Women of Color & Reproductive Rights

— Dianne Feeley

Undivided Rights.
Women of Color Organize for Reproductive Justice
by Jael Silliman, Marlene Gerber Fried, Loretta Ross & Elena R. Gutierrez
Cambridge, MA: South End Press, 2004. $20 paper.

THE AUTHORS OF Undivided Rights attempt to provide both an overview of how women of color approach organizing around reproductive rights, case studies of those specific organizations and the work they do on the ground. Three framing chapters introduce and summarize, while the other dozen describe specific women’s health organizations within the African American, Native American, Asian and Pacific Islander and Latina communities.

If the general state of U.S. health care is woefully inadequate, we can assume that people of color, and specifically women of color, have even less access. Access, after all, is determined by who has health insurance. As the authors note, 87% of white women have some form of coverage compared to 77% of African-American women, 75% of Asian American women and only 58% of Latinas.

Poverty adversely affects health in a number of concrete ways. It places greater stress on poor people, and traps them into unsafe and toxic neighborhoods.

Tracking Health Care

Since the rise of the women’s health movement in the 1970s, a number of books have documented the way class, race and gender have largely determined access to health knowledge and access.

The four authors of Undivided Rights, Jael Silliman, Marlene Gerber Fried, Loretta Ross and Elena R. Gutierrez, are longtime advocates, activists and researchers for women’s well being. They focus on what women of color have done, strongly affirming that as women have created organizations that prioritize race, ethnicity and class along with gender they have built a stronger movement for human rights, and specifically for reproductive rights.

They challenge the notion that women can make reproductive “choices” without grappling with how politics is played out through women’s bodies. Although Undivided Rights focuses mostly on the past twenty years, the authors contextualize the present by summarizing attempts in the United States over the last century to promote population control strategies.

What was an essentially two-track system encouraged breeding among the “better off” and “racially pure” women, while curbing the fertility of those seen as “unfit” or “defective.” Both were coerced, but in opposite ways. The authors also note that this duality has created a complicated political dynamic.

The authors then examine how fertility control and the stereotyping of women are played out today. The fact that women of color and their children are more likely to be poor, and therefore seek food stamps, welfare and other social programs, is used against them. They are perceived to be the “undeserving” poor. And these women of color are primarily portrayed as sexually promiscuous and too irresponsible to make their own decisions.

This myth is institutionalized in President Clinton’s 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA), which denies additional benefits to women who have more children while receiving public assistance. Other provisions of welfare “reform” promote marriage and fund only sexual education that teaches abstinence.

The authors point out that these policies “punish women for being poor by attacking their fertility while not offering any substantive relief from structural poverty.” (8)

Undivided Rights asserts that it is essential for reproductive rights not to be reduced to the right to abortion, or even legal abortion and birth control, as important as these are. The organizations they analyze have linked abortion and contraception to a much wider set of concerns because women’s health needs and lives are so much more.

The Case Studies

The book highlights both nationally known organizations and ones that are locally rooted. Best known is the National Black Women’s Health Project (NBWHP), which emerged out of the 1983 National Conference on Black Women’s Health Issues, held in Atlanta at Spelman College, and attended by 2,000.

Others, like The Mother’s Milk Project, grew out of a local struggle. The Project is based in Akwesasne (known as the St. Regis Mohawk Reservation, situated on the border between New York state and Ontario). It developed out of the Native American sovereignty movement, fueled by the need to reclaim knowledge of traditional health care and midwifery and in opposition to toxic waste from nearby industrial plants.

But Undivided Rights does not just detail success stories. In fact, all the organizations are challenged by underfunding, problems in recruiting the next layer of leaders and activists, and innovative programs that are cut because of limited resources. An additional dilemma is that many of these organizations were started by dynamic women of color, who were often asked to step into leadership positions in more mainstream organizations or to play a central role in pulling national women’s health coalitions together.

There is also an acknowledged tension between various leaders over what strategy to pursue. The future of NBWHP, which has undergone drastic changes and now calls itself the Black Women’s Health Imperative, remains uncertain although it has left “an important legacy.” (82)

In some ways the sober analysis of particular “case studies” is both exciting and frightening. It’s wonderful to read about how empowering self-help programs are for so many women, but disappointing to find out a particular program couldn’t be sustained.

But then I remembered that three important reproductive rights organizations I’d been active in no longer exist!

Power Through Dialogue

The conferences the National Black Women’s Health Project held in its beginning years brought women of color together to discuss, learn and strategize. These were key in inspiring a diverse group of women to go home and build NBWHP chapters or other women of color heath organizations.

By the end of the 1980s The National Latina Health Organization, modeled on NBWHP, held a national bilingual conference on health issues, attended by over 350. Its presenters represented a range of approaches on women’s health within the Latina community, including traditional healers, midwives and herbalists.

Despite the fact that these conferences drew a diverse pool of women and provided energy to hammer out a common political agenda, nonetheless it was difficult for the organizations to sustain that momentum.

Central to several key women of color organizations has been the self-help model. Using a process of dialogue and active listening as a way of demystifying the health problems communities faced, the self-help model assumes that collectively participants can thread through the difficult problems — including racism, poverty, low self-esteem and stress — and use their intelligence to find meaningful solutions.

This approach is central to sparking self- healing as well as social action. The authors quote Sharon Gary-Smith, NBWHP’s first Self-Help group developer, to summarize the process as “a safe, validating environment for us to learn how to come together to share our stories, to be appreciated for the struggles we have participated in, to review our circumstances, and to make decisions designed to change our lives and our health circumstances.” (71)

Also central to a variety of the organizations highlighted in Undivided Rights is the commitment to intergenerational dialogues as a method of education. One of NBWHP’s first projects was making a film, “On Becoming a Woman,” to help African-American mothers and daughters talk about menstruation and sexuality.

African American Women Evolving (AAWE) also initiated a series of dialogues between mothers and daughters about a range of reproductive health issues. Eventually AAWE produced a video “Mothers and Daughters: Sharing the Knowledge,” with a discussion guide based on their work.

The Native American Women’s Health Education Resource Center built itself through using an elders’ model, in which younger activists seek sustenance from the wisdom of their elders and from traditional culture. The National Latina Health Organization also built their first conference using self-help and intergenerational models as their cornerstones.

Reaching Youth

A number of the organizations saw programs designed to reach young women as central to their mission. Asians and Pacific Islanders for Reproductive Health (APIRH) developed wide-ranging leadership training for girls and young women in three California cities, while the National Latina Health Organization began with a one-to-one mentoring program that eventually developed into an after-school health education program in half a dozen Oakland high schools.

While there are many mainstream programs that attempt to address teen-age pregnancy, the self-help model these women of color programs use stress knowledge, empowerment and integrating discussions about sexuality with issues about poverty, race, sex and environmental justice.

Given the orientation of the organizations in Undivided Rights, several chose to solicit feedback from their communities through developing and administering health surveys. They then analyzed the findings not only to tailor workshops and training sessions that could meet the needs of women, but also to document the health needs of the communities studied.

This includes feeding the information they gather back into the community. For example, AAWE surveyed almost 300 pharmacies in the Chicago area in order to find out how accessible emergency contraception was for women of color. They did not just release the data to the press, but held a meeting of community groups to discuss the findings and develop a strategy for increasing access.

That is, the women of color organizations attempt to combine grassroots programs with policy and advocacy work. It has taught them to study and listen to their communities, pinpointing serious health problems and attempting to have them redressed.

For example, in 2002 the Native American Women’s Health Education Research Center surveyed the Indian Health Service (IHS), the agency in charge of Native American health care. They found that 85% of IHS units were noncompliant with official IHSpolicy; 62% provided neither abortion services nor funding in the case of rape or when a woman’s life was endangered by her pregnancy. IHS facilities did not make RU 486 available despite an IHS statement that they could do so.

This noncompliance thus reinforces an old pattern of coercive sterilization — this time as the only realistic birth control method. In its role as advocates, the Resource Center is using its survey to demand that Native women be able to receive services to which they are legally entitled.

Women of color organizations have also criticized the marketing of hormonal methods of birth control particularly to young women of color. As Andrea Smith noted, “while sterilization abuse in the US has ebbed since the 1970s, state control over reproductive freedom continues through the promotion of unsafe, long-acting hormonal contraceptives like Depo-Provera and Norplant for women of color, women on federal assistance and women with disabilities.” (112)

Delegates from U.S. women of color organizations participated in the International Conference on Population and Development in Cairo (1994), the Fourth World Conference for Women in Beijing (1995), the World Conference Against Racism (2001), UN conferences on HIV/AIDS and other international women’s health meetings. The authors suggest that as a direct result the organizations were able to “incorporate the global human rights framework into their activism.” (42)

Reconnecting Reproductive Rights

In a certain sense Undivided Rights is more a handbook than a history of a certain section of the reproductive rights movement. It advocates a perspective and points to a number of organizations founded by women of color who have worked to build an expansive model of reproductive health.

I am in agreement with that perspective and only wish the book could have shown how the movement of the late 1960s and early ‘70s had a similar one. At that period there were few women of color organizations — although women of color did organize themselves at most women’s conferences, including National Organization for Women conventions.

Of course, as Undivided Rights points out, because women of color have been historically targeted for population control, many of the nationalist organizations at that time — though the authors cite the Young Lords and the Black Panther Party as exceptions — had a pro-natalist position.

Nonetheless at the first Chicana conference, attended by 600 Chicanas in May 1970, one of the two resolutions that came out of the “Sex and the Chicana” workshop demanded: “Free, legal abortions and birth control for the Chicano community, controlled by the Chicanas. As Chicanas, we have the right to control our own bodies.”

The conference also called for 24-hour childcare centers in Chicano communities, explaining that there was a critical need since “Chicana motherhood should not preclude educational, political, social and economic advancement.”

I understand that the authors of Undivided Rights did not take on the task of writing a comprehensive history of the women’s health movement, but I’d like to take the opportunity to point out that opposition to sterilization abuse was a demand raised by a section of the women’s movement well before the Roe v. Wade decision.

We didn’t have access to stories of abuse — these were documented in the 1973-75 period — but we compiled and analyzed the data we had. I still have “Some Facts on Forced Sterilization,” a two-sided leaflet put out by the Women’s National Abortion Action Coalition (WONAAC) in 1971.

By the mid-’70s the facts on sterilization abuse forced the federal government to issue a guideline for all hospitals and institutions receiving federal funding for sterilizations. This required a woman’s voluntary informed consent and outlined a number of patient rights: the right to be free from coercion or intimidation by doctors or other health care workers, the right to change one’s mind after signing (placing a three-day waiting period between signing the consent form and the actual operation), and the right to know what the operation involved.

In New York City the Committee to End Sterilization Abuse first demanded the implementation of the guidelines and, by 1977- 78, extension of the waiting period to 30 days. (See Karen Stamm’s memorial to Helen Rodriguez-Trias in ATC 101, Nov./Dec. 2002).

But there was a huge struggle within the women’s movement over advocating the longer waiting period. There were two problems to overcome. The first resulted from the fact that while women of color and anyone institutionalized in a prison or mental hospital or on welfare might be subjected to forced sterilization, previously many white and middle-class women who sought sterilization as a birth control procedure had been unable to obtain one.

The question was posed: “Well if there are two groups of women demanding different solutions, how do you choose?” Our answer was: “There is clearly one category who are more vulnerable. What might be an inconvenience to a woman who seeks sterilization is an essential protection for a woman whose rights are being violated.”

The second problem was that in the post- Roe v. Wade era conservatives were demanding a waiting period between signing the consent form for an abortion and obtaining the procedure. The question was raised: “If the women’s movement supports a waiting period for a sterilization procedure, how can we be opposed to a waiting period for an abortion? Aren’t we being inconsistent? Wouldn’t lengthening the waiting period for sterilization give aid and comfort to the right wing in their fight to limit abortions by any means necessary?”

Our answer was that the procedures were not equivalent. We need to frame the discussion about both issues as protecting women’s rights to informed consent and access to health care.

As a member of the New York chapter of NOW, I participated in that debate and helped win both my chapter and the regional NOW to support the waiting period. Unfortunately we did not win the debate at the national NOW convention — but we tried.

I believe the inability of the NOW leadership at the time to conduct a democratic discussion on the issue was a setback for the women’s movement, and certainly embittered many women of color who participated in the debate. It’s true that Undivided Rights covers a later period, but the authors seem to imply the issue wasn’t discussed within NOW.

Whittled-Down Agenda

Perhaps I find myself disagreeing in small but important ways most with Undivided Rights’ Chapter 2. That is the chapter that analyzes the mainstream pro-choice movement in the post-Roe period. The book relies heavily on William Saletan’s Bearing Right: How Conservatives Won the Abortion War (which I reviewed in ATC 109, March/April 2004).

I’m not going to review that period in detail here, but I do agree that today the mainstream pro-choice organizations see their primary task keeping abortion legal. Thus they support — whether reluctantly or enthusiastically — politicians who are for limiting access to, but not outlawing, the abortion procedure.

This strategy is a fool’s errand because it undermines the fight for women’s right to control our bodies. The result has been that women’s reproductive rights have been whittled down to legal abortion under certain circumstances and only in the larger metropolitan areas.

Additionally, the battle to maintain legal abortion has been primarily viewed as a legislative and legal one, which is why the authors of Undivided Rights note that NOW is different from Planned Parenthood and NARAL: it seeks to organize massive demonstrations that can open up the political debate.

Yes, I too am glad NOW calls these mass demonstrations from time to time. It is an exhilarating feeling when one is at the march and sees the variety of people, particularly different generations, committed to reproductive rights. But I am always so incredibly disappointed by the top-down organizing.

The April 2004 March for Women’s Lives was more than a million strong and there were many women of color present, even on the speakers platform. But with such featured speakers as Hillary Clinton and Madeline Albright the message seemed confined to choosing the lesser evil at the ballot box.

I realize that my quarrel with some points of the authors’ historical analysis is really more of a reflection on what has happened to feminism: The lively debate and dialogue among the mainstream, radical and socialist feminists that comprised the heady days of the 1970s no longer exists, for a number of reasons.

While I miss that debate, it’s great to have the women of color organizations bring thoughtfulness to the issue of reproductive freedom. Undivided Rights doesn’t present and analyze some of the debates I wish it had, but on the other hand it lets us know about some important reproductive rights projects led by women of color.

ATC 117, July-August 2005