This week begins the major UN Rio+20 “Earth Summit,” and I’ll be covering women and reproductive health (RH) issues as relate to the official UN proceedings, the NGO perspectives, and global south women’s personal stories on how Rio+20 touches their lives.
June 18, 2012, From Rio:This week begins the major UN Rio+20 “Earth Summit,” and I’ve just arrived at the sprawling “Rio Centro” complex where the official UN negotiations and many non-governmental organizations’ (NGOs) side-events are taking place. While here for the duration of the meeting, I’ll be covering women and reproductive health (RH) issues as relate to the official UN proceedings, the NGO perspectives, and global south women’s personal stories on how Rio+20 touches their lives.
The scene here at Rio Centro is against a backdrop of lush tropical vegetation and the distinctive towering Rio de Janeiro mountain ranges. Once inside, the scale of activity is daunting: thousands of country delegates, non-governmental organization (NGO) representatives, students and youth advocates, and grassroots leaders from around the globe – are all vying for their piece of protecting the planet’s natural resources. There are many voices here, and I am concentrating on how “women and RH” will play out, how it will feature in the final Rio+20 outcome document, and beyond the Rio+20 meeting.
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Dr Musimbi Kanyoro, Executive Director, Global Fund for Women
Today I attended a keystone side-event which set the scene perfectly, on “Sustainability Revisited: Population, Reproductive Health (RH), and the Planet”, co-organized by the Aspen Institute’s Global Leaders Council for Reproductive Health, International Planned Parenthood Federation (IPPF), and the UN Foundation (UNF). High level speakers included Gro Harlem Brundtland, former Prime Minister of Norway and a crafter of the original Rio outcome Agenda 21, Musimbi Kanyoro, CEO of the Global Fund for Women, Mary Robinson, former President of Ireland, Timothy E. Wirth, President, UNF, Tewodros Melesse, Director General, IPPF, and Peggy Clark, VP, Aspen Institute as Moderator.
The remarkable leadership panel had a consensus on several key points, including:
Sustainable development requires the empowerment of women as a pre-condition for any real change, the key components of which are the right to education, economic opportunities, and universal access to family planning
Neither reckless resource consumption nor rapid population growth are sustainable
Empowerment of women and family planning are human rights issues that are mainstream, not to be sidelined or seen as controversial as they are now
Filling the 215 million strong “unmet need” for family planning and reproductive healthcare is an essential, cost-effective tool for achieving women’s empowerment and sustainable development
The side-event speakers also reported on the status of the official UN Rio+20 deliberations.
Panelists Gro Harlem Brundltand, Peggy Clark, Mary Robinson and Timothy E. Wirth
The feeling was mixed, that reference to women and RH is now in the negotiated text (it wasn’t in the original draft), but there’s a big risk of it being put on the back-burner, with feeble mention and no commitments. Negotiators have not been able at this point to get clear text on women and RH issues in the Rio+20 outcome document. In these finals days of negotiations, the speakers felt we must hold firm and prevent a backsliding from the strong language on these issues already achieved at the UN International Conference on Population and Development (ICPD) and Beijing Women’s conferences.
A key point was that it was critical that reference to women and RH be in the framing language – or “vision section” – in the introduction of the Rio+20 outcome document. As Mary Robinson put it, these are mainstream development issues and must be treated that way in the Rio+20 document.
There is pressure by the Vatican (is that really a country? It has a full vote at the UN!) and Algeria to strike all reference to women’s empowerment and RH, or at least move it to the back of the document to obscurity. Stay tuned on that one! The fight is on and I can tell you this leadership panel’s message was clear. As Senator Wirth stated, “It’s fine if they stay in the 19 century, but we are going to move ahead”.
Closing statements at the side-event centered on facing opposition to these issues with strong, clear messages in support of women’s empowerment, universal access to RH, meeting the unmet of family planning globally – and the finances to support it all. And Dr Kanyoro’s voice summation was poignant: “I speak as a person from a developing country and as a woman, and to argue that population growth isn’t important just isn’t right. Population growth weakens our development systems, and is not going to help women or developing nations. We need to address population growth from the perspective of empowerment of women.”
So, although the official Rio+20 process focuses primarily on assessing, managing and financing for protection of the world’s natural resources, there are increasingly strong forces highlighting the human dimension.
As the Rio+20 outcome document will frame how nations worldwide will achieve sustainable development in the foreseeable future, it is obvious there is a strong drive to include women, reproductive health and rights as central. The Women’s Major Group is taking the lead in monitoring and providing input to the official negotiations of specific Rio+20 outcome document text on gender. And many other women’s and RH advocates here in Rio are organized, speaking out, and powerful as they present passionate, informed and strategic input into this Rio+20 process. From what I see here, these issues are gaining traction as the negotiations move forward. Watch this space as the week goes on for how it all turns out.
Tomorrow: I visit a Rio favela or shanty-town to see a family planning clinic and speak with youth there. Later in the week I will interview women’s activists and grassroots leaders including a peasant farmer from Uganda, community activist from the Pacific Cook Islands, and youth leaders from Nigeria and the Philippines on “women and RH”, and their hopes for Rio+20.
State legislatures came into session in January and quickly focused on a range of sexual and reproductive health and rights issues. By the end of the first quarter, legislators in 45 states had introduced 1,021 provisions. Of the 411 abortion restrictions that have been introduced so far this year, 17 have passed at least one chamber, and 21 have been enacted in five states (Florida, Indiana, Kentucky, South Dakota, and Utah).
This year’s legislative sessions are playing out on a crowded stage. The U.S. Supreme Court is considering a case involving a package of abortion restrictions in Texas; that decision, when handed down in June, could reshape the legal landscape for abortion at the state level. Moreover, just as state legislatures were hitting their stride in late March, the U.S. Food and Drug Administration revised the labeling for mifepristone, one of the two drugs used for medication abortion. That decision immediately put the issue back on the front burner by effectively counteracting policies restricting access to medication abortion in a handful of states. (Notably, the Arizona legislature moved within days to enact a measure limiting the impact of the FDA decision in the state.)
Progress on Several Fronts
Despite the ongoing attention to restricting abortion, legislators in several states are looking to expand access to sexual and reproductive health services and education. By the end of the first quarter, legislators in 32 states had introduced 214 proactive measures; of these, 16 passed at least one legislative body, and two have been enacted. (This is nearly the same amount introduced in the year 2015, when 233 provisions were introduced.)
Although the proactive measures introduced this year span a wide range of sexual and reproductive health and rights issues, three approaches have received particular legislative attention:
Allowing a 12-month contraceptive supply. Legislators in 16 states have introduced measures to allow pharmacists to dispense a year’s supply of contraceptives at one time; these bills would also require health plans to reimburse for a year’s supply provided at once. (In addition, a bill pending in Maryland would cover a six-month supply.) Legislative chambers in three states (Hawaii, New York, and Washington) have approved measures. Similar measures are in effect in Oregon and the District of Columbia.
Easing contraceptive access through pharmacies. Legislators in 12 states have introduced measures to allow pharmacists to prescribe and dispense hormonal contraceptives. As of March 31, bills have been approved by at least one legislative chamber in Hawaii and Iowa and enacted in Washington. The measures in Hawaii and Iowa would require pharmacist training, patient counseling, and coverage by insurance; the Hawaii measure would apply only to adults, while the Iowa measure would apply to both minors and adults. The new Washington law directs the state’s Pharmacy Quality Assurance Commission to develop a notice that will be displayed at a pharmacy that prescribes and dispenses self-administered hormonal contraception. Under current state law, a pharmacy may prescribe and dispense these contraceptives under a collaborative practice agreement with an authorized prescriber. Oregon has a similar measure in effect. (California, the only other state with such a law, issued regulations in early April.)
Expanding education on sexual coercion. Measures are pending in 17 states to incorporate education on dating violence or sexual assault into the sex or health education provided in the state. A bill has been approved by one legislative chamber in both New Hampshire and New York. The measure approved by the New Hampshire Senate would require age-appropriate education on child sexual abuse and healthy relationships for students from kindergarten through grade 12. The measure approved by the New York Senate would mandate education on child sexual abuse for students from kindergarten through grade 8. And finally, in March, Virginia enacted a comprehensive new law requiring medically accurate and age-appropriate education on dating violence, sexual assault, healthy relationships, and the importance of consensual sexual activity for students from kindergarten through grade 12. Virginia will join 21 other states that require instruction on healthy relationships.
Ongoing Assault on Access to Sexual and Reproductive Health Services
Even as many legislators are working to expand access to services, others are continuing their now years-long assault on sexual and reproductive health services and rights. Restricting access to abortion continues to garner significant attention. However, last year’s release of a series of deceptively edited sting videos targeting Planned Parenthood has swept both the family planning safety net and biomedical research involving fetal tissue into the fray.
Abortion bans. Legislative attempts to ban abortion fall along a broad continuum, from measures that seek to ban all or most abortions to those aimed at abortions performed after the first trimester of pregnancy or those performed for specific reasons.
Banning all or most abortions. Legislators in nine states have introduced measures to ban all or most abortions in the state, generally by either granting legal “personhood” to a fetus at the moment of conception or prohibiting abortions at or after six weeks of pregnancy. Only one of these measures, a bill in Oklahoma that would put performing an abortion outside the bounds of professional conduct by a physician, has been approved by a legislative chamber.
Banning D&E abortions. Legislators in 13 states have introduced measures to ban the most common technique used in second-trimester abortions. Of these, a bill in West Virginia was enacted in March over the veto of Gov. Earl Ray Tomblin (D). A similar measure was approved by both houses of the Mississippi legislature and is being considered by a conference committee. (Kansas and Oklahoma enacted similar laws last year, but enforcement of both has been blocked by court action.)
Banning abortion at 20 weeks post-fertilization. South Dakota and Utah both enacted measures seeking to block abortions at 20 weeks during the first quarter of the year. The new South Dakota law explicitly bans abortions at 20 weeks post-fertilization (which is equivalent to 22 weeks after the woman’s last menstrual period). The Utah measure requires the use of anesthesia for the fetus when an abortion is performed at or after that point, something that providers would be extremely unlikely to do because of the increased risk to the woman’s health. In addition to these new measures, 12 other states ban abortion at 20 weeks post-fertilization.
Banning abortion for specific reasons. In March, Indiana enacted a sweeping measure banning abortions performed because of gender, race, national origin, ancestry, or fetal anomaly; no other state has adopted such a broad measure. The Oklahoma House approved a measure to ban abortion in the case of a fetal genetic anomaly; the state already bans abortion for purposes of sex selection. Currently, seven states ban abortion for the purpose of gender selection, including one state that also bans abortion based on race selection and one that also bans abortion due to fetal genetic anomaly.
Family planning funding restrictions. In the wake of the Planned Parenthood videos, several states have sought to limit funding to family planning health centers that provide or refer for abortion or that are affiliated with abortion providers. These efforts are taking different forms across states.
Medicaid. Measures to exclude abortion providers (e.g., Planned Parenthood affiliates) from participating in Medicaid have been introduced in five states, despite the clear position of the federal Centers for Medicare and Medicaid Services that such exclusions are not permitted under federal law. In March, Florida Gov. Rick Scott (R) signed a Medicaid restriction into law. By the end of the first quarter, measures had passed one chamber of the legislature in Arizona, Mississippi, and Missouri; a measure introduced in Washington has not been considered. (A related measure enacted in Wisconsin in February limits reimbursement for contraceptive drugs for Medicaid recipients.)
Similar attempts by six other states have been blocked by court action since 2010. These measures include laws adopted by Indiana and Arizona as well as administrative actions taken in Alabama, Arkansas, Louisiana, and Texas.
Other family planning funds. Legislators in 13 states have introduced measures to prevent state or federal funds that flow through state agencies from being distributed to organizations that provide, counsel, or refer for abortions; the measures would also deny funds to any organization affiliated with an entity engaging in these activities. Measures in three of these states have received significant legislative attention. In February, Wisconsin enacted a measure directing the state to apply for Title X funds (the state is not currently a grantee under the program); if the state’s application were approved, the measure would ban this funding from going to organizations that engage in abortion care-related activity. A measure that would deny funds to organizations engaged in abortion care-related activity passed the Kentucky Senate in February. A similar measure in Virginia, which would both prohibit an abortion provider from receiving funding and give priority to public entities (such as health centers operated by health departments) in the allocation of state family planning funds was vetoed by Gov. Terry McAuliffe (D) in March.
Related funds. In February, Ohio Gov. John Kasich (R) signed a measure barring abortion providers or their affiliates from receiving federal funds passing through the state treasury to support breast and cervical cancer screening; sex education; and efforts to prevent infertility, HIV in minority communities, violence against women, and infant mortality.
Fetal tissue research. The Planned Parenthood videos have also led to legislation in 28 states aimed at research involving fetal tissue. Measures have passed one legislative chamber in four states (Alabama, Iowa, Idaho, and Kentucky), and new laws have been enacted in four states (Arizona, Florida, Indiana, and South Dakota) in the first quarter alone. All four laws ban the donation of fetal tissue for purposes of research. These new laws are the first to ever ban the donation of fetal tissue. The Arizona law also bans research using fetal tissue, and the new South Dakota law strengthens the state’s existing ban by now considering fetal tissue research as a felony; four other states (Indiana, North Dakota, Ohio and Oklahoma) have similar provisions in effect.
Zohra Ansari-Thomas, Olivia Cappello, and Lizamarie Mohammed all contributed to this analysis.
Ideological warfare about abortion via advertising has a long track record, though it’s a past largely forgotten in history’s fog and the present’s relentless attacks on abortion rights. Today’s reproductive rights and justice advocates can’t afford to forget that past.
This piece is published in collaboration with Echoing Ida, a Forward Together project.
Across the United States, billboards are visible evidence of the contentious abortion debate. Enlarged images of fetuses, cherubic babies, distressed women, and Bible verses tower over highways and byways like anti-abortion sentinels overseeing America’s culture wars.
Notice I didn’t mention images that show happy, pro-choice women, for it’s a lopsided roadside debate.
Rarely do we see billboards promoting abortion rights or the broader ideals of reproductive justice; there are few examples like New Voices Cleveland’s recent sponsorship of these billboards that affirmed, in the wake of the police killing of 12-year-old Tamir Rice in the city, that reproductive justice includes the right to parent and protect children. Abortion opponents have effectively cornered the market on this advertising medium and, to paraphrase a hackneyed phrase from “American Idol” judges, have made the billboard their own.
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But the good news: The billboard is just a tool (like video is a tool)—and tools can be harnessed for any movement. In fact, past abortion-rights advocates used billboards to good effect—even before Roe v. Wade. Ideological warfare about abortion via advertising has a long track record, though it’s a past largely forgotten in history’s fog and the present’s relentless attacks on abortion rights. Today’s reproductive rights and justice advocates can’t afford to forget that past. They may need to “go back to the future” to resurrect this tool in an era where women face increasing restrictions on abortion, and providers face proposed laws that would curtail their ability to offer reproductive health care to women most in need.
So what is it that advocates need to remember or learn? For starters, many early billboards functioned as straightforward advertising for abortion—even when it wasn’t widely legal. This roadside sign popped up in McGrann, Pennsylvania, in 1971 and pointed people to neighboring New York state, which had legalized abortion in 1970.
Similar billboards featuring phone numbers began sprouting like giant flowers on the American landscape. As this picture demonstrates, referral services—some nonprofit and some that operated as for-profit entities—also took to streetsides before Roe to tell women that they could find health carein the form of abortion and sterilization.
Distributing information about abortion through billboards or other advertisements was not without risk; those who did so could face arrest. In 1972, Charlottesville, Virginia, newspaper editor Jeffrey Bigelow was charged with running advertisements for a New-York based abortion referral service and convicted under a state law banning any public promotion of abortion services. The case eventually made its way to the U.S. Supreme Court, but took a back seat to the bigger challenges to abortion bans: the cases that would become Roe and Georgia’s Doe v. Bolton. Bigelow v. Virginia was eventually decided in 1975; Bigelow’s conviction was overturned because there could be no limits on the advertising of a service that had become legal.
At the same time, the young anti-abortion movement was also rolling out its own billboards, said historian Jennifer Donnally, a Hollins University visiting professor who researches abortion politics and the new right. From the early days when anti-abortion advocates were organizing against state-level abortion law reform, they have made billboards a key part of their messaging.
“Anti-abortion billboards began to appear on highways in New York, Massachusetts, Michigan, and Washington [state] prior to the 1973 Roe v. Wade decision as part of statewide campaigns against abortion repeal efforts,” Donnally told Rewire.
Many of those billboards were tied to specific ballot measures or potential law changes. In 1970, when Washington state planned a referendum where voters could decide to allow abortion in some circumstances, opponents (and their billboards) came out in full force. “Kill Referendum 20, not me,” implored a billboard picturing a fake fetus cradled in an adult hand. Accused of using tasteless scare tactics, Voice of the Unborn (the group behind the billboards) replied through a representative, reported the New York Times in October of that year: “They show an exact medical school replica of a 4-month-old baby. If the billboards seem to be shocking, perhaps it’s the idea of abortion that’s shocking.” (The referendum passed with 56 percent of the vote, and allowed women and girls to have abortions if they requested them, with the consent of their husbands or guardians, and if the procedure was performed by a licensed physician.)
Donnally noted that anti-abortion billboards have taken different forms and served many purposes over time. They moved from makeshift messages in cornfields to slick public-relations creations, and they mobilized supporters in different ways according to the movement’s age and successes.
“The publicity billboards educatedthe public and recruited potential activists. Behind the scenes, efforts to place billboards trained anti-abortion activists in fundraising and media relations while also [making] activists feel effective when the movement was in its early stages, following setbacks or celebrating victories. Sometimes, billboard campaigns were sophisticated. Other times, a farmer in a rural area who had a hard time connecting to anti-abortion chapters concentrated in cities and towns took action into his or her own hands,” added Donnally. “They made a plywood anti-abortion sign and posted it on their land next to a heavily traveled highway.”
After the Bigelow ruling, anti-abortion advertising gained steam in the mid-1970s. A February 1976 Village Voice article called John C. Willke, then a practicing obstetrician and a future president of the National Right to Life Committee, the “visual aids guru of the pro-life movement.” Willke’s first visual aids were often slideshows that Willke and his wife presented in talks to high schoolers.
But, according to the article, Willke’s “newest project [was] the creation of the three billboard posters. The least offensive reads ‘Abortion: A woman’s right to choose.’” “Choose” was crossed out and replaced with “kill.” A second billboard depicted tiny feet and this text: “This baby won’t keep his mother awake at night … at least not yet.” Willke planned to erect a fetus billboard atop a building across from a Minnesota hospital that provided abortions, the article added.
Willke’s focus on the fetus and abortion’s supposedly negative and life-changing effects on the woman—now cornerstones of anti-abortion rhetoric—was an experimental and emergent strategy then. Emphasizing abortion as an emotional harm and women as its simultaneous victims and perpetrators, right-to-life groups were often explicit when telling their members how to best deploy billboards. An undated newsletter from the Jackson, Mississippi-based Christian Action Group provided hand-drawn illustrations of possible billboards, one showing “baby’s first visit to the doctor,” a menacing-looking physician holding a black sack and a frazzled woman hovering in the background. Also included was a sample billboard that showed a hand wielding a scalpel, labeled “a pro-choice pacifier.”
The illustrations came with this advice on using billboards to the best advantage: “One form of ‘advocacy advertising,’ such as political advertising, is to convince people of the justification of your point of view. Another is to make people ashamed to be with your [opponents]. These billboards are the latter.” Cultivating and multiplying shame was a tactic. As abortion opponents’ philosophy went, Americans—even the most well-intentioned or those ignorant of the “real” story about abortion—needed to be confronted visually with their silent complicity.
When Roe came under significant legal challenge in the 1980s, billboards became even more overtly political. In 1988, the year before the U.S. Supreme Court decision Webster v. Reproductive Health Services that allowed states to restrict abortion, a Planned Parenthood billboard showed six male (and mostly anti-abortion) Supreme Court justices holding their own sign saying “Freedom of Choice,” but with Chief Justice William Rehnquist slamming his gavel on the word “of” and Justices Harry Blackmun and Clarence Thomas holding a replacement sign with the word “from.” Also in 1988, anti-abortion activists experimented with a new form of advertising by placing anti-abortion placards in Atlanta taxis during the Democratic National Convention there.
A year later, in 1989, Prolife Across America was up and running. It works as an anti-abortion billboard mill, cranking out design after design (as well as radio spots and other advertising).
Therein lies the difference: Billboards have been institutionalized in anti-abortion media strategy and organizations, but they seemed to fade from the strategic agendas of reproductive rights organizations. In 2014, the Prolife Across America/Prolife Minnesota tax return reported that its designs were emblazoned on more than 6,000 billboards, reaching Americans stuck in traffic or driving to work every day with its larger-than-life messages. The group often says those messages are hotlines for pregnant women, educational, and roadside ministry all wrapped into one. Other organizations provide templates or the actual printed vinyl panels that bear the messages and drape over the standard billboard frames for prices as cheap as $200 (not including the cost of billboard rental, which varies widely according to geography, company, and the estimated number of motorists and views at given locations).
As the billboard has become a consistent anti-abortion platform, the messages billboards have carried read like a conversation between abortion opponents and other social movements. Billboard makers have blatantly adaptedthe slogans of feminism and civil rights and even the images of Black political leaders such as Frederick Douglass or Barack Obama—and with varying degrees of deftness or tone-deafness.
By the 1990s, billboards in the Midwest had reworked a common feminist bumper sticker to read “Pro-life: The radical idea that fetuses are people.” Later, billboards took an explicitly racial turn. In 2011, billboards proclaiming “Black & Beautiful” alongside pictures of Black infants appeared in Oakland, California. Sponsored by the anti-abortion group Issues4Life, the billboards appropriated the language of the Black Panther movement, which had its most well-known and vocal chapter in the Bay Area city.
Images and messages on billboards that explicitly targeted Black communities—and paved the way for others aimed at Latinos and Asians—were not entirely new. As scholar Gillian Frank has pointed out, a 1972 Michigan referendum about changing that state’s abortion law pushed anti-abortion groups to begin developing brochures that pictured Black babies and compared abortion to slavery, now old-hat anti-abortion fare.
More than 20 years later, diverse groups protested the encroachment of racist billboards in their home communities. In Oakland in 2011, Strong Families and a coalition of multiracial groups joined forces to persuade CBS Outdoor to take down controversial signage—a campaign similar to one used a year before by the Atlanta-based SisterSong Women of Color Reproductive Justice Collective when billboards also owned by CBS and claiming that “black children are an endangered species” appeared in the Georgia capital. Earlier this year, the reproductive justice group SisterReach successfully pushed for the removal of anti-abortion billboards in Tennessee.
Yet the hand that giveth does taketh away. Contemporary groups fighting for abortion access find that many billboard and other advertising companies reserve the right to deny or take down controversial content. And those contractual stipulations mean that some companies will reject outright advertising that specifically references abortion or simply points women to services—for fear that the other side will cause a ruckus and demand its removal. Fears of the “A-word” have made it into the online world, with Google determining that abortion ads were “non-family-safe” content and categorizing them with adult advertising and entertainment.
Whatever the advertising format, it’s clear that this type of commercial and political speech isn’t going away. And few people know that better than Jasmine Burnett, New Voices Cleveland’s field organizer in the Midwest. In 2010, she led the campaign to take down a SoHo, New York, billboard that proclaimed the most dangerous place for a Black person was the womb, and this year, Burnett was a driving force behind the Cleveland billboard.
Burnett said that it’s not enough to mount defensive campaigns that respond to the propagandistic billboards that increasingly dot urban and mostly Black neighborhoods. What’s necessary is billboard activism that moves beyond reproductive rights’ preoccupation with abortion and, in keeping with a reproductive justice lens, addresses the racism that’s an American bedrock.
“Anti-abortion billboards are an affront and an attack. [In doing the billboards, New Voices Cleveland] wanted to provide other spaces for creative thought, affirmation, and liberation,” said Burnett. “We work for the full health and well-being of Black women and people. For us, full health means having a different image of ourselves, being able to control and discuss our reproduction, and thinking about how we navigate self-determination in the midst of white supremacy.
“There are not many [billboards or other advertising] that talk about Black people’s lives,” Burnett added. “And we wanted our billboards to say, ‘We support your decision and right to parent or not parent. And we care about your life.’”