Social Work and the Reproductive Justice Framework

Policies and debates about contraception, abortion access and the ability of individuals to make their own reproductive decisions have consistently been central for many reproductive rights and justice scholars and activists. These topics have also mobilized individuals to take political action. Social workers have often been at the forefront of mobilizing for social justice issues, however their involvement in the reproductive justice movement has in many ways been limited. In a review of the reproductive justice literature in social work journals conducted in 2018, only 3 articles substantially included a discussion of reproductive justice in their work.

This gap is particularly concerning considering the politically-crafted crisis in reproductive health care exacerbated by recent abortion restrictions, which particularly undermine the reproductive and sexual health concerns of women, individuals with uteruses and non-binary individuals impacted by these laws. Social workers who are conversant in, and practice from, a reproductive justice framework are part of a necessary antidote to this crisis. Abortion bans, limited access to contraception, the criminalization of miscarriage and the undermining of Medicaid expansion and access to health insurance all require the increased mobilization of social workers to deal with the impact these policies will have on communities and clients. 

Reproductive Justice 

Reproductive Justice as a political movement and analytical framework emerged out of critiques that reproductive rights discussions were often centered on the concerns of white, straight, and formally educated women, ignoring the issues that were key to individuals outside of these groups. As scholars and activists Loretta Ross and Kimala Price have noted, reproductive justice was developed as a unifying framework that went beyond the legal right to abortion and contraception access issues central to the reproductive rights movement and included the reproductive health concerns of poor women and women of color. 

Ross (2006) and Price (2010) have defined “Reproductive Justice,” as “the complete physical, mental, spiritual, political, social and economic well-being of women and girls…” and as being realized when “…women and girls have the economic, social and political power and resources to make healthy decisions about our bodies, sexuality, and reproduction for ourselves, our families, and our communities…”.

Reproductive choice is defined broadly and holistically in this framework. It includes personal freedom related to governmental regulation and polices, but just as importantly, centers the importance of choice related to additional constraints, such as environmental contaminants, or a lack of access to childcare. Price describes Reproductive Justice as centering on the three core values of “the right to have an abortion, the right to have children, and the right to parent those children”.

These core values provide a way to conceptualize the linkage between larger social justice movements with reproductive health. Reproductive Justice is strongly rooted in intersectional and feminist theory and critiques the exclusion of women of color in the reproductive rights movement. Though originally theorized primarily in relation to movement building for political action, disciplines such as law and sociology are increasingly using the reproductive justice framework in academic and scholarly work, though social work has not yet integrated this framework into the research and practice of the profession. 

Social Work and the Reproductive Justice Framework

Reproductive Rights and Justice frameworks are highly congruent with the ethical and theoretical foundations of the social work profession in addition to the profession’s goal of promoting and advocating for social justice. However, despite Social Work’s focus on incorporating and applying social justice theories to practice and research, reproductive rights and justice are not frequently focused on in social work publications. The social work profession is unique in being one of the few that specifically mandates this requirement to promote social justice.

As highlighted in the preamble of the Social Work Code of Ethics: “the primary mission of the social work profession is to enhance human well-being…with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty…social workers promote social justice and social change with and on behalf of clients…[and] strive to end discrimination, oppression, poverty, and other forms of social injustice”. The emphasis on advocacy and performing work which promotes justice is one of the distinctive qualities of the occupation.

The importance of utilizing the reproductive justice framework in this call to more broadly promote social justice is highlighted by the fact that social workers increasingly provide a large number of reproductive and sexual healthcare resources and services and frequently act as gatekeepers for those seeking medical care. 

In 2018 I conducted a literature review of the top 50 social work journals. The search term “reproductive justice” was used to identify 10 articles published between 1994 and 2018. Though 55 articles were found with the search term “reproductive rights”, only 3 articles were found that substantially included a discussion of the reproductive justice framework. A content analysis of the articles was done to explore the study population, location, purpose and topic, year published, journal, key findings, and social work implications.

An upsurge in reproductive justice research was called for by all 10 articles. Though it is encouraging that the social work profession was highlighted as being congruent with the reproductive justice framework, this research shows that there is a lack of articles on reproductive justice and that the framework has yet to be integrated into research on sexual and reproductive health within the profession. 

What Now?

As my work and other scholars have noted, there is an existing gap in social work research and practice which the reproductive justice framework can begin to address. This framework is required because of the limitations in how the language of “choice” has been used to categorize the sexual and reproductive decisions of marginalized groups of people as “poor choices” while ignoring broader structural barriers. This rhetoric continues to direct and influence debates around reproductive and sexual health and further marginalizes vulnerable groups of people. Social workers have historically and continue to often be in positions of facilitating or restricting access to social services, making the need to incorporate a reproductive justice framework in this work essential.

The use of a reproductive justice framework offers social workers the chance to facilitate a holistic model of healthcare for their clients and to preform research on healthcare access and systems that centers social justice. Although social work has yet to meaningfully incorporate a reproductive justice framework into its research or practice, there are many opportunities for the reproductive justice framework to be applied. Recent government restrictions and legal battles highlight the immense urgency of this work, as social workers will no doubt continue to be at the forefront of advocating for reproductive and social justice.

Read more in Jessica Liddell (2018), “Reproductive Justice and the Social Work Profession: Common Grounds and Current Trends” (Affilia).

What the Media Left Out About the Last Democratic Debate

Senator Kamala Harris.

Senator Kamala Harris was without peer during the fourth Democratic presidential primary debate. In fact, it’s difficult for me to identify Sen. Harris’ strongest moments because she optimally accomplished so much with each statement. I think the quality of her performance Tuesday night calls for a point-by-point breakdown. So, I’ll try my best.

First, a snapshot of her game: Kamala Harris achieved (and sustainably grounded) position as master of her domain. She scored efficiently. She argued elegantly. She empathized naturally. She outclassed all opponents through a sheer display of self-possession. Her touch and tact, sincerity and sophistication, reflected a clear, robust understanding of the complex situational dynamics at play. Successfully capitalizing on each opportunity, Sen. Harris occupied and punctuated her time cerebrally — and, she protected her time as well. Time and again, the poise and ease of her stage presence exampled presidential command.

What stood out most in Sen. Harris’ opening statement was her facility in seamlessly and vividly connecting the dots of Donald Trump’s devastation. Moving from the great Maya Angelou’s perceptive insight about “listening to somebody when they tell you who they are the first time,” and Trump saying that he could shoot someone on Fifth Avenue and get away with it to the democratic visions of America’s framers, Harris diagnosed the disease (Trump) and offered the right solution (checks and balances) in a context conducive for unity: “Our system of democracy.”

Regardless of an individual’s background or ideological preferences, most Americans value our self-corrective democratic system of government. Also strong and cleanly executed was the way Sen. Harris noted, at the outset, how her experience as a progressive prosecutor uniquely positions her to read Trump like a children’s book: “I know a confession when I see one.”

Harris’ second statement, once again, showed her to be not just the adult in the room, but a candidate fundamentally committed to fighting for the most vulnerable amongst us. Directly and poignantly, she issued perhaps the most imperative observation in the entire debate: “This is the sixth debate we have had in this presidential cycle and not nearly one word, with all of these discussions about health care, on women’s access to reproductive health care, which is under full-on attack in America today.”

After the applause, Harris made no bones about getting to the heart of the matter. Her passionate, thoughtful expression embodied the frustration of women across America as well as her steadfast determination to resolve this crisis once elected.

I can’t say that I’m surprised by this example of moral leadership, but I am very grateful.

I also want to acknowledge Senator Cory Booker for accentuating and building on Senator Harris’ remarks by reminding us that “women should not be the only ones taking up this cause and this fight.”

Back with more firepower, Harris, in all of her brilliance, took an abstract (relatively dry) question about a wealth tax and turned it into an incredibly powerful account that gripped me in a very personal way. She described how her mother would sit at the kitchen table, late at night, trying to figure out a way to provide for her daughters, and she spoke about fathers doing everything they could to support their families and meet the bills at the end of the month. It just so happens that the challenges Sen. Harris gave voice to encapsulate my own father’s experience through much of my life. What moved me most in that moment was the depth and calm of her concern. Her solicitude felt durable and unadulterated — like it could withstand the messiness of political conflict and the harshest reality of any setback that might come with being president.

Her resolve gave me confidence as I marveled at the power of her light to uplift.

It was at this point that I thought to myself, the moderators, just on the basis of her performance thus far, will have to find a way to prioritize her inclusion.

Despite their failure, her performance only elevated. At her next opportunity, Sen. Harris exemplified peak preparedness, using feminine pronouns to capsulize a commander-in-chief’s responsibility to “concern herself with the security of our nation and homeland” before following through with a lucid, compact, and highly detailed answer that named names, delineated the most relevant ramifications, and specified her intention to “stop this madness,” under a Harris administration.

Following that, Harris attained perfection, offering an impeccable response to Anderson Cooper’s gun control question about “enforcing a mandatory buyback.” She exhibited complete control in her ability to deliver a thorough, colorful, and well-paced answer without error. This response from Senator Harris belongs on any shortlist of captivating, exemplary presidential debate moments.

With patient equipoise, Harris held her powder as a number of candidates bent over backwards to throw their hardest blows at Senator Elizabeth Warren. Once their energy was spent, Harris rose to the occasion with characteristic confidence and self-direction. “No, I don’t agree with that at all.” Harris proceeded to skillfully press Sen. Warren to agree that Trump’s twitter account should be suspended. Upon being interrupted, Senator Harris firmly (and appropriately) impressed her dominance: “I’m not finished.”

With little recourse, Warren fumbled, scurried to evade the question, and barely escaped entrapment by way of moderator interference.

In Harris’ penultimate declaration, she held forth assertively and decisively on reproductive rights, beginning, “My plan is – as follows…,” and ending, “It is her body. It is her right. It is her decision.” Put simply, Harris seized this opportunity to definitively declare her commitment to ensuring that all women have the right to determine what they do with their bodies, and explain precisely how she would enact such justice.

To round out the night, Sen. Harris separated herself from the pack emphatically once more by answering the final question about friendships with political adversaries swiftly and without mishap. While every other candidate meandered and several appeared to be searching for an answer as they spoke, Harris replied immediately: Probably Rand Paul. What is more, she gracefully culminated her closing remarks with personal power and inspiration by telling her own story, and explaining that if Donald Trump had his way, her story would not be possible.

Unfazed by bias and seemingly unbothered by every obstacle, Kamala Harris accoladed a feat of prowess for the history books. While I am not the least bit surprised, I am both proud and supremely delighted.

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.

The Impact of Recent Court Decisions on Abortion Access

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Protesters hold signs in support of Obamacare’s birth control mandate CREDIT: THINKPROGRESS/SY MUKHERJEE

In the recent Supreme Court of the United States (SCOTUS) decision Whole Women’s Health v Hellerstat, it was determined that Targeted Regulation of Abortion Providers (TRAP) laws create an undue burden for women seeking abortion.  In the latest ruling in Alaska, the decision overturned their state-level parental notification law because it violated the Alaskan constitution. These decisions have begun to unmask biased, unscientific abortion policies in the United States, and they should be celebrated everywhere as monumental victories for client self-determination and human rights.

These rulings represent the possibility that the tables may be turning in favor of fact-based abortion policy. Also, they give advocates in this area hope that when abortion policy represents a biased, undue burden, as TRAP laws and parental notice laws do, they will be considered and ruled as such.

These cases also create precedents for the contemplation of the undue burden created by other laws restricting abortion, including mandatory waiting periods, which strip self-determination from social work clients, likely causing secondary trauma when clients are attempting to access a routine health procedure that is safe and absolutely legal in the United States.

The removal of these additional legislative barriers are a particular triumph for social work clients, who at the very moment of this ruling were already finding it harder and harder to access abortion because of the burden of pseudoscientific policy restrictions. These restrictions have been implemented at unprecedented levels since the 2010 midterm elections. Abortion access is such a problem in Texas that women were already attempting to end their own unwanted pregnancies without medical intervention which harkens back to the days of illegal abortion.

While these rulings will not address all abortion access problems immediately, they represent a rational response to moralized abortion policy, which will keep clinics open in Texas and facilitate abortion access for adolescents in Alaska that is on par with that of adults.

The impact of these decisions is also distinct because they expose the intent of the policies, which was to make abortion inaccessible by victimizing vulnerable patients with unnecessary regulation, while couching the laws as means to make abortion safer, when abortion services were already safely provided for both adults and adolescents under existing clinic regulations.

Current decisions are drawing attention to the rhetoric falsely decrying a need for women’s safety in the form of TRAP laws. They expose the actuality that unnecessary abortion regulation decreases family safety by impeding the timing and spacing of births and sets the stage for forced pregnancies similar to those experienced by women in countries like Ireland and Nicaragua where abortion is illegal outright.

TRAP and parental consent laws have been exposed as tools of oppression used by politically motivated legislators to cut off access to abortion for a subset of the population. They also bring to the forefront the understanding that abortion is a low-risk procedure that can be safely performed in clinic environments under existing regulations, for both adults and adolescents.

These decisions also expose the conflict between politically motivated abortion policy in the United States and a sound public health approach to the reproductive health needs of vulnerable groups, by demonstrating that unscientific abortion policy keeps economically disadvantaged women from accessing abortion, while merely inconveniencing adult women of means who have the resources needed to overcome the restrictions. Additionally, these rulings open the door for a scientific presence in our nation’s understanding of abortion and the laws and policies that govern it, because if we can demonstrate that these laws are thinly-veiled attempts to restrict abortion access, then we can demonstrate that the other laws are too.

The overturning of these laws has not created a panacea for abortion access in the United States.  During the time SCOTUS was considering their case, new anti-abortion tactics designed to stigmatize abortion were implemented in the form of fetal pain and funeral policies, which took effect over the summer and spring.

These pseudoscientific laws are currently traumatizing abortion patients who are already facing difficult decisions around unwanted pregnancies that are often surrounded by trauma. Moreover, these laws highlight how out of touch state legislators made up of primarily white, upper-class men are with the best interests of their constituents. They also reflect an ongoing preoccupation with promoting abortion stigma to the detriment of addressing other pressing social issues such as poverty and economic development.

The SCOTUS ruling does not address the Hyde amendment, which restricts all federal funding of abortion in programs such as Medicaid, military health programs and prison health programs. Hyde prevents low income women, and women of color who are more likely to live in poverty and rely on Medicaid, from accessing abortion. This is a prime time for social work advocates to highlight the burdens that Hyde creates, which include completely blocking access to the procedure for those who cannot gather the funds for it.  Social work advocates can call attention to the ongoing burden of Hyde by lobbying for the law’s repeal.

In order to support self-determination, the National Association of Social Workers advocates access to all forms of reproductive health services, including abortion. If we are to achieve social justice for women and pregnant people in the United States, it is imperative that social work capitalizes on these recent rulings to revive our advocacy efforts in this area and work to eliminate pseudoscience in remaining abortion policy.

Write about abortion, talk about abortion, normalize abortion and contact legislators to voice support for our clients needing access to abortion. These rulings represent the tables turning towards a more scientific approach to abortion in the United States, and if we make the best use of this opportunity we can lead the way towards rational abortion policy in that promotes access to the full range of reproductive health options for all clients everywhere.

Social Work Students Defend Planned Parenthood Against Deceitful Smear Campaign

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As Social Work students, we are concerned about the deceitful attempt to defund Planned Parenthood, an organization that provides vital health care services to 2.7 million Americans each year. In Louisiana alone, Planned Parenthood annually provides 16,000 visits in both Baton Rouge and New Orleans for services that include birth control, cancer screenings, STD tests and treatment, and other preventative healthcare such as much-needed sexual health education.

This smear campaign is part of a 10-plus year pattern of harassment and violence by extremists whose focus is banning abortion and preventing women from accessing preventive health care at Planned Parenthood health centers. The group behind this video smear campaign is a part of the most militant wing of the anti-abortion movement. They have been behind the bombing of clinics, and the murder of doctors in their homes and in their churches. This group has zero credibility. They set up a fake company. It appears that they used fake government IDs. They’ve even filed fraudulent tax documents and have completely lied about who they are and what they do all in an effort to end safe and legal abortion and bring down Planned Parenthood.

Additionally, we would like to clarify a few things for readers. Donating fetal tissue is a common medical procedure that goes to research seeking to cure Alzheimer’s and Parkinson’s diseases. The only monetary transaction in the video discussed was standard reimbursement costs. There is nothing in these videos that suggest any violation of law, and these tapes are heavily doctored. The clips take the conversations out of context, while the full tapes show the doctors in question state repeatedly that Planned Parenthood does not profit from the consensual donation of fetal tissue.

Furthermore, we want to clarify that Planned Parenthood does not receive federal funding for abortion services. Federal funds are restricted from funding these services by the Hyde Amendment. What the money does fund is healthcare for people who need it. In Louisiana, we have a dearth of healthcare services for low-income people, made worse in recent years.

Social workers see the tragic consequences of lack of health care every day. Per the CDC New Orleans is number two in the nation for HIV infections, and Baton Rouge is number three per capita. People here are struggling with higher-than-average rates of chronic illnesses, and they cannot afford to find treatment. Social Work Students United for Reproductive Freedom (SWURF) does not see this as a pro-choice versus pro-life issue. We see it as a human rights issue. It is about the right to have freedom over one’s body without government intervention. It is about the health of Louisiana women, men, and children. For those reasons, we support Planned Parenthood.

Social Work Students United for Reproductive Freedom – Tulane University Student Members

Kara Cohen, Dana Carbo, Emily Costello, Miriam Eisenstat, Livia Harkow, Becca Hutchinson, Catherine Kelleher, Alex Loizias, Val Lippman, Cat Patteson, Charles Schully, Miranda Stone

For Information, contact us on Facebook at Social Work Students United for Reproductive Freedom or on Twitter at @tulaneSWURF

Press Release: Social Work Helper was not involved in the creation of this content.

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