The American healthcare system is under scrutiny as restrictive abortion policies rise across the country. Amidst the lobbying, lawmaking, and advocacy, the unequal landscape of reproductive healthcare around the world is coming to light.
Since the Supreme Court’s 2022 ruling in Dobbs v. Jackson Women’s Health Organization, which struck down the constitutional right to abortion, states across the country have implemented stricter restrictions and bans on abortion. On April 9, Arizona’s Supreme Court reinstated a Civil War-era law that bars abortion in most circumstances.
California’s protective legislation allows it to remain a safe-haven for individuals seeking abortion access across the country, but reproductive justice includes more than the right to terminate a pregnancy. Many advocates point to the importance of intersectionality in the movement.
“Full reproductive health and reproductive justice goes beyond just talking about abortion,” said Jennifer Dunn, J.D., legal expert on pregnancy care and co-founder of the California Abortion Alliance. “You are looking at not just the right to abortion, contraception — You’re also looking at the right to have a child, the right to a safe and healthy pregnancy, the right to parent your child in a safe, healthy place.”
Out-of-State Access
Andrew Adams, Chief of Staff and Head of Strategic Communications for Planned Parenthood Mar Monte (PPMM), says that Santa Cruz has seen a rise in out-of-state patients since the Dobbs v. Jackson decision. PPMM operates 35 clinics across mid-California and Northern Nevada, including locations in Santa Cruz and Watsonville.
“The challenges [out-of-state patients] face are often greater because they’re forced to flee to a reproductive freedom state like California where abortion remains safe and legal,” Adams said.
Twenty-nine percent of women of reproductive age in the U.S. are living in states where abortion is either unavailable or restricted.
Adams said patients from as far as Ohio, Texas, Alabama, Arizona, and Louisiana have come to Santa Cruz seeking abortion and reproductive health services from PPMM clinics. He cites cost of travel, time off of work, and childcare services as some of the barriers patients face when seeking out-of-state abortion services.
Reproductive Barriers for Women of Color
For people of color (POC) in the U.S., disparities in access to reproductive healthcare are higher than their white counterparts. POC are at higher risk for miscarriages, reproductive cancers, and maternal mortality, among other complications.
According to the National Institute of Health, “the Center for Reproductive Rights describes this racial-ethnic gap as a human rights issue, stating that ‘several U.S. policies may exacerbate these disparities by disproportionately burdening access to healthcare for women of color.’”
Amy Krauss, visiting assistant professor of feminist studies at UC Santa Cruz, spoke to the collective shift in perspective needed to address the various inequities individuals face during or when trying to terminate pregnancy.
“As we start to think about how [abortion access after Roe] might be encoded in health care policy and state law, there’s an opportunity to shift our private rights framing to reproductive justice,” Krauss said. “Integral to that is a question of not just the right to end pregnancy but also how to respond to histories of reproductive control that includes mass incarceration, immigrant detention at the borders.”
Reports emerged in September 2020 exposing an immigration detention facility in Georgia that performed coerced hysterectomies on immigrant women. The reproductive abuses in Immigration and Customs Enforcement detention have been recognized as a human rights violation.
Indigenous campesinas and immigrants in Santa Cruz County have found culturally sensitive services through Campesina Womb Justice (CWJ) — a mutual aid organization that provides traditional medicinal and reproductive care.
Campesina is the Spanish word for “peasant,” describing women farmworkers who use pre-industrial farming practices, with limited land ownership.
Maria Ramos Bracamontes, founder of CWJ, said the communities they serve are in search of reproductive healthcare services that keep pregnancies safe.
“The type of reproductive justice that we do is trying to protect Indigenous life in all the ways that it’s being attacked, whether it’s not having enough interpretation services or living wages or enough food,” Bracamontes said. “There’s a lot of abuse, discrimination, racism.”
Black and Indigenous women experience pregnancy-related deaths at rates two and three times greater than that of white women. Furthermore, low-income Latina and Black women are more likely to be advised by healthcare professionals to limit their childbearing or discouraged from having children altogether. Nurses and midwives of color, like Bracamontes, want to see more representation on the legislative front.
Historically, according to Bracamontes, the medical industrial complex’s elimination of midwives, who were mostly Indigenous and Black, played a role in legislation being more anti-women, and anti-nature. Bracamontes wants women to be at the forefront of the conversations on reproductive health, especially midwives.
“When there is a healthy environment where we’re not polluting the women, we’re not oppressing the women,” Bracamontes said. “They’re going to have healthy pregnancies and their children are going to be connected to the Earth and humanity.”
