Joseph founded a nonprofit, Commonsense Childbirth, in 1998 to inspire change in maternity care to better serve people of color. As a licensed midwife, Joseph seeks to transform how care is provided in a clinical setting.
This piece is published in collaboration with Echoing Ida, a Forward Together project.
Jennie Joseph’s philosophy is simple: Treat patients like the people they are. The British native has found this goes a long way when it comes to her midwifery practice and the health of Black mothers and babies.
In the United States, Black women are disproportionately affected by poor maternal and infant health outcomes. Black women are more likely to experience maternal and infant death, pregnancy-related illness, premature birth, low birth weight, and stillbirth. Beyond the data, personal accounts of Black women’s birthing experiences detail discrimination, mistreatment, and violation of basic human rights. Media like the new film, The American Dream, share the maternity experiences of Black women in their own voices.
A new generation of activists, advocates, and concerned medical professionals have mobilized across the country to improve Black maternal and infant health, including through the birth justice and reproductive justice movements.
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Joseph founded a nonprofit, Commonsense Childbirth, in 1998 to inspire change in maternity care to better serve people of color. As a licensed midwife, Joseph seeks to transform how care is provided in a clinical setting.
At her clinics, which are located in central Florida, a welcoming smile and a conversation mark the start of each patient visit. Having a dialogue with patients about their unique needs, desires, and circumstances is a practice Joseph said has contributed to her patients having “chunky,” healthy, full-term babies. Dialogue and care that centers the patient costs nothing, Joseph told Rewire in an interview earlier this summer.
Joseph also offers training to midwives, doulas, community health workers, and other professionals in culturally competent, patient-centered care through her Commonsense Childbirth School of Midwifery, which launched in 2009. And in 2015, Joseph launched the National Perinatal Task Force, a network of perinatal health-care and service providers who are committed to working in underserved communities in order to transform maternal health outcomes in the United States.
Rewire spoke with Joseph about her tireless work to improve maternal and perinatal health in the Black community.
Rewire: What motivates and drives you each day?
Jennie Joseph: I moved to the United States in 1989 [from the United Kingdom], and each year it becomes more and more apparent that to address the issues I care deeply about, I have to put action behind all the talk.
I’m particularly concerned about maternal and infant morbidity and mortality that plague communities of color and specifically African Americans. Most people don’t know that three to four times as many Black women die during pregnancy and childbirth in the United States than their white counterparts.
When I arrived in the United States, I had to start a home birth practice to be able to practice at all, and it was during that time that I realized very few people of color were accessing care that way. I learned about the disparities in maternal health around the same time, and I felt compelled to do something about it.
My motivation is based on the fact that what we do [at my clinic] works so well it’s almost unconscionable not to continue doing it. I feel driven and personally responsible because I’ve figured out that there are some very simple things that anyone can do to make an impact. It’s such a win-win. Everybody wins: patients, staff, communities, health-care agencies.
There are only a few of us attacking this aggressively, with few resources and without support. I’ve experienced so much frustration, anger, and resignation about the situation because I feel like this is not something that people in the field don’t know about. I know there have been some efforts, but with little results. There are simple and cost-effective things that can be done. Even small interventions can make such a tremendous a difference, and I don’t understand why we can’t have more support and more interest in moving the needle in a more effective way.
I give up sometimes. I get so frustrated. Emotions vie for time and energy, but those very same emotions force me to keep going. I feel a constant drive to be in action and to be practical in achieving and getting results.
Rewire: In your opinion, what are some barriers to progress on maternal health and how can they be overcome?
JJ: The solutions that have been generated are the same, year in and year out, but are not really solutions. [Health-care professionals and the industry] keep pushing money into a broken system, without recognizing where there are gaps and barriers, and we keep doing the same thing.
One solution that has not worked is the approach of hiring practitioners without a thought to whether the practitioner is really a match for the community that they are looking to serve. Additionally, there is the fact that the practitioner alone is not going to be able make much difference. There has to be a concerted effort to have the entire health-care team be willing to support the work. If the front desk and access points are not in tune with why we need to address this issue in a specific way, what happens typically is that people do not necessarily feel welcomed or supported or respected.
The world’s best practitioner could be sitting down the hall, but never actually see the patient because the patient leaves before they get assistance or before they even get to make an appointment. People get tired of being looked down upon, shamed, ignored, or perhaps not treated well. And people know which hospitals and practitioners provide competent care and which practices are culturally safe.
I would like to convince people to try something different, for real. One of those things is an open-door triage at all OB-GYN facilities, similar to an emergency room, so that all patients seeking maternity care are seen for a first visit no matter what.
Another thing would be for practitioners to provide patient-centered care for all patients regardless of their ability to pay. You don’t have to have cultural competency training, you just have to listen and believe what the patients are telling you—period.
Practitioners also have a role in dismantling the institutionalized racism that is causing such harm. You don’t have to speak a specific language to be kind. You just have to think a little bit and put yourself in that person’s shoes. You have to understand she might be in fear for her baby’s health or her own health. You can smile. You can touch respectfully. You can make eye contact. You can find a real translator. You can do things if you choose to. Or you can stay in place in a system you know is broken, doing business as usual, and continue to feel bad doing the work you once loved.
Rewire: You emphasize patient-centered care. Why aren’t other providers doing the same, and how can they be convinced to provide this type of care?
JJ: I think that is the crux of the matter: the convincing part. One, it’s a shame that I have to go around convincing anyone about the benefits of patient-centered care. And two, the typical response from medical staff is “Yeah, but the cost. It’s expensive. The bureaucracy, the system …” There is no disagreement that this should be the gold standard of care but providers say their setup doesn’t allow for it or that it really wouldn’t work. Keep in mind that patient-centered care also means equitable care—the kind of care we all want for ourselves and our families.
One of the things we do at my practice (and that providers have the most resistance to) is that we see everyone for that initial visit. We’ve created a triage entry point to medical care but also to social support, financial triage, actual emotional support, and recognition and understanding for the patient that yes, you have a problem, but we are here to work with you to solve it.
All of those things get to happen because we offer the first visit, regardless of their ability to pay. In the absence of that opportunity, the barrier to quality care itself is so detrimental: It’s literally a matter of life and death.
Rewire: How do you cover the cost of the first visit if someone cannot pay?
JJ: If we have a grant, we use those funds to help us pay our overhead. If we don’t, we wait until we have the women on Medicaid and try to do back-billing on those visits. If the patient doesn’t have Medicaid, we use the funds we earn from delivering babies of mothers who do have insurance and can pay the full price.
Rewire: You’ve talked about ensuring that expecting mothers have accessible, patient-centered maternity care. How exactly are you working to achieve that?
JJ: I want to empower community-based perinatal health workers (such as nurse practitioners) who are interested in providing care to communities in need, and encourage them to become entrepreneurial. As long as people have the credentials or license to provide prenatal, post-partum, and women’s health care and are interested in independent practice, then my vision is that they build a private practice for themselves. Based on the concept that to get real change in maternal health outcomes in the United States, women need access to specific kinds of health care—not just any old health care, but the kind that is humane, patient-centered, woman-centered, family-centered, and culturally-safe, and where providers believe that the patients matter. That kind of care will transform outcomes instantly.
I coined the phrase “Easy Access Clinics” to describe retail women’s health clinics like a CVS MinuteClinic that serve as a first entry point to care in a community, rather than in a big health-care system. At the Orlando Easy Access Clinic, women receive their first appointment regardless of their ability to pay. People find out about us via word of mouth; they know what we do before they get here.
We are at the point where even the local government agencies send patients to us. They know that even while someone’s Medicaid application is in pending status, we will still see them and start their care, as well as help them access their Medicaid benefits as part of our commitment to their overall well-being.
Others are already replicating this model across the country and we are doing research as we go along. We have created a system that becomes sustainable because of the trust and loyalty of the patients and their willingness to support us in supporting them.
Joseph speaking with a family at her central Florida clinic. (Credit: Filmmaker Paolo Patruno)
JJ: I consider health care a human right. That’s what I know. That’s how I was trained. That’s what I lived all the years I was in Europe. And to be here and see this wanton disregard for health and humanity breaks my heart.
Not expanding Medicaid has such deep repercussions on patients and providers. We hold on by a very thin thread. We can’t get our claims paid. We have all kinds of hoops and confusion. There is a lack of interest and accountability from insurance payers, and we are struggling so badly. I also have a Change.org petition right now to ask for Medicaid coverage for pregnant women.
Health care is a human right: It can’t be anything else.
Rewire: You launched the National Perinatal Task Force in 2015. What do you hope to accomplish through that effort?
JJ: The main goal of the National Perinatal Task Force is to connect perinatal service providers, lift each other up, and establish community recognition of sites committed to a certain standard of care.
The facilities of task force members are identified as Perinatal Safe Spots. A Perinatal Safe Spot could be an educational or social site, a moms’ group, a breastfeeding circle, a local doula practice, or a community center. It could be anywhere, but it has got to be in a community with what I call a “materno-toxic” area—an area where you know without any doubt that mothers are in jeopardy. It is an area where social determinants of health are affecting mom’s and baby’s chances of being strong and whole and hearty. Therein, we need to put a safe spot right in the heart of that materno-toxic area so she has a better chance for survival.
The task force is a group of maternity service providers and concerned community members willing to be a safe spot for that area. Members also recognize each other across the nation; we support each other and learn from each others’ best practices.
People who are working in their communities to improve maternal and infant health come forward all the time as they are feeling alone, quietly doing the best they can for their community, with little or nothing. Don’t be discouraged. You can get a lot done with pure willpower and determination.
Rewire: Do you have funding to run the National Perinatal Task Force?
JJ: Not yet. We have got the task force up and running as best we can under my nonprofit Commonsense Childbirth. I have not asked for funding or donations because I wanted to see if I could get the task force off the ground first.
There are 30 Perinatal Safe Spots across the United States that are listed on the website currently. The current goal is to house and support the supporters, recognize those people working on the ground, and share information with the public. The next step will be to strengthen the task force and bring funding for stability and growth.
Rewire: You’re featured in the new film The American Dream. How did that happen and what are you planning to do next?
JJ: The Italian filmmaker Paolo Patruno got on a plane on his own dime and brought his cameras to Florida. We were planning to talk about Black midwifery. Once we started filming, women were sharing so authentically that we said this is about women’s voices being heard. I would love to tease that dialogue forward and I am planning to go to four or five cities where I can show the film and host a town hall, gathering to capture what the community has to say about maternal health. I want to hear their voices. So far, the film has been screened publicly in Oakland and Kansas City, and the full documentary is already available on YouTube.
Rewire: The Black Mamas Matter Toolkit was published this past June by the Center for Reproductive Rights to support human-rights based policy advocacy on maternal health. What about the toolkit or other resources do you find helpful for thinking about solutions to poor maternal health in the Black community?
JJ: The toolkit is the most succinct and comprehensive thing I’ve seen since I’ve been doing this work. It felt like, “At last!”
One of the most exciting things for me is that the toolkit seems to have covered every angle of this problem. It tells the truth about what’s happening for Black women and actually all women everywhere as far as maternity care is concerned.
There is a need for us to recognize how the system has taken agency and power away from women and placed it in the hands of large health systems where institutionalized racism is causing much harm. The toolkit, for the first time in my opinion, really addresses all of these ills and posits some very clear thoughts and solutions around them. I think it is going to go a long way to begin the change we need to see in maternal and child health in the United States.
Rewire: What do you count as one of your success stories?
JJ: One of my earlier patients was a single mom who had a lot going on and became pregnant by accident. She was very connected to us when she came to clinic. She became so empowered and wanted a home birth. But she was anemic at the end of her pregnancy and we recommended a hospital birth. She was empowered through the birth, breastfed her baby, and started a journey toward nursing. She is now about to get her master’s degree in nursing, and she wants to come back to work with me. She’s determined to come back and serve and give back. She’s not the only one. It happens over and over again.
This interview has been edited for length and clarity.
The executive directors of the National Network of Abortion Funds and the Abortion Care Network discuss the challenges and opportunities they have faced so far as leaders of abortion access organizations in the context of one of the most hostile cultural and political climates since the landmark Roe v. Wade decision in 1973.
In this exchange, Yamani Hernandez, executive director of the National Network of Abortion Funds, and Nikki Madsen, executive director of the Abortion Care Network, discuss the challenges and opportunities they have faced so far as leaders of abortion access organizations in the context of one of the most hostile cultural and political climates since the landmark Roe v. Wade decision in 1973.
The two leaders also highlight the importance of working across movements to build momentum around expanding abortion care. “In order to rise above the challenges that 2016 will surely present, we will need to continue to work with and alongside movements like Black Lives Matter and Fight for $15, in addition to lifting up abortion care providers and seekers across the country,” said Hernandez.
Madsen added: “Working in partnership and building bridges across movements for health, rights, and justice, and prioritizing the voices and needs of those who face the greatest injustice, will create the kind of robust and broad movement that may finally be effective in confronting the root of our collective oppression, and actually achieve the goal of true reproductive justice.”
Rewire: What brought you to a movement seeking unrestricted access to abortion?
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Yamani Hernandez: I came to the abortion-specific movement because, among other things, I was frustrated with the messaging around abortion, which I felt didn’t necessarily represent my abortion experience and was not super accessible to people in the various communities I come from. I was also frustrated with how dangerous parental involvement laws were seemingly a low priority within the broader movement. “Pro-choice” people will often shy away from advocating for young people’s unfettered access to abortion. Young people are not offered comprehensive sexuality education; birth control is hard to get; and then, if a young person becomes pregnant, they are shamed for parenting and shamed for attempting to access abortion services. I really viewed my arrival to this movement as a way to change it from the inside.
Nikki Madsen: I think a culmination of many moments in my life brought me to this movement and have kept me here for more than a decade. My parents holding open and frank conversations with me about sex; my two step-siblings becoming pregnant and parenting in their teens; volunteering for the National Organization for Women and Planned Parenthood as a young adult; having women’s studies and sociology professors who believed in me; taking a “history of the fetus” course in graduate school (best class ever!); volunteering as a clinic escort at a local, independent abortion care clinic; learning about my grandmother’s pre-Roe abortion; facilitating an after-abortion support group for many years and helping people access financial resources for abortion care in my prior job at Pro-Choice Resources; and planning and creating a family of my own have all shaped the person I am today and my commitment to this essential human rights work.
Rewire: What challenges do you see the movement confronting in 2016?
YH: There’s no denying that we are in a tough climate right now. While we’ve made some great strides forward in 2015, the year was also marked by attacks on abortion providers, TRAP laws, the continuation of the Hyde Amendment—which bans Medicaid coverage of abortion—and stark racism. The election is likely to set the tone for many of our health-care rights, from the Affordable Care Act to protections for or restrictions on abortion, and a lot is at stake. After five years of increased restrictions, we need more elected leaders to speak up for abortion access. Whether we’ll see that in 2016 or in the years that follow is unpredictable, and it’s hard to know whether we’re close to some much-needed victories for low-income people and people of color, or whether we’ll have to struggle more than ever to exercise our basic human rights. The safety of those seeking and providing abortions, the ability to afford health care, and the safety of communities of color are issues integral to the success of the movement. In order to rise above the challenges that 2016 will surely present, we will need to continue working with and alongside movements like Black Lives Matter and Fight for $15, in addition to lifting up abortion care providers and seekers across the country.
NM: It sure would be nice to think that the New Year would bring a respite from the constant challenges of 2015. We all have anxious eyes on the Supreme Court. If the Court rules in favor of Texas’ omnibus abortion law, HB 2, we will see access diminish as more clinics are forced to close their doors, and emboldened legislatures pass more and farther-reaching laws that make it difficult, if not impossible, for people to receive the care they need. We are hopeful that the Court will see the injustice and unconstitutionality in HB 2 and strike it down, but even if it does we are likely to see a continued onslaught of attacks from anti-choice extremists. The dynamics of an election year are likely to escalate already elevated rhetoric against providers and people who seek abortions, which we will see playing out not only in legislatures, but on the streets in front of clinics. I also believe we will continue to see the prosecution of pregnant people for everything from drug use to miscarriage. Attacks on pregnant people are unlikely to stop.
Rewire: What is your hope for bridging intersections between movement leaders, and in what ways do you think intersectionality brings strength to the movement?
We show up for movements that affect those seeking abortions because we don’t lead one-issue lives, and there are many ways we can make real progress in abortion accessibility by supporting economic and racial justice initiatives.
YH: My hope lies in building authentic relationships and integrating our work based on the ways that actual lives are lived. For instance, when people call abortion funds because they have to choose between paying for rent or paying for health care, there’s not only an economic issue but a housing issue. Intersectionality brings strength to the movement because advocates don’t have to sacrifice other aspects of our identity and experience in order to do this work. We know that advocates’ personal experiences actually inform the work they do, and people can bring their whole selves to work when we start connecting abortion access with other political and social needs. Activists from different movements are stronger together, and we can’t keep preaching to the choir. We need more people speaking up and rejecting the status quo, across lines of race, class, gender, geography, and issue area. We show up for movements that affect those seeking abortions because we don’t lead one-issue lives, and there are many ways we can make real progress in abortion accessibility by supporting economic and racial justice initiatives. Abortion rights activists have been showing up for Fight for $15, with national office staff members in Boston and Madison marching in solidarity with low-wage workers, demanding a $15 minimum wage and the right to unionize. We have also made efforts to lift up this issue up in our online and offline communications with supporters and constituents. Since then, we’ve been proud to see the Fight for $15 movement talk about reproductive rights in the context of economic justice. It’s been great to be able to lift one another up.
NM: After the gravity of the challenges we face, this is where I find hope. While Abortion Care Network is obviously focused on abortion care, we know that abortion occurs within the context of people’s lives, where there are many layers of concerns and injustices at play. People’s need for abortion care is wrapped up in their desire for healthy and safe families and communities. Abortion is the exercising of the basic human rights to self-determination and bodily autonomy. We must recognize that the threats to family and community, and the assaults on those basic human rights, are multifaceted and hit people—especially LGBTQ people and people of color—from many directions and in many layers. When we see the struggle for justice in its full frame, and don’t just focus on our own little piece, we can create a more powerful and unified front against our common oppressors. In fact, it’s the only way we can. Working in partnership and building bridges across movements for health, rights, and justice, and prioritizing the voices and needs of those who face the greatest injustice, will create the kind of robust and broad movement that may finally be effective in confronting the root of our collective oppression, and actually achieve the goal of true reproductive justice. It is heartening to see a new generation of activists and organizations leading us in that direction.
Rewire: How do you think the reproductive rights movement should go about investing in new leaders?
YH: I think there are two crucial ways we can invest in new leaders. First, “new” leaders can be younger leaders and sometimes “new” leaders can be people outside of the existing movement. I think that we should invest in explicit succession plans that free up space for new people to join. It would be great for new leaders to have a standard movement-wide orientation that informs them about our history, our opposition, and the unique aspects of doing our work. Second, I could envision a formal executive director support group that these new leaders are brought into. Individual coaching is great, but group coaching could also be really useful. Taking the time to listen to the unique perspectives of each individual could be an essential part of this investment and I can envision this taking place very effectively in a group setting. Drawing strength from the relationships and dialogue we have with one another, “each one reach one” will strengthen not only each individual leader but also the movement as a whole.
NM: Oh how I wish I had the answers. I do think identifying people who will serve as movement mentors for new leaders is essential. And a support group would be lovely.I do know for certain that it’s essential we think beyond our traditional pathways to leadership and structural supports that favor already privileged people. I think much like raising a child, it’s all about your support system. I’m lucky that my position at Abortion Care Network came with a built-in support system, a network comprised of experts and compassionate individuals who allowed me to ask questions and brainstorm ideas. They have lifted me up on the toughest days. For example, just a few weeks before the Colorado shootings at Planned Parenthood, Jamar Clark was shot and killed by police officers in my hometown of Minneapolis. These two tragedies happening so close to one another left me emotionally and physically exhausted as I tried to balance my work demands, commitments to my broader human rights community, and my family. Cristina Aguilar, executive director from COLOR, reached out to me in response to my public statement on the Colorado shootings and offered support—that simple gesture made all the difference in the world.
Rewire: Reflecting on Roe v. Wade, how would you describe what has been happening since it became law, and what is your vision for reclaiming any rights we have lost?
YH: Among many other things, we’ve seen anti-choice lawmakers try literally anything to obstruct access to abortion. We’ve seen waves of clinic closures, steadily increasing numbers of people forced to carry their pregnancy to term against their will, and youth-targeted anti-abortion laws that exist in states that are otherwise progressive when it comes to reproductive health and sex education. Abortion has been stigmatized, racialized, and criminalized to the point that a person can’t have a miscarriage without facing the potential for incarceration, particularly if they are a person of color. Simply put, having something legally on the books and how it actually plays out are entirely different things.
My vision is that all people not only have reclaimed rights but also the resources and recognition to thrive. That means that they can afford the families they want and that they are safe. It also means that they can afford their health care, that it’s in close geographic proximity to them, that it is compassionate health care, and that they don’t have to wait forever to get it. Though the climate is challenging, we are seeing an impressive and powerful wave of people saying, “Enough!” Across the United States, leaders are rising to the challenge, and more and more people continue to join our movement every day. That’s in no small part due to the efforts of member funds on the ground, and providers, and those seeking abortions, telling their experiences and declaring that abortion will not continue to be a health-care option for only those with economic resources. We’re refusing en masse, and people are awake and angry because abortion is a fundamental societal good. We can’t afford to keep going back, and the urgency is spreading like wildfire.
… we must be bold in our language, unafraid to speak openly, proudly, and without defensiveness about the nature of abortion and the positive role it plays in the health and well-being of people, families, and communities.
NM: There just isn’t a simple answer to this question, but there is no doubt that we have lost ground, and I believe that is owed to a movement that has been too narrow in its focus, and too afraid to speak our truth. We have focused primarily on a narrow definition of the right to privacy and to choose, and have used language that both stigmatizes (i.e., “safe, legal and rare,” “no one is pro-abortion, we are pro-choice,” etc.) and lacks the complexity of people’s feelings about abortion. The result has been a movement that has been too quick to accept narrow political victories at the expense of broader justice and access, one that has failed to speak effectively to a broad cross-section of the U.S. public, and that may have contributed to the prevailing silence that exists around the abortion experience. Meanwhile our opponents’ attacks have been broad and their rhetoric bold. When they have been unable to attack the basic isolated right we have protected, they have effectively chipped away at access, disproportionately impacting the most marginalized people and targeting providers, which has weakened our movement at its very base. Our opponents have also effectively spoken to people’s emotions and have systematically shamed and silenced the millions of people who have had abortions. I believe the route forward lies in a broad, intersectional movement that recognizes abortion not as an isolated right, but as a piece in a broader puzzle of justice, and in a unified and coordinated movement for justice. I also believe we must be bold in our language, unafraid to speak openly, proudly, and without defensiveness about the nature of abortion and the positive role it plays in the health and well-being of people, families, and communities.
Rewire: With the case challenging HB 2 (Whole Woman’s Health v. Cole) at the Supreme Court, what is most important for advocates to lift up in conversations about the case?
YH: In the Supreme Court case, Whole Woman’s Health is challenging parts of HB 2: the regulations that require abortion clinics to make massive upgrades to convert their clinics to ambulatory surgical centers, or mini-hospitals, and admitting privileges at local hospitals for abortion providers. Fighting these regulations is extremely important in maintaining access to abortion care across the country, but we must remember that if we win the case, it’s only a bandage on the broader issue. Our callers in Texas, and across the country, will still have an extremely challenging time saving money to pay for their abortion or finding a clinic that they can travel to. They will still have to take time off of work, unpaid, because their jobs don’t offer sick leave. They might risk their immigration status to travel hundreds of miles for an abortion. They’ll have a hard time finding someone to care for their children while they make the multi-day trip to an abortion clinic, or won’t even make the trip because the logistics are too challenging. This case is very important, and we must remember that politicians have put so many barriers in the way that abortion access is becoming nearly impossible for those without economic resources.
NM: It is pretty simple: HB 2 and similar laws are thinly veiled attempts to shut the doors of abortion clinics and limit abortion care. These laws, enacted under the guise of protecting women’s health through stringent regulation, actually do the exact opposite. When clinics are forced to comply with regulations that fall outside of the standards for all other medical facilities, and that are intentionally so expensive and onerous that compliance is difficult if not impossible, many of them will be forced to close their doors. This will leave great numbers of people in this country without access to abortion care, which we know from looking around the world and throughout history is a real and dire threat to people’s health and lives.
Rewire: In 45 amicus briefs sent to the Supreme Court, many people shared their personal abortion stories. Why do you think they chose to share something so personal with the Court?
YH: People want to share their abortion stories because they want to stop the undue burdens put upon us by the state. If abortion is legal, it should not be so hard to access it. People who have abortions aren’t “victims.” Folks want to share their stories because they are taking back the narrative and showing both their resilience and also that enough is enough. They’re hoping that the listener will leave the conversation with a deeper and more complex understanding of abortion. I believe this is what the storytellers are doing in their briefs. They’re asking the Court to understand why access to abortion was so profound and important in their lives, and to maintain that care across the country.
In one of the interviews for our amicus brief, a 31-year-old Texas woman named Courtney asked if the Court wanted to know why she was having an abortion. Courtney explained, speaking about her existing family and children, “Sometimes you don’t know where your next meal is going to come from or how you’re going to pay this bill or [how you’re going to save money] to make sure they eat.” She said she’d rather have an abortion “than bring another kid into the world and make them suffer.” It’s people like Courtney who want the Court to hear their stories. They are doing their best to make their voices heard and speak up about why they decided an abortion was the right decision for them; and in Courtney’s case, it’s because she wants to ensure she is able to provide for her three children. She loves them deeply and she wants the Court to know that abortion was the best decision for her and her family.
NM: Abortion is such a normal and common experience. And yes, it is personal, but the idea that it is something we don’t or shouldn’t talk about is part of the stigma that has been placed on people, not necessarily a universal instinct that abortion need be private. I think there is a growing frustration among people who have had abortions that their experience is both broadly misrepresented in the prevailing public dialogue, and that it is being used to take away from others the necessary access to care. In recent years, organizations dedicated to combating stigma and individuals aided by online communities and social media have created a groundswell of sharing of abortion stories. I feel a growing recognition of the power of those collective stories and resistance of that stigma and silence. Those briefs were powerful and have impact, hopefully with the Court, but also with the public. As a movement we must harness that power, but also effectively support those who are able and willing to share their stories and the personal contribution they have made.
Rewire: The restrictions placed on abortion providers by HB 2 pose a threat to safe and legal abortion access in the state of Texas. What are the national implications of the law?
A threat to legal abortion access in any state is a threat to legal abortion access in every state.
YH: Texas is the largest state where we’ve seen these harsh laws, but the laws are by no means isolated. Neighboring states like Louisiana all the way through the deep South also are losing clinics and creating a sparse patchwork of access. On the other side, we see New Mexico having to absorb a wave of overflow. During the period when HB 2 was being enforced, our Texas abortion funds reported callers having long wait times and many having to forgo their abortions due to time and logistical constraints. Our member funds in the South have had to expand to offer practical support like travel and lodging assistance when there was already not enough resources to pay for abortion procedures. It’s straining the safety nets we’re already struggling to hold together and leaving millions without affordable, accessible abortion care. Which is 100 percent the goal of those passing these laws. If HB 2 is allowed to stand, we can expect an almost immediate wave of copycat laws across the South and Midwest, creating a truly stark divide in the ability to get an abortion in the United States. A threat to legal abortion access in any state is a threat to legal abortion access in every state. We can’t sit by and watch that happen there. It’s unacceptable.
NM: Currently, 1.5 abortion care clinics are closing each week in the United States. And according to Abortion Care Network’s internal numbers, since 2005, almost half of independent abortion care providers, who provide the majority of abortion care in this country, have closed their doors. There is no coincidence that these closures have coincided with the repeated passing of sham laws (like those in HB 2) from state to state, which place restrictions on abortion care clinics and providers and do nothing to protect women and people in need of abortion care. If the Supreme Court accepts the lower court ruling, we will see many more abortion clinics close their doors. And although abortion will technically still be legal under Roe, with each legislative session it will slowly become even more inaccessible for people living anywhere other than the coasts.
Rewire: You both started in May, and the Planned Parenthood videos and the cyber attacks both came in July. How has it felt to be hired for one thing but have to navigate to do something totally different, like security?
YH: It is exceedingly difficult. As a new leader with an organization in transition, dealing with operational challenges like security can really compromise more mission-driven work. We’ve had insurance companies tell us they will not cover us for workers’ compensation because we work on abortion, and that covering our employees is a liability. Last week I came close to signing an office lease, only for the landlord to tell me that they will not rent to us. At such a politically hostile time, running an organization with abortion explicitly in its name has been a bit of a storm. I’m just trying to do my job and build the power of our member organizations. I wasn’t prepared for this, personally or organizationally—I think I’ve needed a different kind of support and I don’t entirely know where to get it. I received a lot of support from my staff, and we were still building our team at the time. Planned Parenthood also offered security support, and a couple of funders responded and assisted with funding so we could research solutions. We are continually strengthening our cyber security, and we’ll be working with our network to build theirs as well.
Recently a friend said to me, “It seems like the worst time in history to become an executive director of a national abortion rights group.” He must have sensed my response, because he quickly followed with, “Or maybe it’s the best?”
NM: Recently a friend said to me, “It seems like the worst time in history to become an executive director of a national abortion rights group.” He must have sensed my response, because he quickly followed with, “Or maybe it’s the best?” All of us working in the reproductive rights, health, and justice movements have felt as if we have been on a roller coaster ride over the past few six months—because we have. On days where I long to do the proactive work I was hired to do, but instead find myself responding to the new crisis, I focus on abortion care providers, clinic owners, movement allies, and people in need of abortion care and it inspires me to push forward. Well, that and red wine.
Rewire: When Planned Parenthood is under attack we are all under attack, but all of us don’t have the same resources as the national health-care organization. How do groups and leaders in the reproductive rights movement navigate this?
YH: Larger organizations really need to take smaller ones into the fold when they are dealing with a problem that impacts everyone. Some of this has happened with Planned Parenthood, but in general, there are tons of operational challenges that most of us organizations are not talking about as a group. Our victory is only possible when we are all working to our highest potential in our area of this movement, when we’re building power on a local and grassroots level. While different organizations have varying levels of resources, we’re all critical to long-term success, and we all have our own specialities and areas of expertise. In this historic moment, when we’re under constant attack, but also seeing higher levels of support than ever, we can channel so much passion into this fight. I know that we will win because we are fighting for a social good, but it will take all of us working together.
NM: Many organizations are necessary to create a healthy ecosystem of abortion care in this country. To truly reach this goal, organizations and leaders within the movement need to find better ways to share resources and support one another—especially the smallest and most under-resourced groups that are often serving the most marginalized communities. It’s essential that we create safe spaces to talk about our organizations’ vulnerabilities with our colleagues and how we can cost-share or support one another to fill the gaps. Equally important is that we encourage our own supporters to give and learn about the essential work of our colleagues. No matter how well resourced or under-resourced we are, we must at all times keep the big picture of a “healthy ecosystem” in the forefront of our mind and work toward that goal.
CORRECTION: This article has been updated to reflect the timeline of the release of attack videos against Planned Parenthood.