More Than Medicine. Jennifer Nelson
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community members on their boards.23 Many white feminists responded positively to criticisms made by women of color, although not without difficult conversations that often left women of color exhausted and frustrated. The feminist campaigns to protect legal abortion often kept abortion on the front burner of battles for reproductive rights and health care reform.
By the 1990s, women of color feminists in the United States, with historical links to the civil rights movement, New Left social justice campaigns, the welfare rights movement, and the Women’s Liberation movement, framed their struggle for reproductive justice for all women as a movement broadly associated with human rights. Loretta Ross, reproductive justice activist and historian of the movement, explained, “[W]omen of color activists demand ‘reproductive justice,’ which requires the protection of women’s human rights to achieve the physical, mental, spiritual, political, economic and social well-being of women and girls.”24 The demands of the reproductive justice movement are not demands for legal “rights” alone. Rather, demands hinge on associations between health promotion and the satisfaction of basic human needs. Ross, Sarah J. Brownlee, Dázon Dixon Diallo, and Luz Rodriguez, members of the SisterSong Collective, a women of color reproductive justice organization, clarified that “rights are born out of needs; rights are legal articulations of claims to meet human needs and protect human freedoms.”25 They further explained why a human rights framework is appropriate to help meet women of color’s particular political demands: “The United States lacks a sufficient legal framework that guarantees women of color safe and reliable access to health care; emphasis on individual civil and political rights neglects economic, social and cultural human rights.” They went on to point out that human rights ensure that legal rights are accessible: “The human rights framework challenges the United States to demand that economic, social and cultural human rights receive the same level of priority and applicability as that given to civil and political rights.”26
A human rights discourse moves the conversation beyond the dichotomy of the “right to choose” abortion or carry a pregnancy to term versus the absence of that choice to an understanding that real choices require economic, cultural, and social environments that ensure a real range of options. If a woman has the right to choose an abortion but she cannot afford it and federal Medicaid will not pay for it, does she really have a choice? Her choice might be reduced to self-abortion, going without other necessities to pay for an abortion, or carrying an unwanted pregnancy to term. What happened to her right to choose an abortion? Abortion is legal, but it is not accessible to many women. Women of color involved in the reproductive justice movement insist that government has an obligation to ensure an “environment in which policies, laws, and practices enable women to realize their reproductive rights.”27 A human rights frame insists on providing the “means” for meaningful choices—and real access to rights guaranteed by law.
While women of color activists have allied with the Pro-Choice movement, scholars of the reproductive justice movement point out that reproductive justice is not a “subset of the pro-choice movement.” Reproductive rights scholar Kimala Price asserts, “It is a movement in its own right; the difference is that intersectional politics are at the center of its political mission and vision. Intersectional politics informs its political agenda.”28 Rather than building a movement around demands for personal reproductive control, reproductive justice activists’ inclusive demands foster a coalitional politics across common interests. Maintaining abortion legality, ensuring abortion access, protecting and strengthening women’s access to various forms of birth control, educating and protecting women from reproductive abuses and population control, as well as fighting for an environment in which women can bear and raise healthy wanted children are at the center of the coalitional struggles of the reproductive justice movement. Other issues of importance are ensuring the reproductive rights of incarcerated women, ending gender and sexual violence broadly defined, and promoting sexuality education. Price also points out that reproductive justice organizations have organized with social justice movements not associated with reproductive politics or health care promotion; for example, in California, reproductive justice activists partnered with immigrant and civil rights organizations to defeat initiatives that would restrict access to voting.29
In the remainder of this book, the first chapter traces the emergence of the Neighborhood Health Center movement from the civil rights and New Left movements. Health care was fundamentally linked to the eradication of poverty and the social inequalities that sustained poverty. Neighborhood Health Centers built by these campaigns for broad health promotion that advocated economic, social, and legal equalities paved the way for today’s Community Health Centers, which are likely to provide important preventive health services as the Affordable Care Act is implemented in coming years. The health care movement that came out of the civil rights movement, however, also linked preventive care to addressing the lack of power held by the poor to craft solutions to their own problems. They believed that community health care could be used to mobilize people to fight against economic and social inequalities that produced cyclical poverty and ill health linked to factors such as lack of access to healthy food, clean drinking water, or adequate housing. Although not the first Americans to insist that the roots of ill health were not linked to disease per se, but rather to deep social inequities associated with race and class, those who built the first Neighborhood Health Centers and other community clinics were certainly successful in redefining health and health promotion in national conversations. Yet, while they made race and class central to these conversations, they did not emphasize inequities associated with sex, sexual identity, or gender.
In chapter 2 I recount the Seattle Women’s Liberation movement effort—organized by feminists in the University of Washington YWCA—to ensure that women living in Seattle, and traveling to Seattle from other parts of Washington State, surrounding states, and Canada would receive abortions in a safe and caring context. Washington State voters legalized abortion by referendum in 1970, making it one of a handful of states in the country with legal abortion before Roe v. Wade. Although nonresidents of the state could not legally acquire an abortion, many women still traveled for the procedure and needed assistance once they arrived in a strange city. University of Washington YWCA feminists organized the Abortion Birth Control Referral Service (ABCRS) to evaluate physicians willing to perform abortions and provide referrals to out-of-state abortion patients, women from rural parts of the state, and Seattle women who wanted an abortion but didn’t know whom to contact to obtain one.
Archival sources for this chapter include patient feedback forms provided by ABCRS to women to assess their abortion experiences. Volunteers at ABCRS used the feedback collected on the forms to appraise the performance of doctors, hospitals, and clinics providing abortions. Yet, these feedback forms also provide a glimpse into abortion patients’ feelings about their abortions. Women were provided with a space on the form to discuss their attitude towards abortion and whether it changed after the procedure. These rich responses resonate with Andrea Smith’s findings that Native American women’s responses to questions about their position on abortion do not fit neatly into a “pro-life” or “pro-choice” category. Smith’s article focuses on the attitudes of Native American women and other women of color.30 Yet, the ABCRS feedback suggests to me that many women’s positions on abortion did not fit into discreet categories. The feedback forms collected by ABCRS did not indicate the racial or ethnic identities of the patients, but given the racial and ethnic demographics of Seattle, it is likely that the majority of women were white. It is imperative that we listen to women’s actual “voices” to understand how they felt rather than presume that attitudes towards abortion are neatly dichotomized.
Abortion provision in a safe and caring context was only one of the issues Seattle feminists addressed. University of Washington YWCA feminists also created a feminist women’s health clinic—named Aradia after the goddess of the healing arts—to increase women’s reproductive and sexual autonomy. In chapter 3 I tell how Women’s Liberation activists founded Aradia and ran the women’s health center to provide contraceptive care, preventive care such as cancer screening, and information about sex, sexuality, and relationships. Seattle feminists were cognizant of differences among women, particularly on the basis of race and class, that contributed to different health and reproductive care priorities. In order to increase women of color’s access to reproductive health care, YWCA feminists founded a Third World Women’s Resource Center and an affiliated