By Danielle M. Pacia
When conceptualizing the pursuit of reproductive freedom, we must acknowledge the ways that our systems and structures fail Black, Indigenous and people of color (BIPOC) populations.
2020 has been a year filled with anxiety and anger over the COVID-19 pandemic’s disproportionate negative effects on BIPOC populations. Black Lives Matter protests after the unjust deaths of Breonna Taylor, Mia Green, George Floyd, Rayshard Brooks, Riah Milton, and many others whose lives ended far too soon have prompted an overdue awakening. This has caused some to reexamine racism on a personal and institutional level. Like many disciplines in our country, the field of bioethics has begun to recognize how the field reinforces racism within its scholarship.
Part of this effort includes a critical examination of the frameworks we employ when analyzing bioethical subjects and events, and how they may exclude the historical contributions and narratives of BIPOC populations. Merely acknowledging racism is not enough.
Here, I will explain the differences in the terms reproductive justice and reproductive rights and advocate use of the reproductive justice framework instead of the reproductive rights framework. Within bioethics and health law policy, there is often a lack of clarity between the terms, which, in turn, leaves their important conceptual and historical differences ignored.
The reproductive rights framework is largely centered on achieving women’s individualistic reproductive freedom through the legal system and has historically focused largely on the pro-choice and pro-life debate, sex education, and family planning.
But how effective are legal rights when there are other barriers to achieving reproductive freedom? Many believe that the reproductive rights movement’s hyper focus on pro-choice legal advocacy has obscured the socio-political and economic inequalities that are disproportionately faced by BIPOC women — hurdles that will be present regardless of whether or not the right to reproductive care is codified through the law.
For example, although contraceptives are legal in all states, BIPOC women are uninsured at higher rates than white women, and therefore, have more difficulties accessing birth control.
The reproductive justice framework acknowledges the ways that socioeconomic status, gender, and race shape reproductive health care experiences and health policy. Essentially, the reproductive rights framework is a more individualistic and legal approach, while reproductive justice is expansive, intersectional, and holistic.
Black reproductive justice advocate and scholar Loretta Ross explains: “Neglecting to make the link between race, rights and reproduction, the pro-choice movement has always insufficiently analyzed how political activism by communities of color particularly alarms opponents of civil rights, Indigenous rights, women’s rights, gay rights, etc.”
It is also worth noting that many early white feminists like Margaret Sanger who led the reproductive rights movement have been condemned because of their support of eugenics.
As a counter to the reproductive rights movement that was seen as non-inclusive for many BIPOC women, Black women in the 1990s organized and founded the reproductive justice movement. Reproductive justice also focuses on legal rights; however, it is only one aim among several and opts for a more holistic approach.
By broadening its focus to include numerous factors that may serve as barriers to access, the framework includes the experiences of BIPOC who have been burdened by poor access to effective contraceptives, forced sterilization, and environmental racism.
We need to become invested in understanding how racism can impede the reproductive health of BIPOC women, and work to dismantle those oppressive systems while advocating for legal rights. The frameworks that we choose to employ matter — they reflect our values as a field. Dominant use of “reproductive rights” rather than “reproductive justice” may inadvertently cause the exclusion of BIPOC women.
Amy Coney Barrett’s confirmation can make it easy to feel resigned to the reality that Planned Parenthood v. Casey and Roe v. Wade will be overturned. Although the future of reproductive freedom is uncertain and bleak, we now have the opportunity to thoughtfully move forward and become more inclusive when we work for access to reproductive health.
In order to fulfill the promise that many in bioethics have made, the field must have a constant, antiracist, and inclusive effort to dismantle the systems of oppression that are embedded within it. We must support and use frameworks like reproductive justice that account for the broader societal structures that inhibit BIPOC women from achieving autonomous decision-making in reproductive health. It is arguably more important than ever for bioethics to lend a hand in helping reproductive healthcare advocacy efforts; however, the reproductive freedom that we should seek is one that hinges on more than just legality.
Reading and Video Suggestions:
Danielle M. Pacia currently works at The Hastings Center as a project manager-research assistant. She is an alum of the Harvard Master of Bioethics program and received a BA in Bioethics from the University of Alabama, Tuscaloosa. Before working at The Hasting Center, she served as the head program manager of the Yale Institute in Bioethics and interned at the Petrie-Flom center while earning her master’s degree.