Beyond Abortion: Reproductive Justice Envisions More

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The human right to choose to have children or not to have children is a foundational principle in the vision of Reproductive Justice (RJ). Thus the increase in legal attacks on abortion rights and trans rights is understandably central to the current struggle for bodily autonomy by activists. When the Supreme Court’s Dobbs v. Jackson decision overturned Roe v. Wade in June, 2022, the issue of abortion once again exploded onto the national spotlight. The loss of federal protections for abortion was devastating, but in reality the anti-abortion movement had already successfully limited access for millions. As a result of TRAP (Targeted Regulation of Abortion Providers) laws, by 2022 six U.S. states were down to only one abortion clinic. As of today, 24 states have limited abortion, 14 of which have implemented near-total bans.

Mobilization after the fall of Dobbs was initially phenomenal. So-called “rage” donations infused abortion funds with millions of dollars (though there has been a subsequent drop-off). New abortion clinics opened in pro-abortion states, often near state borders. Urbana-Champaign’s Planned Parenthood resumed providing procedural abortions, and Equity Clinic, an independent abortion clinic, opened in Champaign. Carbondale now has three abortion clinics, up from a single clinic pre-Dobbs. And new organizations like Elevated Access stepped up as well, helping people travel to access health care now illegal in their home states.

The expansion of access to medication abortion (wherein people self-manage their abortion by taking the medications mifepristone and misoprostol) has been a crucial piece of the post-Dobbs effort to make abortion accessible to all. Multiple states have tried to limit access to abortion pills, some by invoking the 1873 Comstock Act banning using the postal service to mail “lewd” materials. Those efforts have not been successful. Recently published research found that medication abortion now accounts for 63 percent of abortions in the U.S., up from 53 percent in 2020. Researchers attribute some portion of this increase to the expansion of telehealth services and people’s ability to receive pills through the mail via organizations like Plan C and Aid Access. Furthermore, in election after election since 2022, voters have demonstrated their support for abortion access. As a result of all these efforts, the number of abortions in the US increased in 2023.

Reproductive Justice is About More Than Abortion

The active response to abortion bans nationwide has been gratifying and lends hope to the possibility of one day regaining federal protection of this human right for all. But being “pro-choice” is not enough. Even if we secured universal abortion rights tomorrow, it would not be enough. Focusing on abortion as a single, rights-based issue fails to address the myriad issues surrounding reproductive decision making and people’s lived experiences. As Audre Lorde said in a 1982 speech, “There is no such thing as a single-issue struggle because we do not live single-issue lives.”

Gathering in Chicago after a series of national and international conferences on global reproductive health in 1994, a group of Black women established the foundations of the RJ framework, which the partnership In Our Own Voice fittingly describes as “a transformational and grassroots-based movement for social change.” While bodily autonomy and the right to choose whether or not to have children are central principles, reproductive justice demands that we also work to create safe, sustainable communities for all. Reproductive justice is trans rights, safe housing, health care for all, environmental justice, freedom from gun violence, a living wage, and so much more. It is important that we recognize the work of activists and practitioners across the Urbana-Champaign area working on the many issues foundational to this powerful liberatory vision. As the director of Uniting Pride, Nicole Frydman, writes, “Reproductive Justice is interwoven and intersectional. It cannot and should not be separated from the ongoing work all marginalized communities are doing in the fight for freedom and equality.”

Birth Justice

A primary principle of the RJ framework emphasizes the right to raise children in environments free from harm, making birth justice a necessary and urgent corollary to the reproductive justice vision. Birth justice maintains that people who are pregnant, giving birth, or have just given birth are susceptible to harm in the current U.S. maternal/infant health context. These harms have led to increasing rates of maternal mortality. In Illinois, Black birthing people are three times more likely to die from pregnancy or birth-related complications than their white counterparts. “For decades, racism and social determinants of health have created and sustained unsafe environments for Black, indigenous, or people of color (BIPOC) people to bring forth new life,” says Isis Rose, local doula and co-founder of BIPOC for Better Birth. Rose points to poor access to prenatal care, reliance on pharmaceuticals, too many obstetric interventions, and surgical births as factors contributing to poor outcomes for BIPOC people.

Birth justice makes pregnancy and birth the starting point for conversations about healthy equity, reclaiming midwifery traditions across communities of color and other practical methods to build better parenting and birthing communities. As Rose states, “The solutions to the very real health and birth outcome disparities that BIPOC and gender-nonconforming pregnant and birthing people face lie in the very communities at risk.” Birth justice activists advocate for the creation of more support systems for pregnant and birthing families, including doulas, community childbirth education, comprehensive sex education and body literacy workshops, freestanding breast/chestfeeding clinics, community midwives, and hospital-based providers who provide shared decision making and provide evidence-based prenatal care. A freestanding birth center in Urbana-Champaign would be one important addition to our community’s resources. “We deserve pregnancies and births that are free from harm and trauma,” Rose concludes. “Our collective wellness depends on it.”

Dr. Tuyet Mai Hoang, a professor in the UI School of Social Work, is also focused on birth justice and the power of wraparound community perinatal support to ensure a healthier start for birthing parents and their infants. The wraparound model represents a grounded approach to understanding the needs of birthing parents, alongside their families and communities. “It’s not just about the health of individuals,” Hoang points out, “but also about the level of care, access to racial and trauma-informed providers, the efforts of local public health policies to tackle mental health challenges, and a community culture of care for families and children.” Care of this nature would provide expectant people with family-centered resources and social support aimed at enhancing well-being throughout the perinatal period. Hoang acknowledges the complex nature of individuals’ reproductive paths, understanding that we cannot detach the effects of personal, structural, and systemic influences from lived experiences. Her goal is to shed light on the unique obstacles faced by our community, as well as the enduring hope and resilience gained by pursuing reproductive justice liberation together with other groups committed to this work. She concludes, “I am humbled to work alongside and to amplify the voices of our community activists and stakeholders to advocate for reproductive justice and against various forms of systemic oppression.”

Liberated Communities

A rights-based approach to bodily autonomy is just one piece of the larger vision of reproductive justice. Birth justice calls on us to recognize and address the inequities underpinning the health and well-being of birthing people, especially marginalized birthing people, such as access to health care, housing, and transportation. By addressing these issues, according to Sabia Wade, author of Birthing Liberation: How Reproductive Justice Can Set Us Free, we can become liberated people within “liberated communities [which] can serve as spaces of purpose, advocacy, and also healing.”

Dr. Julie Laut has been a progressive community activist for nearly 30 years, guided at all times by a passion for learning and a desire to build strong, healthy communities.

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