Читать книгу The Movement for Reproductive Justice - Patricia Zavella - Страница 9

The Movement for Reproductive Justice

Reproductive justice is more than a term, it is a movement.

—NativeYouthSexHealth, tweet posted on November 7, 2014

When I interviewed “Lola,” a community outreach worker in a reproductive justice organization, she insisted on beginning by telling me her life story (in Spanish).¹ In brief, it was a heartbreaking narrative about crossing the US-Mexico border with a smuggler, without authorization. She had climbed the border fence holding a rosary, which caught when she jumped down and ripped off the tip of her finger, which bled profusely. With no options for seeking health care in the United States, Lola immediately returned to Mexico, where she was unable to disclose exactly how she was injured since the smuggler threatened to kill her if she revealed his identity. She recalled, “I think the worst part of the story was how the medical personnel treated me. The doctor said, ‘I don’t understand why you came from your town only to risk your life.’ He told me if my finger got infected, they would have to cut off my hand and maybe my arm or I might die. After the surgery, no one cared that I was crying and crying.” After a long period of recuperation with help from women she met in the border town, Lola reentered the United States without authorization and began working at various low-paying jobs. As an undocumented worker, she had no medical insurance, so she received no health-care services for a number of years. Lola was well aware that it was risky to seek contraception, and she became pregnant.² It was not until she landed a job as a community organizer with a nonprofit devoted to reproductive justice that she had regular access to health care. Over the years as her colleagues marveled about her strength and resiliency, she came to identify with Wonder Woman and has a collection of figurines on her desk. However, without a driver’s license she cannot board planes to travel out of state for her work. These experiences shaped Lola’s desire to continue working for reproductive justice on behalf of immigrants since she knows their struggles firsthand. We both teared up as she declared, “That’s why I have to do something big in this life because I didn’t die when I crossed.… And when we give talks about our reproductive justice work, we have to talk about everything we do because people without documents won’t qualify for anything related to health.”

Lola’s story illustrates the trauma, structural vulnerability, and struggles undocumented women experience on a daily basis.³ Her experience raises concern about why the right to health care seems elusive in the United States for women of color with low incomes. Lola’s story also illustrates how the reproductive justice activism that now grounds her daily life is different from other social movements since it views her structural vulnerabilities as an undocumented racialized woman with a low income as interconnected. This book explores how vulnerable women like Lola participate in a social movement that takes an intersectional approach and that claims that she has the human right to health care with dignity and engages her in a process of empowerment.

Women of color have been organizing on behalf of women’s reproductive health since the 1970s.⁴ The Black Women’s Health Imperative was founded in 1984, and soon thereafter other organizations such as National Latina Health Organization, the Native American Women’s Health Education Resource Center, and Asian Pacific Islanders for Choice were formed and eventually developed nonprofit organizations. These organizations later coalesced into the SisterSong Women of Color Reproductive Justice Collective in 1997.⁵ The term “reproductive justice” (RJ), a neologism that “spliced reproductive rights and social justice,” was coined in 1994 by a group of Black women who formed Women of African Descent for Reproductive Justice in Chicago.⁶ The national debut of reproductive justice as a strategy for building a movement of indigenous women and women of color occurred in 2003.⁷ SisterSong defines reproductive justice as “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.”⁸ This statement critiques the history of sterilization abuse and contraceptive experimentation on women of color—documented in scholarly work and exposed in the award-winning documentary No Más Bebés.⁹ This definition also insists on the right to the preconditions of health as well as access to health care.

Reproductive justice activists address multiple forms of reproductive oppression or injustice, ranging from women never receiving basic anatomy instruction to alarmingly high Black maternal mortality rates. In an interview, Laura Jimenez, executive director of California Latinas for Reproductive Justice, pointed out, “Reproductive justice is a struggle in opposition to what we call reproductive oppression, which all of our communities—the Latino community, African American / Black communities, Asian American communities, Native American communities—have been doing since the time of contact and before.” In a shadow report for the UN Committee on the Elimination of Racial Discrimination, the Center for Reproductive Rights, National Latina Institute for Reproductive Health, and SisterSong critique four dimensions of reproductive injustice, which include “lack of information about sexuality and sexual health; discrimination in the health care system; lack of access to sexual and reproductive health care; and poor quality of sexual and reproductive health information and services.”¹⁰

There is ample scholarship that analyzes various forms of reproductive oppression: Dorothy Roberts argues that there has been a sustained campaign to punish Black women for having children and expressing their concerns in ways that are unintelligible to health-care practitioners.¹¹ Arachu Castro and Virginia Savage, Rogelio D’Gregorio, Lydia Dixon, Iris Lopez, and Rebecca Martínez critique human rights violations through “obstetric violence” that health institutions perpetrate against women, especially indigenous women, including unnecessary cesarean sections as well as cultural insensitivity and racism through which women are pressured to become sterilized, take long-term contraceptives, give birth under traumatizing conditions, or forgo abortions.¹² Khiara Bridges demonstrates how the medicalization of social problems reproduces racial stereotypes and governs the bodies of low-income women of color.¹³ Alysha Gálvez analyzes processes of subjectification of Latina immigrants who are systematically directed toward medicalizing their births, conforming to particular regimens of prenatal care, and abandoning their own healthy practices.¹⁴ Lynn Paltrow and Jeanne Flavin document the hundreds of cases in which women, particularly low-income women of color, perceived to have deliberately harmed fertilized eggs, embryos, or fetuses, were subject to attempts to restrict their liberty.¹⁵ Flavin also documents the multiple ways in which American women who live in poverty or are incarcerated face stigma and even legal procedures in efforts to force them to become the “right” kind of mothers.¹⁶ Jennifer Denbow illustrates how the notion of autonomy and technological innovations mask the plethora of regulations and surveillance of women’s reproductive health and decision-making.¹⁷ Charlene Galameau argues that migrant women farmworkers’ poor reproductive health is rooted in poverty, with low wages, few benefits, hazardous work conditions (including sexual assault and pesticide exposure), and weak labor and safety regulations limiting those hazards, as well women’s double day, in which they perform domestic chores after their work days.¹⁸ The Brown Boi Project and National Latina Institute for Reproductive Health find that LGBTQ and gender-nonconforming, masculine of center, and trans people of color are often excluded from reproductive health care.¹⁹ Barbara Gurr argues convincingly, “medicine serves an imperialist purpose in the State’s double discourse of care for and neglect of Native people, and … the reproductive body is a primary site for this imperialism through the State’s exercise of biopower.”²⁰ Clearly reproductive oppression toward women of color takes many forms, depending on social context, and induces needless social suffering.

The causes of reproductive oppression range from institutional violence that subjects women to various forms of trauma from social workers, health-care practitioners, or religious leaders to discursive approbation by kin or friends for “inappropriate” behavior or inquiries into their personal circumstances, leaving women feeling judged. As the human rights scholar-activist Alicia Ely Yamin points out, “there may be no area where narratives of ‘sin’ and ‘transgression’ are more clearly embedded in policies and laws than sexual and reproductive health.”²¹ More chilling, conservative forces have increasingly waged a war on women’s reproductive and sexual rights in the United States. The conservative movement has curtailed abortion through legislation in states by targeted regulation of abortion providers, mandating pre-abortion wait times and viewing fetal ultrasounds, and pushing legislation for parental consent for minors seeking abortions.²² They also promulgate anti-abortion films, support bogus “crisis pregnancy centers,” introduce legislation regarding “fetal personhood,” and pass laws that ban abortion when embryonic cardiac activity can be detected even though women often are unaware they are pregnant at that point.²³ These are forms of “reproductive governance” in which various actors use “legislative controls, economic inducements, moral injunctions, direct coercion, and ethical incitements to produce, monitor, and control reproductive behaviours and practices.”²⁴

Reproductive justice advocates contest reproductive governance using a holistic approach. They advocate for communities free from state violence expressed through colonialism, neoliberalism, poverty, criminalization, or policies related to child welfare, environmental regulation, immigration, or education that impede women’s rights.²⁵ By including the right to bodily autonomy, reproductive justice critiques the politics of place, where access to health care as well as to parks and open space are linked to the ability to earn a living wage, afford healthy food and quality child care, and express spiritual and cultural traditions.²⁶ Advocates also make pointed critiques of “pregnancy crisis centers” that claim to provide reproductive health services but instead offer misinformation and discourage women from seeking abortions, often for religious reasons.²⁷ Reproductive justice advocates agree with Iris Lopez, who argues for changing conditions to enable women’s full reproductive freedom, so that “women and men have viable alternatives from which to choose, and that the best possible social and political conditions exist that allow women to decide, free from coercion or violence, if, when, and how many children to have.”²⁸

Most organizations using the reproductive justice framework are racially specific. There are, for example, Asian American women’s groups, Black women’s groups, groups that serve Latinx women, and so forth. Yet reproductive justice advocates work in impressive ways to honor solidarity and difference. The women involved in these movements support one another, they build coalitions, and they share resources, even though they largely remain organized within their racially or ethnically specific groups. This book explores how the women involved with these reproductive justice organizations frame their identities as they are influenced by this work and by these interconnections with women in other communities, and it also examines how they conceptualize and reframe the racist and sexist ideologies used against them by conservative politicians in their joint work for social justice. It argues that this movement, with its effective collaboration among like-minded groups all working toward similar goals, offers a model for other social movements.

There are over thirty reproductive justice nonprofit organizations in the United States (with one in Canada) that frame their work around intersectionality and human rights.²⁹ Most of them have small staffs and, as nonprofits, apply for funding from a variety of foundations and donors. I conducted interviews with staff and participants working in thirteen reproductive justice organizations or independent programs located across the United States that were founded at different times: Black Women for Wellness (Los Angeles, 1997), California Latinas for Reproductive Justice (CLRJ, Los Angeles, 2004), Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR, Denver, 1998), Forward Together (Oakland, 1989), Illinois Caucus for Adolescent Health (ICAH, Chicago, 1977), National Asian Pacific American Women’s Forum (NAPAWF, Brooklyn, 1995), National Latina Institute for Reproductive Health (NLIRH, New York and Washington, DC, 2002), Los Angeles Coalition for Reproductive Justice (Los Angeles, 1980), Strong Families Network (Oakland, 2005), Strong Families New Mexico (Albuquerque, 2012), Tewa Women United (TWU, Española, NM, 1989), Western States Center (WSC, Portland, OR, 1987), and Young Women United (YWU, Albuquerque, 1999)—see appendix A for information about the reproductive justice organizations with which I conducted research.³⁰ I analyze specific campaigns by these reproductive justice organizations to illustrate the movement’s dynamism.

Social movements are “groups of individuals who collectively challenge authorities over a sustained period of time, often using public means to express their grievances and resistance.”³¹ The scholarship on social movements often focuses on three different processes with which social movements engage—identity formation, the organization of protests (including their communication strategies), and policy advocacy—and it often ignores the struggles and activism of women of color like Lola.³² Reproductive justice advocates organize their share of mass protests—I happened to interview executive directors of NLIRH and NAPAWF, who co-organized a 2013 demonstration to push for comprehensive immigration reform as they prepared to leave for the DC protest—and they use varied forms of media.³³ However, the work cultivating long-term social transformation by reproductive justice activists is distinct from other social movements. This book explores the ways in which reproductive justice advocates characterize their movement as honoring solidarity and difference by sharing resources and supporting one another through particular struggles or campaigns, in ways that are generally unlike their collaborations with other movements, even as they simultaneously negotiate the challenges involved when members of different social categories approach issues with distinct perspectives.

In this book I propose that we analyze women of color’s empowerment using the analytic of poder (power) that signals the ability of structurally vulnerable people to develop skills or capabilities and aspire to better conditions or even wellness. I build on the anthropologists Ann Bookman and Sandra Morgen’s suggestion that empowerment begins when women “change their ideas about the causes of the powerlessness, when they recognize the systemic forces that oppress them, and when they act to change the conditions of their lives.”³⁴ This perspective suggests that empowerment connotes “a spectrum of political activities that range from acts of individual resistance to mass political mobilization that aim to challenge the basic power relations in society.”³⁵ Thus, “empowerment is a process aimed at consolidating, maintaining, or changing the nature and distribution of power in a particular cultural context.”³⁶

This approach to empowerment is helpful for analyzing the reproductive justice movement’s praxis, “reflection and action directed at the structures to be transformed,” especially related to youth empowerment projects.³⁷ Yet Bookman and Morgen’s notion of empowerment was part of the scholarship that highlighted working-class women’s activism in the late 1980s. Since then, we have witnessed some progressive change as well as unexpected social transformations that seem retrograde. What has activism by low-income women of color looked like since then?

During the Obama administration, there was ongoing activism related to opposing a well-funded conservative movement that successfully imposed restrictions on women’s access to abortion in the states.³⁸ Reproductive justice activists also agitated against the detention of unauthorized migrants and deportation policies by the “deporter in chief.” Actually President Obama had worked to decrease apprehensions and deportations of undocumented immigrants with established roots in US communities who had no criminal records and he issued an executive order on Deferred Action for Childhood Arrivals, which protected undocumented youth. Obama inherited a robust immigration-enforcement regime, as congressional funding for immigration enforcement had increased in the post-9/11 era. Between 2009 and 2016, his administration prioritized national security threats, noncitizens apprehended at the border, gang members, and noncitizens convicted of felonies or aggravated felonies, and his administration abandoned worksite enforcement.³⁹ Nonetheless, with a total of 12,290,905 deportations under Bill Clinton, 10,328,850 under George W. Bush, and 5,281,115 under Obama, state violence has had devastating effects in communities of color.⁴⁰ As Obama’s tenure ended, there was much unfinished organizing work related to growing class inequality, ongoing racial tensions particularly evident in voter suppression and the need for comprehensive immigration reform, and providing full access to health care through the Patient Protection and Affordable Care Act (ACA) regardless of legal status (critical for unauthorized migrants living in the United States), to name a few.⁴¹ The heightened political polarization made such efforts extremely difficult.

Increasingly health care is market driven for consumers rather than rights administered through social policy. The Trump political agenda represented a culmination and more transparent version of neoliberalism that entails a “massive disinvestment in families and communities.”⁴² Neoliberalism encourages individual responses to social problems and characterizes those who struggle, particularly people of color, as deficient and somehow responsible for their own misfortunes.⁴³ Under the guise of health promotion, subjects are exhorted to engage in healthy behaviors, reduce their risks, and consume appropriately, with the implication that noncompliance raises questions about whether they are taking responsibility for their own health, thus silencing the needs of the poor and justifying their exclusion from state-funded health care.

This book helps to shed light on whether reproductive justice activities implicitly advocate individual neoliberal as opposed to community health rights. The movement for reproductive justice has a long history of activism in which activists mobilize poder, multiple forms of capacity building that engage women in policy advocacy and culture shift on behalf of low-income women. We will see that empoderamiento (empowerment) is a complex process in which women form political subjectivity and embrace their identities as powerful women.