Why Understanding Black Women’s Beliefs About Motherhood Can Help Improve Reproductive Health Care

Chanel, now a middle-class mother of one, is just one of many women who have used abortion to end a pregnancy. “In college,” she explained, “I had two abortions and I had them not because I didn’t want to be a mother but because I wasn’t ready. I wanted to finish school and I just felt like I was too young… [M]y mother really stayed on me about not having kids and I saw what it was like for her to have kids at such a young age and to be unmarried… I never wanted to do that.” Researchers can distill Chanel’s lived experience down to the briefest of statistics: Black woman, college-educated; three pregnancies, one child. But her candid testimony sheds needed light on the complexities of personal choices about pregnancies. When I interviewed her, Chanel made it clear that her abortions were her own decision. But such decisions are always made by women in the context of external forces that constrain their options.

Decades of previous research have illuminated the significant racial and economic disparities that affect women who seek access to reproductive health services. Black women, especially, bear the brunt of socioeconomic and political factors that impede their full autonomy in making reproductive choices. Much has been made of data from the Guttmacher Institute showing that abortion rates for Black women are almost three times higher than for white women, and that unintended pregnancies are nearly twice as frequent for Black women. Meanwhile, abortions are increasingly concentrated among poor women, who accounted for nearly half of all abortions according to the latest available 2014 data.

What might create more favorable and equal conditions for Black women dealing with reproductive health issues? Studies have suggested many possible solutions – including better sexual health education for young people; expanded health insurance coverage; and increased access to reproductive care, including all forms of contraception, abortion care without stigma, and quality pre- and post-partum care for mothers and children. Many scholars are now also probing the ways in which institutional racism undercuts good health care for Black women.

Effects of Wealth, Class on Black Women’s Ideas about Motherhood

Although a focus on collecting and analyzing systematic data contributes to our overall understanding of women’s reproductive decisions and consequences, my research using in-depth interviews seeks to fill gaps left by previous studies. Discussions about abortion and contraception for Black women, I find, are often influenced by Black communities’ understandings of the centrality of motherhood in the reproductive life course. A richer understanding of the importance of motherhood to the Black community may help researchers and policymakers provide resources and programs grounded in the realities of Black women’s reproductive lives.

My conversations with research participants highlight the role of class in Black women’s definitions of motherhood and interpretations of “choice.” For poor and lower-class women, womanhood is deeply imbued with the value of motherhood. These women largely approach motherhood as destiny rather than as one choice among many. In contrast, upper- and middle-class women grapple much more with the “hows” and “whens” and “with whoms” – with the mechanics of fitting motherhood into their lives. Kim, a young working-class mother of one, explained that her own mother controlled some of her early reproductive health choices: “When I was younger my mom put me on [birth control] and said it was for my periods.” In contrast, Mia, a 33-year old middle-class women with no children, described a more deliberate decision to avoid pregnancy: “Kids are expensive… It’s cheaper to take birth control than have the kid. [laughter] so um yeah I’ll just keep taking birth control until I hit the lottery.” Both women exercised reproductive autonomy by taking birth control, but only the higher-income woman expressed the feeling that preventing pregnancy was her own choice to make.

Including Understandings of Motherhood in Reproductive Health Policy

As they make reproductive decisions, Black women struggle with expectations and obligations about motherhood. Devising policies that take account of community expectations and constraints may help reduce unintended pregnancies, increase access to reproductive healthcare services, and improve health outcomes for Black women. Exploring the meaning of choices made by Black women can reveal how variously situated women make different decisions. This, in turn, will allow more equitable provision of reproductive services.

My work begins to paint a detailed picture of Black women’s reproductive health journeys. But more research remains to be done. To combat the obstacles Black women face, we must interrogate and supplement quantitative data with qualitative explorations of personal experiences and beliefs. Data and interviews so far suggest a number of useful steps to be taken by key stakeholders ranging from policymakers to doctors:

  • Increase access to insurance to reduce the financial burden of preventing pregnancies or bearing children.

  • Foster cooperation among researchers, clinicians and educators – to improve understandings of beliefs important to the Black community, including ideas about motherhood and the meaning of womanhood. Such understandings can help providers improve the dissemination and reception of reproductive health education and services in the Black community.

  • Earmark funding for more research about the ways Black women in various social positions understand their reproductive lives. And encourage studies that encourage community participation and place a central emphasis on hearing Black women’s voices.

Black women make all sorts of reproductive choices, from using birth control to having abortions to raising babies. As their stories reveal, every choice is influenced by social class and the expectations of their families and communities. Researchers and advocates who want to improve reproductive health outcomes for Black women would do well to listen to what Black women have to say and view individuals’ choices as profoundly shaped and limited by social circumstances and cultural ideas and expectations.

Report Briefing Puts Human Face to Black Women’s Reproductive Justice Challenges

National Black Women Reproductive Justice Agenda on Capitol Hill, Washington DC Photo Credit: @BlackWomensRJ

WASHINGTON — In Our Own Voice: National Black Women’s Reproductive Justice Agenda launched its groundbreaking new report on the state of Black women and reproductive justice. The report offers firsthand accounts of the lived experiences of Black women, giving voice to issues including abortion access, the Affordable Care Act, maternal health and equal access to contraception.

“We held listening sessions with Black women across the country,” said Marcela Howell, founder and executive director of In Our Own Voice. “This report documents the real-life barriers to reproductive health that Black women face and examines the impact of these barriers on our lives.”

The report, “Our Bodies, Our Lives, Our Voices: The State of Black Women and Reproductive Justice,” exposes how both political parties give short shrift to the needs of Black women. One party consistently fails to address police violence against Black people even as we witness yet another Black woman — Charleena Lyles — being murdered in front of her own children.

And the other party ignores our needs in its frantic push to attract more white male voters into its ranks. “But let us be clear, a vision of economic equality that does not also address the multiple facets of racial and gender inequality is not progress — it’s Jim Crow,” Howell said.

“The time is now for Black women to use the power of our vote and our lived experiences to inform real policy change,” Howell added.

After introducing the report, Howell turned the program over to a panel, which delved more deeply into the issues of Black women and the criminal justice system, abortion access, and HIV/AIDS among Black women. The panelists were Deon Haywood (executive director, Women with a Vision), Marsha Jones (executive director, The Afiya Center) and Masonia Traylor (founder and CEO, Lady BurgAndy). Heidi Williamson (CEO of Idieh Consultant Group) moderated the panel.

At the end of the briefing, Howell outlined an agenda for action stemming from the report. The action agenda includes prioritizing voter engagement and GOTV efforts; collaborating with local advocates to develop and support policy change that promotes reproductive justice; investing in Black women leaders, financially and otherwise; building coordinated responses to injustice across movements, organizations, communities and systems; and above all, calling for Black women to tell the stories of their lived experiences and leadership.

“Black women need equity, but we also need to take charge of our own lives by continuing to lead in activism, run for office, finance other Black women candidates and be our own best experts in organizing for policy change,” Howell said.

For more information about “Our Bodies, Our Lives, Our Voices: The State of Black Women and Reproductive Justice,” or to schedule an interview with Marcela Howell or one of the panelists, contact Amy Lebowitz (amy@caminopr.com or 212-255-2575).

The Presidential Policy Series: Women’s Reproductive Health

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Sex has been a major talking point for this presidential race, from the unprecedented situation of the first female candidate from either major party running for President to the numerous accusations regarding Donald Trump’s treatment of women. But how do the candidates differ on issues related to women’s reproductive health? Women’s reproductive health has historically been a particularly divisive issue between the Democrats and Republicans.

Women’s Reproductive Health in the United States

World Health Organization’s definition of women’s reproductive health relates to “adequate sexual health, available contraception methods, and treatment for sexually transmitted diseases.” Women’s reproductive healthcare includes preventative services, testing and treatment for STIs, contraceptive use, well-woman gynecological exams, assisted reproductive technologies, abortions, prenatal care and hysterectomies. The most serious complication of women’s reproductive health is maternal and infant mortality.

From 1900 to today, there have been major advancements in women’s health. In 1991, Congress passed the Women’s Reproductive Health and Medicine Act of 1991. However, women’s reproductive health remains a hotly contested subject. From how to conduct sexual education for adolescents to the national debate on abortion, the United States government does not take a progressive approach to making holistic women’s reproductive healthcare available for all women. Many low-income women, those with limited education, and people of color are disproportionately more likely not to have adequate access to women’s reproductive healthcare. The implementation of the Affordable Care Act significantly expanded coverage for reproductive services for many American women.

Clinton’s Policies on Women’s Reproductive Health

Hillary Clinton has advocated on behalf of women her entire political career. As President, she will work to ensure that Planned Parenthood is fully funded so that the “essential health and reproductive care that Planned Parenthood provides women” continues to be available for women across the socioeconomic spectrum. Secretary Clinton also supports abolishing the Hyde Amendment that prohibits the use of federal funds for abortions. Clinton co-sponsored the Freedom of Choice Act, that sought to declare “that it is the policy of the United States that every woman has the fundamental right to choose to bear a child; terminate a pregnancy prior to fetal viability; or terminate a pregnancy after viability when necessary to protect her life or her health” (Congress.gov). Clinton also advocates instituting mandated 12-weeks paid leave for both parents to stay with their newborn (or adopted) children once they join the family.

Trump’s Policies on Women’s Reproductive Health

Trump’s main policy point on health care is to repeal the Affordable Care Act. On July 22nd, 2015, Trump came out to the Christian Broadcasting Network in support of the Pain-Capable Unborn Child Protection Act that bans abortions after 20-weeks (Christian Broadcasting Network). In 1999, he made a contradictory statement saying that he is “very pro-choice”. In the third presidential debate, Trump most clearly outlined his current views on women’s reproductive health. He supports federal ban on partial-birth abortion and stated that “in the ninth month, you can take the baby and rip the baby out of the womb of the mother.” This description has widely been discredited as inaccurate by the Guttmacher Institute.

One of the few policy agreements between Trump and Clinton is to implement mandated paid leave for new families. Trump and Clinton disagree about the amount of time: Trump promotes a six week paid leave “for new mothers before returning to work” while Clinton promotes 12 weeks of paid leave.

Conclusion: Clinton Champions Women’s Reproductive Health

Clinton has established herself as a champion of women’s reproductive health, both by supporting the availability of a variety of women’s health services and by encouraging increased federal and state funding for the services. Trump does not have a detailed policy plan for women’s reproductive health.

Abortion in the Heartland: What’s the Solution

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The South Winds Women’s Center in Wichita, Kansas has been open since April of 2013, and they just celebrated their 1st year of being open. Opening the clinic was a long and difficult journey that took a lot of fundraising and hard work from the Trust Women Organization and their director Julie Burkhart. Burkhart worked with Dr. George Tiller, an abortion provider, who was assassinated at his church in 2009.

wichita3n-1-webIn the first 7 months, they performed 650 abortions which is almost 100 a month, and a majority of those women were low-income living under the poverty line. To me this is proof that income and poverty have a major impact on reproductive justice. If they are performing almost 100 abortions in Wichita, KS a month, how many more do you think that are actually wanted? People come from states all over to get access to services. Kansas women have 1 choice in Wichita and a few are located in Kansas city, 200 miles away or a few in Oklahoma City, which is also 200 miles away.

Texas recently shut down a huge majority of their clinics. Now, the entire state relies on 5 clinics that provide abortion care. Of course the South Winds Women’s Center offers a whole lot more than just abortion, but once you say abortion, many people stop listening especially in Kansas. Trust Women and the South Winds Women’s Clinic do not necessarily share my views about everything I’m writing, but I wanted to offer an overview of the services we provide here in Wichita, KS.

So, I offer this question to all who are anti-abortion: What is your solution?

In states where the laws are harshest about sexual health education, the teen pregnancy rates are highest. This can not be a coincidence. There are many opinions about sex and very strong opinions on reproductive justice. However, we seem to have no problem profiting off porn and sexual advertisements. But, when it comes to talking to our youth about sex education with options other than abstinence, many people are against it.

It’s time to speak up about sex education and reproductive justice! If you truly want to decrease abortions, we need to get on board with comprehensive sexual health education and access to affordable reproductive health services. According recent studies, abortions have decreased and not it’s not due to the increased anti-choice legislature according to the Guttmacher Institute.

Social Work School Separates from National Association of Social Work

Catholic University of America’s (CUA) National Catholic School of Social Service (NCSSS) has long been a well-respected social work program, with the Gourman Report placing it in the top 11%. Its web site states: “Our commitment to supporting traditional social work values while responding to today’s educational and practice developments continues to make ours a highly regarded program both within the academic world and the practice community.”

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Catholic University of America

Despite this statement, NCSSS’s new dean,Will C. Rainford, LMSW, Ph.D. announced in October that the school was severing ties with the National Association of Social Workers (NASW), the largest membership organization of social workers in America, basing his decision on what he referred to on Twitter as an “overt public policy position that social workers should advocate for access to abortion.”

A Google search for NASW + abortion brought up two hits; arguably a less than overt position. The announcement was made without either informing/meeting with students and/or alumni to discuss the implications of this step. Confusion regarding concerns such as accreditation has inevitably ensued.

It is unclear what prompted this action since NASW issued their Family Planning and Reproductive Health policy statement in 2006: “Self-determination means that without government interference, people can make their own decisions about sexuality and reproduction. It requires working toward safe, legal, and accessible reproductive health care services, including abortion services, for everyone.”

The press release on NCSSS’s web site boasts that its newest Dean was NASW-Idaho Social Worker of the Year with his CV adding that he also served as a member of the same chapter’s Legislative Advocacy Committee between 2005 and 2007. Given Dean Rainford’s previous affiliation with NASW it is hard to believe that he was not previously familiar with the 2006 policy statement, making his stated motivation for NCSSS’s resignation from the organization questionable.

Dr. Frederick Reamer, a highly respected professor of ethics at NCSSS, wrote in Social Work Values and Ethics that NASW is not a pro-abortion organization; rather it is a pro-choice organization (2006). The NASW Code of Ethics does not directly address abortion; rather it states that social workers have an obligation to foster self-determination. However, Reamer writes that the Code of Ethics does state that social workers should refer clients to other professionals when they are not able to provide assistance or be effective.

It is difficult to understate the significance of this membership organization and the state chapters within the social work profession. The NASW Code of Ethics, sacred to the practice of social work, is integrated into educational curriculums. It helps practitioners learn the difference between right and wrong as well as to help them apply that understanding. NASW adjudicates when social workers violate this code and applies sanctions when necessary. Although state licensing boards do not require membership in NASW, they do require adherence to the NASW Code of Ethics. An education that excludes this code clearly puts future practitioners at a disadvantage.

NASW also accredits CEUs; an annual necessity for licensed social workers. NCSSS itself offers CEU workshops throughout the year and it is unclear what impact no longer being affiliated with NASW will have on these continued education opportunities. Discounted CEU workshops have also traditionally acted as an incentive for field instructors to take on students in field placements and if discontinued may impact the field placements NCSSS is able offer.

To understand the motivation behind seceding, the school of social work must be placed within the context of CUA as a whole. CUA isn’t the average regularly religiously affiliated school, it is a pontifical university established and approved by the Holy See and governed by the Pope. It was established in 1889 with the mission of the instruction of Catholicism and human nature with the goal of furthering strengthening the Church via scientific and humanistic research as informed by the Catholic faith. Since 1889, tremendous advances have been made in science contributing to mankind’s understanding of both reproduction and the prevention of disease including the scourge of HIV/AIDS. The intrinsic humanistic benefits of this progress have been ignored by a Church still dwelling in an era with a primarily agrarian economy and high infant mortality rates.

With this decision, Dean Rainford has shown not only poor judgment but poor timing as well. Pope Francis has reinvigorated many who felt the Catholic Church was no longer relevant, recently writing that the church has grown “obsessed” with abortion, gay marriage and contraception, putting dogma before love. Although remaining pro-life, Pope Francis has conceded that the church has done little to help women who were in need of it. However, the Vatican also recently distributed a survey designed to assess the difficulty of practicing the church’s preachings in a modern world, asking Catholics about their use of contraceptives, feelings on homosexuality, and divorce. This is remarkably progressive for the church and while it has taken a step forward, NCSSS has simultaneously taken a large one back.

Dean Rainford has also potentially tarnished the high regard in which the program has been held by assigning it more of a religious mission and less of a social service one. Religious schools are not legally required to be accredited. Lack of accreditation has typically been associated with schools that award degrees with little to no coursework to any “student” who can pay the price. Should NCSSS slide down this path, it is sure to devalue the substantial financial investment associated with getting a Master’s degree.

The process of NCSSS’s resignation from NASW can be seen as a metaphor for the arguments over reproductive rights. Those who hold the power (the administration at NCSSS), have made an important decision on behalf of those do not (the student body). Self-determination, so prioritized in this field, has been ignored by the administration at NCSSS. As Dr. Reamer wrote, if a practitioner is unable to assist a client, they should make an appropriate referral and excuse themselves.

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