women receive when (if) these barriers are overcame is safe, effective, and comprehensive. I kept this post short in the hopes of fostering a discussion about what lawyers, law students, community folk, and other RJ activists can do/are doing in response to the existence of clinics like Dr. Gosnell’s.

Lara Shkordoff

Last week, I had the opportunity to participate in a really interesting webinar about Emergency Contraception with Dr. James Trussell, a leading researcher in contraceptive efficacy and contraceptive methods. The webinar was focused on updates on research about emergency contraception and some of its reasons for failure, as well as information about the newest EC option, Ella, which was recently approved by an advisory committee to the FDA. Much of the information presented related to the participants of the studies that were done to calculate the effectiveness of EC.

One of the most interesting aspects of the presentation was actually the question and answer period at the end of the presentation.  The main audience of this webinar turned out to be health care providers and medical professionals who counseled women about emergency contraception options across the country and even Canada. The questions that they asked Dr. Trussell reminded me that there are so many unique situations that people can find themselves in. Some expressed concern about their patient’s ability to access medication that is not available over-the-counter in rural areas, being able to afford emergency contraception without insurance, and whether using emergency contraception could interfere with breast-feeding. It was great to hear so many people who would be able to provide them with accurate information in a non-judgmental setting.  Since the announcement of the FDA’s consideration of Ella, the amount of misinformation represented on blogs, websites and news reports reminds me how important it is to have accurate, fact-based information from professionals readily available. It hopeful to know that many of the people giving advice and counsel to young women have taken the time to educate themselves on the facts of emergency contraception from one of the leading experts in the field.

Jeryl Hayes

As most of you heard the Nelson-Hatch amendment failed in the Senate this week. Many reproductive organizations, among others, launched a visible grass-roots campaign to make sure that this Stupak-like amendment was not included in the Senate’s version of a health reform bill. Some were critical that pro-choice groups did not work proactively enough to defeat these measures before the debate entered the public arena.  I had informal discussions with friends regarding the matter. On one hand, I am frustrated that advocates for reproductive justice are once again in a reactionary position (defeat Stupak-Pitts! defeat Nelson-Hatch!) rather than proactively advocating for expansive and inclusive reproductive justice measures. I am also concerned that other important reproductive justice issues are being ignored in the public debate. What about affordability, prevention, and immigrant rights?   

On the other hand, I do not think it is fair to place all responsibility and blame for the passage of the Stupak amendment on just two organizations. I have heard some say that advocates hoped to work quietly behind the scenes to avoid turning the federal health reform debate into an abortion debate. What is the appropriate role for reproductive health, rights, and justice organizations? What can we learn from the Stupak-Pitts and Nelson-Hatch advocacy efforts? How can we work better moving forward?

Jennifer Smith

Because most participants in the insurance exchange would receive some federal subsidy (the New York Times reports that “anyone earning less than $88,000 for a family of four — four times the poverty level — would be eligible for a subsidy under the House bill”), insurers in the exchange are strongly incentivized to cut abortion coverage from their offerings. The result?  A de facto ban on abortion coverage within the insurance exchange – a ban which would affect even those who don’t receive federal health subsidies.

There are many stories to be told here, but I’ll limit myself to just a few. First, even if we’re not losing the culture war, Democrats apparently think we are. Disturbingly, 20 Dems with pro-choice track records voted in favor of the Stupak Amendment; at least 11 of them are in vulnerable positions for 2010, and they presumably believe that a vote for reproductive health is more dangerous than a vote for health reform. (Nate Silver points out that voter polls indicate the contrary.) The Left collectively needs to grapple with some large questions around the future of RJ and the Democratic Party.

Our second story: Congress hasn’t simply sold out women’s health; they’ve specifically sold out the health of low-income women. As RJ activists, we should be particularly attuned to intersections of economic justice and reproductive health, and to the ways in which the Stupak Amendment furthers the economic stratification of abortion access. (more…)

A recent NY Times pair of articles focuses on the human, medical, and social costs of implanting multiple embryos via IVF and IUI, resulting in a spike in both multiple births and a litany of health risks to these babies. The articles, and ensuing barrage of public comments, can be read here: “The Gift of Life, and Its Price,” “Grievous Choice on Risky Path to Parenthood.” In IUI, parents who conceive multiples also face the decision of whether to terminate some fetuses using the procedure termed “selective reduction”. IUI is much cheaper than IVF, and more readily covered by insurance, but the chance of success is lower and ability to control multiples non-existent.

The most startling assertion in the IVF article was an analysis by reproductive health experts and providers explaining the financial and business motivations on providers to disregard medical guidelines by implanting more embryos than may be safe for mom or her babies. Fertility practices want to boost their success rates and attract clientele in a highly competitive and lucrative medical field, and parents apparently think that implanting more, or rejecting selective reduction in IUI, will secure greater chances of a viable pregnancy and satisfy their emotional or religious needs to a degree that makes the risks worth taking. If the underlying reason for the increase in multiple implantations and subsequent births is really a symptom of our profit-based medical system, some suggest we utilize insurance schemes as a way to address this issue. If insurance companies are required to cover IVF, whereas many now only cover IUI, they could regulate the financial incentives by only reimbursing doctors for single implantations. (more…)

I have been interning at LSRJ for over a month now, and it has been a great learning experience, even though much of what I have learned makes me simultaneously sick to my stomach and incredulous that such egregious violations of human rights can still go on in this day and age. I attended LSRJ’s first Summer Networking Lunch last week at Legal Services for Prisoners with Children (LSPC), a legal services and advocacy organization that, as the name implies, works with incarcerated parents, with an emphasis on prisoners from Communities of Color and low-income communities. Most of us are aware that in the U.S., incarceration disproportionately impacts People of Color, the poor, and other marginalized populations. However, it was not until this Networking Lunch that I began to more fully realize that the harms done by incarceration unjustly impacts, not just the individuals who are imprisoned – many of whom are sentenced for non-violent drug offenses – but also their families and communities. Those sentenced to prison are taken well outside of their communities – presumably to take them away from the “influences” that made them turn to crime in the first place – where they are separated from their loved ones and are unable to maintain ties to their community that, if preserved, would perhaps make reintegration into society much more successful. This is especially hard for prisoners with children; even though a great many of those incarcerated are imprisoned for non-violent drug offenses, incarcerated parents are regularly disallowed from even basic physical contact with their children for more than a year. They also have very little time to even see their children, as those looking after their kids must take time off of work and expend resources they probably don’t have to bring the children to the prison, where there is no real place for kids to be comfortably. Families, and therefore the community at large, are further ripped apart if family members of prisoners (often grandparents of those incarcerated) who are perfectly able and willing to take care of these kids are disallowed from doing so because of laws that restrict the placement of children with ex-felons – even if the felonies were for crimes completely unrelated to children and were non-violent and occurred many years ago. Though it might seem reasonable at first to disallow placement of children with felons, in many cases, it seems that placing children with family members who love them and their incarcerated parents, who will work to keep the family together and who are invested in the success of these kids, is much better than taking children completely out of their community and placing them in homes at great distance from all of their social ties, and often into communities that in no way resemble the ones from which they came. In this way, many communities not only lose members due to incarceration, but also lose a lot of bright kids due to the repercussions of the incarceration of their parents – and this loss of human capital is often permanent.

-Tina Sinha

When I tell people that I am interested in both criminal justice and reproductive justice, they often look at me askance, or raise their eyebrows.  Don’t these two fields clash a lot, they ask? Well, yes, in some ways. But women’s health advocates and prison reform activists have more in common than many might think. Beyond the fact that there are more women in prison than ever before because women’s incarceration rates have skyrocketed since the beginning of the so-called “war on drugs,” women’s lives are effected by high prison rates in multiple other ways. Feministing‘s Samhita draws the connections in her most recent (and last) post on the Nation’s Passing Through.  One reason, she says, that the women’s health and anti-incarceration movements need to start talking to each other is that women’s STD rates are exponentially higher in communities that have the highest incarceration rates, even in women who are not engaging in so-called risky behavior. A recent Washington Post Op-Ed has more:

One obvious reason is that conversations about sexual behavior, race and sexually transmitted infections remain taboo. Another is that the incidence of many STDs, particularly HIV, is concentrated in poor, segregated neighborhoods that are characterized by high rates of incarceration. Inner-city populations of African Americans and Latinos account for almost two-thirds of the 2.2 million Americans in prison nationwide, and two disturbing trends are increasingly present in these communities.  

One is the shift in the patterns of marriage and courtship that result when so many men are removed from a community. The other is an increase in the number of “multiple concurrent sexual partnerships,” in which individuals are engaged in sexual relationships with more than one person at a time. In many communities, when one sexual partner is imprisoned, the person left behind chooses another partner. When widespread, this behavior creates an efficient, effective pattern for introducing and maintaining an STD through a network of sexual relationships. 

As the Op-Ed, written by two public health academics, later notes, we as a society ignore the fallout of our addiction to incarceration at the peril of our health — and particularly of women’s health.  But the op-ed gets something seriously wrong:  it suggests that we can place blame for the high rates of HIV and other STDs at the feet of the women left behind when their men are dragged off to jail. We shouldn’t be placing blame on the community at all. And as Samhita rightly notes, it’s not quite so simple:

High rates of incarceration has such deleterious side effects that we have only begun to understand. Beyond dismantling and shaming entire communities, the onslaught of emasculating practices via police has created greater threats to masculinity, which backfire in the form of unsafe sexual practices, multiple partners and in its extreme form, rape.  

It may be true that, as some claim, the feminist/women’s health movement fanned the flames of the incarceration fury — particularly in the 1990s with the push toward victim’s rights. But it’s time to move beyond the divisive past and start to work from our commonality — that women and men, both inside and outside the prison walls, deserve better.