What will it take to reduce the reproductive health disparities of Black women? What can we do to reduce the rates of HIV/AIDS among Black women? How can we create healthy communities where women and girls live free from sexual and domestic violence?

What will it take to reduce the reproductive health disparities of Black women?  What can we do to reduce the rates of HIV/AIDS among Black women?  How can we create healthy communities where women and girls live free from sexual and domestic violence?  How can we reduce the rates of unplanned pregnancy among Black women and girls?  The Black community can no longer afford to view issues of reproductive and sexual health as a White woman’s issue.  We must instead begin to look at them in a broader political context and understand how policies like welfare reform, access to contraceptives and other family planning services, the debate around abortion, the war on drugs and the criminalization of Black women who use drugs, serve to further a patriarchal agenda that is still very much intent upon controlling the childbearing of Black women and other women of color.   When we understand these issues not individually but as part of a larger concept of Reproductive Justice, it becomes evidently clear that women of color, low-income women and young women must be as equally empowered as our white counterparts socially, politically and economically in order to achieve human rights for everyone.

For women of color, race, class and gender are not separate issues but intersect.  The Reproductive Justice framework highlights the intersectionality of race, class and gender because it is rooted in the recognition of the histories of reproductive oppression and abuse in all communities, especially communities where women of color, low-income women and young women live.  It further looks at women’s ability to exercise self-determination, including making decisions about their reproductive lives and how those decisions are impacted by power inequities in society’s institutions, the environment, economics and culture.

Origins of Reproductive Justice

The phrase “Reproductive Justice” was coined by a group of Black women in 1994 attending a reproductive health and rights conference in Chicago.  The issue of debate then was healthcare reform.  These visionaries were clear that any plan for healthcare reform needed to include coverage for the full range of reproductive health services, including pre- and post-natal care, birth control, infertility treatments and abortion services.  They were visionaries because 15 years later, our country is again standing at the brink of creating a national health plan that will hopefully ensure all Americans have health coverage.  That vision has led to the creation of a whole new movement founded and led by women of color – Reproductive Justice.

The disparities in reproductive health are about more than the differences between the “haves” and the “have nots” or the right to have an abortion.  The struggle for women of color, Black women especially, has been about the right to be healthy, have healthy families and live in healthy communities.  It has been about the totality of our lives and how we are able to transcend the conditions that impede our ability to be healthy.  

Our lives are more than the value of our uteruses, and when we experience reproductive oppression, it impacts our total lives.  Consequently, we cannot “overcome” one form of oppression without addressing the other forms of injustice we experience.  As a woman of color working for Reproductive Justice at the grassroots level, it is imperative that I also fight against sexual and domestic violence, homophobia, HIV/AIDS, access to abortion and the right to bear children as a part of a broader effort to realize human rights for all.  The Reproductive Justice framework recognizes the totality of my life as a woman of color and empowers me to do the work in ways that respect culture and embrace my leadership ability and potential.

Reproductive Health Disparities for Black Women

The reproductive health of Black women has to become a greater priority for each of us individually, our communities collectively and policymakers. Black women are adversely affected by reproductive health services and policies in areas ranging from access to adequate family planning resources to the devastating affects of HIV/AIDS in the Black community.  Statistics show that Black women and low-income women, who are disproportionately Black, are most likely to be affected by public policies and private agendas that prevent them from realizing optimum reproductive health. Consider the following: •    In 2006, four out of five newly HIV infected women in 2006 were Black women.  They account for 55.6 percent of the Chicago residents living with HIV.  According to the AIDS Foundation of Chicago, communities like East Garfield Park, Washington Park, the Near South Side, Woodlawn, West Garfield Park and the Near West Side have the highest AIDS prevalence rates in Chicago.  Black residents comprise the majority of the population in these neighborhoods. •    In 2007, Blacks had approximately 70 percent of the gonorrhea cases, 48 percent of the Chlamydia cases and 46 percent of the syphilis cases. •    In 2008, the Centers for Disease Control released a study that showed that one in four, or 26 percent, of teenage girls between 14 and 19 years old in the United States (3.2 million teenage girls) have been infected with the human papillomavirus, Chlamydia, the herpes simplex virus or trichomoniasis.  Forty-eight percent of the teenage girls in the study infected with sexually transmitted infection (STIs) were African-American.   •    In 2007, the gonorrhea rate among Blacks was 19.1 times the reported rate among whites. •    Blacks make up only 12 percent of the population but accounted for one-half of the AIDS diagnosis in 2006. •    HIV was the third cause of death among Black women ages 25-34 in 2004. •    Of the top ten states with Blacks Americans living with AIDS, Illinois ranked ninth in 2006. •    Heterosexual contact is currently the greatest risk factor for Black women contracting HIV/AIDS. •    In 2006, 17.5 million U.S. women needed publicly funded contraceptive services and supplies because their income is below 250 percent of the federal poverty level. •    Non-use of contraception is greatest among those who are young, Black, Hispanic or less educated. •    Black women are almost four times as likely as white women to have an abortion. There are similar disparities in the area of maternal and child health in Illinois.  Black babies are 2.7 times as likely to die before their first birthday as White babies.  Black women are 2.4 times more likely to die during childbirth than their White counterparts.

We have to bring our heads up out of the sand as a community and begin to address the disparities facing the jewels of our community – Black women and girls.  For women, access to reproductive healthcare is a vital part of our primary healthcare.  Our lack of frank conversation and activism around reproductive and sexual health makes us, in a sense, co-conspirators in our own health disparities.  Our unwillingness to talk with our daughters and sons about their bodies and sexuality does them a grave disservice because they are not empowered with an understanding of their bodies or have life-saving information to help them make responsible choices and decisions.  We cannot expect them to have a vested interest in something they don’t understand.  How can we be disappointed and frustrated with our young people around issues of reproductive and sexual health when we have not given them the basic tools to make healthy decisions?  “Just say no…” did not work in efforts to reduce drug use and it certainly is not the most effective strategy in reducing risky sexual behavior. Study after study has shown that abstinence-only education is not the most effective strategy.  Young people need medically accurate, age appropriate information about sexuality, HIV/AIDS and STIs so that they can make good decisions.

Even with respect to the Centers for Disease Control’s data indicating that Black female teenagers were more than twice as likely as their white or Mexican-American counterparts to have one or more of four STIs, we must pull back the lens and understand the reproductive health disparities facing women of color are broad.  SisterSong, the women of color national reproductive health collective, is leading the way in re-examining how we look at this data and urging us to also view it through a gender violence lens.  And, rightly so, when we consider that an estimated 60 percent of teenagers’ first pregnancies are a result of molestation, rape or attempted rape, as cited in the August 2008 article published by the Center for American Progress and authored by Malika Saada Saar of the Rebecca Project for Human Rights.  The national statistics show that one in four Black women will experience sexual assault in her lifetime.  We must contextualize the valuable data from the CDC and look at the rates of sexual assault and partner violence among teenagers when we look at rates of unintended pregnancy and abortion. To realize true reproductive justice, women need access to the full range of reproductive health care. That includes family planning, safe contraceptives and safe abortion services.  No matter where we are individual on the issues of abortion, we must have the conversations in a way that promotes reaching common ground and that respects and support women being self-determining.  This means support women to have children, parent children, adopt children, and where the women determine best, obtaining an abortion.  Under the Reproductive Justice framework that also means the necessary social, economic and cultural supports to realize each of these decisions.  Our country has to become a place that promotes a Reproductive Justice agenda that creates and supports the conditions where women live in homes and communities free from all forms of sexual and domestic violence. Ours must become a country that sets an example for the rest of the world of how women live free from all forms of sexual oppression. Women must be entrusted to be the true agents of their own lives afforded with the economic and social supports to make the best decisions for themselves, their families and their communities.

The Reproductive Justice framework is one that promotes a holistic approach to creating a society where women are healthy, have healthy families and live in healthy communities. This means living in a country where people have jobs paying living wages, safe and adequate housing, affordable health care, access to safe, healthy foods, and sustainable and clean environments. True Reproductive Justice means that women not only are able to make and exercise decisions about having an abortion but also have the social and economic supports to raise and parent children. They need access to pre- and post-natal care, as well as support for the right to play pivotal roles in decisions about labor and delivery experiences.

Women incarcerated must be afforded the right to have birthing experiences with dignity and not shackled down to beds like animals. They also must be able to access abortion services.  Parenting women with substance abuse problems must receive social and economic assistance and support to not only live substance free, but have access to services and housing that support them being fully functioning mothers enabled and empowered to raise their children and not have them taken away to become a part of the child welfare system. It is only when this country redresses these and other problems will we be a country that has ended the sexual and reproductive oppression of women, especially the oppression of women of color. There has been a paradigm shift as women of color have offered a critical analysis about the intersections of race, reproduction, and social and economic policies.  We are challenging the status quo and asking for public officials and the general public to look at who suffers the brunt the most and what is the economic tide at the time.  The overall health of women cannot be separated from the current economic crisis.  The loss of jobs has not only meant huge deficits in household incomes, but also scores of individuals left without health insurance, and in some instances, homeless.  What that means in day-to-day realities for many women and girls is an inability to access vital health services like annual pap smears, family planning, mammograms, and pre- and post-natal care, HIV/AIDS and STI screening and treatment, and prescription drugs and care for other pre-existing health conditions.

Connecting Reproductive Justice to a Broader Human Rights Agenda

Reproductive Justice is about more than defending rights but is instead about fighting for the enabling conditions for women and girls to realize those rights.  These are the basic human rights and freedoms all of us are entitled to under the Universal Declaration of Human Rights adopted and proclaimed in 1948 by the General Assembly of the United Nations.  It is about creating the enabling social and economic conditions that make it possible to realize our freedoms and rights to healthcare, clean environments, economic security, food security, etc.

For example, when we talk about the war on drugs who are we talking about really? We are talking about urban areas predominantly populated by people of color, Blacks in particular, who have the least access to education, employment and health care. When we talk about the environment, what does it mean in terms of the toxins people are exposed to in urban areas that impact their reproductive and overall health?  In March 2009, the Safe Cosmetics Campaign, a national coalition of nonprofit health and environmental groups released a report about dozens of top-selling children’s bath products contaminated with cancer-causing chemicals including formaldehyde and 1.4-dioxane.  The Environmental Protection Agency has identified formaldehyde as a probable carcinogen. 

Formaldehyde can cause adverse skin reactions in adults and children who are sensitive to the chemical. Contact dermatitis specialists recommend that children avoid exposure to products containing formaldehyde. The Consumer Product Safety Commission has said that even a trace of 1.4-dioxane is cause for concern—products like Johnson’s Baby Shampoo, Sesame Street Bubble Bath, Grins & Giggles Milk & Honey Baby Wash and Huggies Naturally Refreshing Cucumber & Green Tea Baby Wash.  What most consumers will find interesting is that these and other products are classified as cosmetics by the US Food and Drug Administration.  What is most problematic about this is that there is no stringent regulation of the cosmetics industry. The FDA does not review – nor does it have the authority to regulate – what goes into cosmetics before they are marketed to salons and consumers. As we strive to be beautiful, we also must consider our visits to our neighborhood nail salons for manicures and pedicures.  How many different chemical toxins are we exposed to when we walk in the door? The discussion must and should change when you walk in and see the workers wearing masks and the fumes are so strong you smell them the moment you open the door.  As a customer, you don’t have a mask and receive the fumes even more.  But when we look beyond the individual customer, we cannot help but think about the fact that many of the smaller shops have workers who are of Asian descent.  They work in the shops being exposed to the fumes all day.  It is a health concern not just for the customer, but for the scores of women of Asian descent who work in the salons.  And the problem of toxic chemicals is not just isolated to nail salons owned and operated by Asian owners.  OPI nail products are used in many salons both White-owned and those owned by people of color.  It was not until 2007 that the makers of OPI nail products finally started to remove the toxic chemicals DBP, toluene and formaldehyde from their nail polishes.  All three of these chemicals are known to cause cancer and reproductive toxicity.  This is not to say that getting our nails and toes done is a health hazard.  But it must give pause for concern about the various chemicals and toxins we are exposed to during our visits and how we as consumers can work together with beauty professionals to use safer products with fewer or no harmful chemicals.

Similarly we must be concerned about the foods we eat.  Beyond counting calories and watching weight, the conversations must move to what is in the foods we eat.  It’s one thing to tell people to watch their caloric intake, but the discussions changes when we talk about who has access to healthier foods.  Many communities of color lack grocery stores that carry organic and natural foods free of toxins and pesticides.  Additionally the difference between the cost of a regular half gallon of whole milk and a half gallon of organic whole milk is substantial and puts it out of reach of those individuals with limited financial resources.  The problem becomes one of economic access and who can afford healthier food.

The Black community must become more involved in working toward the human rights of all beings, women and girls especially, and our work has to be centered not around reproductive choice but grounded in Reproductive Justice.  Through the Reproductive Justice framework, you are working to defend and expand the totality of women’s lives in all areas that impact their reproductive and sexual health.  It means that you are defending more than a woman’s right to have an abortion but also her right to have children.  You are working to defend her right not just to have children but to parent her child.  You are working to defend her right to determine what type of labor and birthing experience she wants to have.  You’re working to defend her right to live free from violence.  You’re working to defend her right to be treated with dignity when she’s trying to access health care services.  Finally, you are working toward securing the economic, social and cultural support for women and girls to be able to realize all of the above .

This is the work that we must begin to do within the Black community to create a society where Black women are healthy, have healthy families and live in healthy communities. Toni M. Bond Leonard is the President/CEO of Black Women for Reproductive Justice (BWRJ). Founded in 1996, BWRJ’s mission is to help Black women and girls realize reproductive justice.  We seek to build a grassroots constituency organized to collectively affect changes in the public and private institutions and policies that prevent us from obtaining optimum reproductive and sexual health.  To find out more about BWRJ, its programs and to get involved in bringing Reproductive Justice to the communities where Black women live, contact us at 773-955-2709 or visit our website at http://www.bwrj.org.  Mrs. Bond Leonard is also the Board President of SisterSong and the National Network of Abortion Funds.  BWRJ works in collaboration with groups to promote the Reproductive Justice framework. ______ Copyright 2009 Toni Bond Leonard. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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