Commentary Abortion

A New Generation of Abortion Activists: Reclaiming the Conversation on Abortion One Meeting at a Time

Carly Manes

There are reproductive rights and justice advocates who are having abortion conversations that do not involve scare tactics. They are having these conversations on their campuses, in their homes, and in their communities, and they are doing it the right way. 

To commemorate the 40th Anniversary of Roe v. Wade, this blog is part of a series profiling a new generation of activists working to destigmatize abortion and ensure access to safe, affordable abortion care.

Published in partnership with Advocates for Youth.

I had never heard of the “Genocide Awareness Project” until late last fall one day when I happened to stumble upon a display of pictures in the center of the University of Michigan’s campus. It featured pictures of fetuses and abortion providers branded with swastikas. These pictures were erected in the center of my campus, each grotesque board at least five by six feet.

I learned that the Genocide Awareness Project is a group that travels around the nation to different universities to put up this visually scarring “masterpiece” of theirs in an effort to shock students and start a conversation around abortion that is, to say the least, unproductive and offensive. I knew that equating abortion to genocide—and abortion providers to Nazis—was not the conversation I wanted my campus to engage in if we were to talk openly and honestly about abortion and abortion access.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

It was just dumb luck that I happened to stumble upon the Advocates for Youth website that very same week. After exploring the website and finding the 1 in 3 Campaign, I knew that I had material to work with to create a dialogue on my campus that could actually spark real change and meaningful conversation. It reminded me that there were reproductive rights and justice advocates who were having abortion conversations that did not involve scare tactics. They were having these conversations on their campuses, in their homes, and in their communities, and I knew that they were doing it the right way. The 1 in 3 Campaign does not demonize the practice of abortion, or the women who receive this type of medical care. Instead, it gives them a platform to share their stories.  

That is how I began my work as an abortion activist on my campus. I found a campaign I believed in and started a real conversation with students who knew that what they had seen earlier that semester was not a stepping stone to progress, but a manipulative tactic to engage students in a one-sided conversation on abortion. 

My student group, Students for Choice, began holding small dialogues with the goal of revealing the true facts about abortion and access to safe, affordable abortion care. So far, we have held over 25 abortion dialogues (so far!) based on a five-minute compilation video of different women’s abortion stories. After watching this video, a group of diverse students with a variety of opinions on issues related to abortion talk openly about their feelings in regard to this diverse set of women’s experiences and the participants’ perspectives on abortion in general. Our goal is to create a safe space for these conversations; my group members and I simply facilitate. 

We have planned a panel this March on the issue of abortion stigma, featuring an abortion provider, an abortion activist, and a youth activist coordinator who works specifically on youth organizing around this issue.

As a group of activists, we meet weekly to implement new programs and dialogues to ensure that the conversation on our campus around abortion access is one that is productive and honest. The 1 in 3 Campaign gave us the opportunity to do so. 

As we approach the 40th Anniversary of Roe v. Wade and are once again reminded of the landmark decision four decades ago that legalized abortion, we remember that our work as youth activists is important, significant, and celebrated. Because what good is a right if you can’t exercise it? So we fight on.

Culture & Conversation Maternity and Birthing

On ‘Commonsense Childbirth’: A Q&A With Midwife Jennie Joseph

Elizabeth Dawes Gay

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.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

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.

Photo Credit: Filmmaker Paolo Patruno

Joseph speaking with a family at her central Florida clinic. (Credit: Filmmaker Paolo Patruno)

RewireWhat are your thoughts on the decision in Florida not to expand Medicaid at this time?

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.

RewireDo 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.

RewireYou’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.

RewireThe 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.

RewireWhat 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.

Commentary Race

Have a Problem With Black-Only Spaces? Get Over It

Ruth Jeannoel

As the parade of police killings of Black people continues, Black people have a right to mourn together—and without white people.

This piece is published in collaboration with Echoing Ida, a Forward Together project.

Dear Non-Black People:

If you hear about a healing space being organized for Black folks only, don’t question or try to be part of that space.

Simply, DON’T.

After again witnessing the recorded killings of Black people by police, I am trying to show up for my family, my community, and victims such as Alton Sterling and Philando Castile. I am tired of injustice and ready for action.

But as a Black trans youth from the Miami, Florida-based S.O.U.L. Sisters Leadership Collective told me, “Before taking action, we must create space for healing.” With this comment, they led us in the right direction.

Like This Story?

Your $10 tax-deductible contribution helps support our research, reporting, and analysis.

Donate Now

Together, this trans young person, my fellow organizers, and I planned a Black-only community healing circle in Miami. We recognized a need for Black people to come together and care for each other. A collective space to heal is better than suffering and grieving alone.

As we began mobilizing people to attend the community circle, our efforts were met with confusion and resistance by white and Latinx people alike. Social media comments questioned why there needed to be a Black-only space and alleged that such an event was “not fair” and exclusionary.

We know the struggle against white supremacy is a multiracial movement and needs all people. So we planned and shared that there would be spaces for non-Black people of color and white people at the same time. We explained that this particular healing circle—and the fight against police violence—must be centered around Blackness.

But there was still blowback. One Facebook commenter wrote,

Segregation and racial separation is not acceptable. Disappointing.

That is straight bullshit.

To be clear, Black-only space is itself acceptable, and there’s a difference between Black people choosing to come together and white people systematically excluding others from their institutions and definitions of humanity.

But as I recognize that Black people can’t have room to mourn by ourselves without white tears, white shame, white guilt—and, yes, white supremacy—I am angry.

That is what racist laws have often tried to do: Control how Black people assemble. Enslaved people were often barred from gathering, unless it was with white consent or for church.

Even today, we see resistance when Black folks come together, for a variety of reasons. Earlier this year, in Nashville, Tennessee, Black Lives Matter activists were forced to move their meeting out of a library because it was a Black-only meeting. Last year, students at University of Missouri held a series of protests to demand an end to systemic racism and structural racism on their campus. The student group, Concerned Students 1950, called for their own Black-only-healing space, and they too received backlash from their white counterparts and the media.

At our healing circle in Miami, a couple of white people tried to be part of the Black-only space, which was held in another room. One of the white youths came late and asked why she had to be in a different room from Black attendees. I asked her this question: Do you feel like you are treated the same as your Black peers when they walk down the street?

When she answered no, I told her that difference made it important for Black people to connect without white people in the room. We talked about how to engage in political study that can shape how we view—and change—this world.

She understood. It was simple.

I have less compassion for adults who are doing social justice work and who do not understand. If you do not recognize your privilege as a non-Black person, then you need to reassess why you are in this movement.

Are you here to save the world? Do you feel guilty because of what your family may have done in the past or present? Are you marching to show that you are a “good” person?

If you are organizing to shift and shake up white supremacy but can’t understand your privilege under this construct, then this movement is not for you.

For the white folk and non-Black people of color who are sincerely fighting the anti-Blackness at the root of most police killings, get your people. Many of them are “progressive” allies with whom I’ve been in meetings, rallies, or protests. It is time for you to organize actions and events for yourselves to challenge each other on anti-Blackness and identify ways to fight against racial oppression, instead of asking to be in Black-only spaces.

Objecting to a Black-only space is about self-interest and determining who gets to participate. And it shows how little our allies understand that white supremacy gives European-descended people power, privilege, and profit—or that non-Black people of color often also benefit from white supremacy just because they aren’t Black in this anti-Black world.

Our critics were using racial privilege to access a space that was not for them or by them. In the way that white supremacy and capitalism are about individualism and racing to the top, they were putting their individual feelings, rights, and power above Black people’s rights to fellowship and talk about how racism has affected them.

We deserve Black-only community healing because this is our pain. We are the ones who are most frequently affected by police violence and killings. And we know there is a racial empathy gap, which means that white Americans, in particular, are less likely to feel our pain. And the last thing Black people need right now is to be in a room with people who can’t or won’t try to comprehend, who make our hurt into a spectacle, or who deny it with their defensiveness.

Our communal responses to that pain and healing are not about you. And non-Black people can’t determine the agenda for Black action—or who gets a seat at our table.

To Black folks reading this article, just know that we deserve to come together to cry, be angry, be confused, and be ready to fight without shame, pain, or apologies.

And, actually, we don’t need to explain this, any more than we need to explain that Black people are oppressed in this country.