2023 Annual Report Annual Report

Megan Simmons, MPA, JD

Policy Director, National Birth Equity Collaborative 

In 1994, 12 Black women coined the term Reproductive Justice to more clearly define the unique circumstances experienced at the intersections of bodily autonomy, maternal care, health equity, and institutional racism. They identified themselves as the Women of African Descent for Reproductive Justice. Reproductive justice centers a human rights framework and is defined as: “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.” Before social determinants of health were part of the public health lexicon, Black women’s lived experiences made them keenly aware that they could not divorce their reproductive experiences from the dearth of economic, educational, and health care options that were systemically assigned to them simply because of their race.  Black women continue to lead the fight for reproductive rights as they have been the most desperately impacted by the barriers to access since the foundation of the United States. 

J. Marion Sims “Father of Gynecology” developed advances in gynecological care by experimenting on Black women without anesthesia. The enslavement of Black people on American soil rendered Black women property, unpaid laborers and vessels to create additional property to work without compensation. Black babies were seen as a commodity instead of human. These concepts of bodies devoid of humanity assessed to Black women and babies, still manifest in reproductive law, policy and medical care culture to relegate Black personhood into conditions of servitude. Reports of Black women’s pain is often ignored by physicians as the myth that Black people do not experience pain still permeates modern medicine. Black birthing people on average are approximately 3 times more likely to die of complications from pregnancy than white women. What is notable is that the Center for Disease Control and Prevention (CDC) makes clear the deaths are preventable over 60% of the time. These alarming numbers are juxtaposed against the recent decision to overturn Roe v Wade, which is the landmark case that recognized abortion as a constitutional right for 50 years. Both medical crises are squarely in alignment with some of the reasons the term “reproductive rights” was not expansive enough for Black mamas. 

The outrage associated with abortion presents as selective and self-serving when there is not the same outrage over the wealth gap, food insecurity, police violence against Black bodies, or the uninsured. Moreover, when there is opportunity to enact actionable policy, appropriations, or both that can assuage these societal ills, typically the calls for support fall flat on some of these “outraged” individuals. For example, the Black Maternal Health Momnibus Act is a comprehensive suite of bills to address maternal health equity by way of research, education, wages, and other specific strategies to reduce maternal mortality and morbidity. The bill has not been passed in Congress even though maternal mortality continues to increase in the United States. An increase in the federal minimum wage is another example of an opportunity to ensure people can work to live and not live to work. The current federal minimum wage is 7.25, however; a worker would need to earn 25.82 to afford the average two-bedroom apartment in the U.S. This is particularly, impactful to Black women as they are disproportionally underemployed and overrepresented in low wage employment. Reproductive Justice leaders make the connection to policymakers and the general public that the decision to continue an unintended pregnancy is directly impacted by whether an individual can house themselves and children born to them. For Black woman often their “choices” are eroded by injustices like inadequate education and wage inequalities, well before a pregnancy occurs. The criminal injustice system strategically removes partners, spouses, fathers, and children from their homes to maintain the status quo and disrupting family units and economic stability.  Further it is well documented that the lack of culturally competent gynecologic care, puts Black birthing people, regardless of socio-economic level, at a higher risk for death. Black birthing people are literally being forced to risk their lives to bring children into a world where many will not be afforded full access to humanity, they will simply exist to work. Reproductive justice activists acknowledge and amplify the harms caused by American institutions that continue to coerce the reproductive decision-making process that Black women experience and the consistent barriers to the full range of reproductive care.

The current trajectory of reproductive rights solidifies the conditions of constant servitude that was forced upon Black women since they were enslaved. The Women of African Descent for Reproductive Justice had the foresight to set a foundation couched in human rights principles as a roadmap for optimal and action-oriented outcomes as they continued to dredge toward personal liberty. Black women continue to lead reproductive justice initiatives by way of the legislatures, community-based organizations and research. The demands for reproductive rights by Black women have been consistent and holistic as they continue to listen to the lived experiences of Black women and fashion modern strategies in a way that reflects current reproductive needs.