"to go back and get it:"

The night I found out my closest sister was pregnant I was on my way home from a lecture by a Planned Parenthood representative. The lecture was about the lack of access to sexual health services in poor communities and communities of color. I was catching a ride home with someone I knew and my cousin, sister, friend called to say "I have something to tell you.....I'm pregnant" We were both 19 years old. I was in my sophomore year of college. She was living in small town, America just trying to make it.


The abstract concept that people, with out money, living in rural areas, or in urban centers, where billboards say "who's your daddy?" and promote cigarettes and liquor consumption, do not have access to accurate information about sexual health and reproduction became extremely concrete. My closest sister was pregnant. As an abortioneer my first reaction was, "ok, ok you have options" After a few hours talking with her mom and calling me she firmly decided to keep the pregnancy. As an abortioneer I was very supportive of my childhood soul mate choosing motherhood.
If my sister had a ride to the nearest planned parenthood nearly an hour away she might have been on birth control. She may have also chosen not to use birth control. The thing is her lack of access to transportation and money meant she also lacked access to birth control. She didn't have the ability or opportunity to make a choice about what birth control method to use, if any.

During the Planned Parenthood lecture I attended earlier in the evening I also learned that the father of gynecology, J. Marion Sims, developed much of the science of gynecology through experiments on enslaved African women and poor Irish immigrants. He did not use anesthesia on these patients because there was a widespread belief that they were less sensitive to pain than wealthy white women. J. Marion Sims owned slaves and it is documented that he did experimental procedures on women that he "owned". He was well known as a plantation physician and treated numerous enslaved Africans.

I was appalled to find out that gynecology was born out of a racist and classist history. In this country social inequality is built into the most basic fibers. The enslavement of Africans, annihilation of natives, and exploitation of poor people is at the very roots of the development of the good ol' U.S. of A. This country was built by people of color and poor people to serve the needs of wealthier white landowners. The science of gynecology is no exception.

The ability to determine one's life is based on one's access to resources. People who are historically disenfranchised do not have the ability to access necessary resources. Maybe that necessary resource is a ride to planned parenthood for birth control or STD testing. Maybe that resource is a safe abortion, or maybe its a condom or an education.

The history of this country cannot be erased. The West African Adinkra symbol Sankofa means "to go back and get it" and is representative of learning from the past. Racism and classism is not ancient history. Access to resources is one very concrete way the history of racism and classism in this country has translated into today. The ability to control one's body and reproduction is the most basic human right. Women need access to birth control and sexual health care in order to gain this very basic human right.

"What Can the White Man Say to the Black Woman?"

O RLY? How about, "Every __ minutes, our next possible leader is incarcerated, gunned down, flunked, raped, given a black eye, impregnated, refused a job, denied benefits, evicted, exposed to industrial waste from next door, and otherwise cut down by the society that presumes to tell her, or tell his/her mother, what to do"? 

It seems we have not yet finished with the ludicrous gaggle of racist billboards, springing up from coast to coast, which chastise black women for "endangering" their own race (well, they use the creepy word "species") or for depriving the world of "our next possible leader" (weirdly, they say this although Obama's mother was white). Since this gaggle refuses to fade from our visual diet just yet, I wanted to at least offer you the following as a sort of curricular complement to it* (with thanks to NNAF who pointed it out to us).

One last thing: notice the date this speech was given. Yes, 1989. "Black women endanger their unborn children" is not a new insult, and the fact that black women's challenges to it have been consistent over time and remain unsatisfied to this day speaks volumes about the intentions of those who would tell them what to do about their pregnancies.


What Can the White Man Say to the Black Woman?
By Alice Walker, address in support of the National March for Women’s Equality and Women’s Lives in Washington D.C., 22 May 1989


What is of use in these words I offer in memory of our common mother. And to my daughter.

What can the white man say to the black woman?

For four hundred years he ruled over the black woman’s womb.

Let us be clear. In the barracoons and along the slave shipping coasts of Africa, for more than twenty generations, it was he who dashed our babies brains out against the rocks.

What can the white man say to the black woman?

For four hundred years he determined which black woman’s children would live or die.

Let it be remembered. It was he who placed our children on the auction block in cities all across the eastern half of what is now the United States, and listened to and watched them beg for their mothers’ arms, before being sold to the highest bidder and dragged away.

What can the white man say to the black woman?

We remember that Fannie Lou Hamer, a poor sharecropper on a Mississippi plantation, was one of twenty-one children; and that on plantations across the South black women often had twelve, fifteen, twenty children. Like their enslaved mothers and grandmothers before them, these black women were sacrificed to the profit the white man could make from harnessing their bodies and their children’s bodies to the cotton gin.

What can the white man say to the black woman?

We see him lined up on Saturday nights, century after century, to make the black mother, who must sell her body to feed her children, go down on her knees to him.

Let us take note:

He has not cared for a single one of the dark children in his midst, over hundreds of years.

Where are the children of the Cherokee, my great grandmother’s people?

Gone.

Where are the children of the Blackfoot?

Gone.

Where are the children of the Lakota?

Gone.

Of the Cheyenne?

Of the Chippewa?

Of the Iroquois?

Of the Sioux?

Of the Mandinka?

Of the Ibo?

Of the Ashanti?

Where are the children of the Slave Coast and Wounded Knee?

We do not forget the forced sterilizations and forced starvations on the reservations, here as in South Africa. Nor do we forget the smallpox-infested blankets Indian children were given by the Great White Fathers of the United States government.

What has the white man to say to the black woman?

When we have children you do everything in your power to make them feel unwanted from the moment they are born. You send them to fight and kill other dark mothers’ children around the world. You shove them onto public highways in the path of oncoming cars. You shove their heads through plate glass windows. You string them up and you string them out.

What has the white man to say to the black woman?

From the beginning, you have treated all dark children with absolute hatred.

Thirty million African children died on the way to the Americas, where nothing awaited them but endless toil and the crack of a bullwhip. They died of a lack of food, of lack of movement in the holds of ships. Of lack of friends and relatives. They died of depression, bewilderment and fear.

What has the white man to say to the black woman?

Let us look around us: Let us look at the world the white man has made for the black woman and her children.

It is a world in which the black woman is still forced to provide cheap labor, in the form of children, for the factories and on the assembly lines of the white man.

It is a world into which the white man dumps every foul, person-annulling drug he smuggles into creation.

It is a world where many of our babies die at birth, or later of malnutrition, and where many more grow up to live lives of such misery they are forced to choose death by their own hands.

What has the white man to say to the black woman, and to all women and children everywhere?

Let us consider the depletion of the ozone; let us consider homelessness and the nuclear peril; let us consider the destruction of the rain forests_in the name of the almighty hamburger. Let us consider the poisoned apples and the poisoned water and the poisoned air and the poisoned earth.

And that all of our children, because of the white man’s assault on the planet, have a possibility of death by cancer in their almost immediate future.

What has the white, male lawgiver to say to any of us? To those of us who love life too much to willingly bring more children into a world saturated with death?

Abortion, for many women, is more than an experience of suffering beyond anything most men will ever know; it is an act of mercy, and an act of self-defense.

To make abortion illegal again is to sentence millions of women and children to miserable lives and even more miserable deaths.

Given his history, in relation to us, I think the white man should be ashamed to attempt to speak for the unborn children of the black woman. To force us to have children for him to ridicule, drug and turn into killers and homeless wanderers is a testament to his hypocrisy.

What can the white man say to the black woman?

Only one thing that the black woman might hear.

Yes, indeed, the white man can say, Your children have the right to life. Therefore I will call back from the dead those 30 million who were tossed overboard during the centuries of the slave trade. And the other millions who died in my cotton fields and hanging from trees.

I will recall all those who died of broken hearts and broken spirits, under the insult of segregation.

I will raise up all the mothers who died exhausted after birthing twenty-one children to work sunup to sundown on my plantation. I will restore to full health all those who perished for lack of food, shelter, sunlight, and love; and from my inability to see them as human beings.

But I will go even further:

I will tell you, black woman, that I wish to be forgiven the sins I commit daily against you and your children. For I know that until I treat your chil dren with love, I can never be trusted by my own. Nor can I respect myself.

And I will free your children from insultingly high infant mortality rates, short life spans, horrible housing, lack of food, rampant ill health. I will liberate them from the ghetto. I will open wide the doors of all the schools and hospitals and businesses of society to your children. I will look at your children and see not a threat but a joy.

I will remove myself as an obstacle in the path that your children, against all odds, are making toward the light. I will not assassinate them for dreaming dreams and offering new visions of how to live. I will cease trying to lead your children, for I can see I have never understood where I was going. I will agree to sit quietly for a century or so, and meditate on this.

This is what the white man can say to the black woman.

We are listening.


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Stripped

I went to a strip club this weekend. I don't go to strip clubs often but on occasion, typically at another friend's request I end up in a strip club. I rarely have an amazing time in strip clubs but this weekend was especially disturbing. I walked into an all black strip club located in a a area with a several other multiracial strip clubs and a few predominately white clubs. In the club I entered there were at least 30 women working in a one large room, with one stage. One woman danced on stage while the others lounged or tried to work the audience. I had no money and I was with a group of 4 other people, one of those people and I were the only white people in the bar.

I felt guilty for being in that space without money to give the women dancing. I had not planned to end up in a strip club. The women were not turning me on, really I had no desire to tip them beyond a sense of obligation because I was in the bar. Tipping is the point of being in a strip bar. I grew very uncomfortable, here I was with over 2 dozen black women working their bodies because that is how they make money. It would be very rude to go into a restaurant, sit down, and proceed not to order anything. In fact I would be asked to leave. As a white person I knew I took up space that no one else in the bar took up. Lots of people were tipping the women a dollar here or there, way less than any of the women's worth. When I say I took up space that no one else did its for me to explain. White people are privileged in this country. So there is an assumption that I have access to resources such as money. I don't think any one should go to a strip club unless they are ready to tip the dancers. Due to systemic racism, as I white person I most likely have access to certain resources that a black woman may not have access to. Thus making it even more important that as a white person in an all black strip bar I go ready to tip.

There were dozens of black men in the bar who were not tipping. For me, this did not justify my inability to tip. I did not want to do what those men were doing and I have no idea if the same men who were not tipping the woman on stage had at least paid for a "lap dance" in the back. My discomfort was about my relationship to that space. It felt reminiscent of a slave auction block, and yet I did not even have money to justify my voyeurism or participation. I did not want to participate in that kind of exploitation of black women's bodies. I am not against strip bars, sometimes I even have a good time. I think the thing that bothered me most is that I had no money to tip and the people I was with had very limited money to tip. Essentially the money my friends had was not enough to justify a group of 5 people inhabiting that space. Strippers don't strip for fun generally, they strip to earn $$$.

I voiced my discomfort to my friends, including the other white person. I was not heard by my friends and we stayed for a while before we left. I woke up thinking well if nothing else at least I have something to blog about. I definitely felt disappointed my friends are OK with being in that space with little money to compensate the women for their work. I was in a group of both people of color and white people, as well as straight people and queer people. So for each of us the space we take up in this particular situation varies and I cannot speak to whether they should have been in that space or not but I knew that personally I did not have any reason to be there without money. Had I been in a group of people who had big $ and could "make it rain", maybe the dynamic would have changed. For me it was not right to be in this strip club with a group of people who had little to no money to tip the dancers.

Someone I know is making a documentary about black strippers in gay communities who strip for gay people. Once she said part of what her documentary looks at is "how work shapes identity". I think about this statement partly because she was referring to how work as a stripper and entertainer helped shape the identity of the people she followed in her documentary. For me working in abortion has shaped my identity. I did not know I had so much feminism hiding in me until this weekend. I identify as a feminist but I have never had this kind of anger arise as a result of the objectification of women's bodies, at least not that I could really identify in real time.

I can not disconnect my work in an abortion clinic from experiences like this one. I kept on thinking of the stripper I got into a conversation with at work a few weeks ago. I kept hoping none of these women would end up in the clinic and remember my face because I watched and did not tip. My work has informed my identity as a feminist and anti-racist woman.

Racist Anti-Abortion Bill Boards, Again?

Many of us heard about these billboards popping up in Georgia last year, Anti Anti, , Vulva Flower and I wrote about the racist bill boards reading "Black Children are an Endangered Species. I had not heard about any more of these offensive bill boards until now. The Life Always group recently unveiled another equally offensive bill board last week. However, there is victory according to this blog the Women Of Color Policy Network announced that the bill board would be taken down immediately.

This newer bill board reads "The Most Dangerous Place for An African American is in the Womb" This message is so appalling I almost don't know how to respond. Do the folks who put this together take modern day manifestations of racism into account at all? Black men and people are still routinely harassed by police for simply being black, Black people are still being incarcerated at an insanely high rate for non-violent crime, and even Wikipedia knows that race and poverty are linked, poverty rates are much higher for people of color than white folks. So the point is if the people funding these bill boards, Life Always, are so concerned for the well being of black folks it sounds like there are a lot of ways redirect there energies and actually work towards dismantling systemic racism in the United States, its rampant.

I'm glad this bill board was taken down. I have heard rumors that similar bill boards were removed in Atlanta but remain up in other parts of rural Georgia. A writer from Colorlines identifies several reasons she hates these bill boards but makes the point that they have motivated women black women to come together across class and religious lines. I also hate these bill boards and I hope that blatant racist disrespect of black womens' lives and choices motivates women to voice their support for reproductive rights and choice.

Maybe you should ask, "Why did we make her wait so long?"

I'd wanted to write a good solid post expanding on my last one -- about why some women "wait so long" to have an abortion -- and connecting the dots to social justice. It is Martin Luther King day, after all, and while we ought to be carrying his goals of racial and economic justice in our minds every day, it always helps to describe the links aloud. But: I've been getting sick this weekend and today I woke up with puffy eyes and that underwater feeling in my head and it's making me feel dizzy. I'm going to limit this to my research summaries, because you're smart and insightful enough to connect the dots yourself, and because I can't see my keyboard very well. 

*

In 2008 researchers at ANSIRH published an unusual study of delay in obtaining abortion care [PDF]. For purposes of analysis, they divided the process into three stages -- between the first missed period and the first pregnancy test; between the first pregnancy test and the first call to an abortion provider; and between that first call and actually having the abortion -- and then identified the circumstances that were closely associated with longer time for each stage. The factors associated with delay varied based on stage. In the first stage, significant delay before the pregnancy test occurred for women who were obese, weren't sure of the date of their last period, were assessed as being in denial about pregnancy or "afraid of an abortion," abused drugs or alcohol, or had had a second-trimester abortion in the past. (A lot of these seem logical, don't they?) 

However, these were not significantly associated with delay in the second stage; rather, women had a longer stage 2 if they had had trouble obtaining MediCal (California's health insurance for low-income residents, which includes coverage for in-state abortion care), and if they had "had difficulty with their decision to terminate this pregnancy." In the third stage, delay in having the abortion itself was associated with (again) having had a second-trimester abortion in the past; having been initially referred to some other clinic than the study site; having an unsupportive partner; and having had difficulty coming up with the money to pay for an abortion. 

So logistical barriers emerge in stage 2 and 3, and especially economic ones. Social/emotional barriers are still present, but different from in stage 1. (Understandably you might delay your call to the clinic if you're having a hard time deciding what to do with your pregnancy; you might try to reconcile a reticent partner to your decision before you head to the appointment -- or your partner might be actively trying to prevent you from getting there!) 

(Additional interesting findings from the last stage: what shortened the time between calling a clinic and having an abortion? (1) Nausea and vomiting [heh, shocker]; (2) having had “difficulty deciding” to seek an abortion. That is, if a woman struggled with her decision, she was likely to have a longer time than other women between taking a pregnancy test and calling a clinic, and a shorter time than other women between calling a clinic and having an abortion.) 

*

From several of the same California researchers, a 2006 multivariate logistic regression study: "Delays in suspecting and testing for pregnancy cumulatively caused 58% of second-trimester patients to miss the opportunity to have a first-trimester abortion. Women presenting in the second trimester experienced significantly more delaying factors, with logistical delays occurring significantly more frequently for these women (63.3% versus 30.4%). Factors associated with second-trimester abortion were delay in obtaining state insurance, difficulty locating a provider, initial referral elsewhere, and uncertainty about last menstrual period." Interestingly, second-trimester abortion was associated with both having had a prior second-trimester abortion and never having had an abortion before. 

*

In 2006 the Guttmacher Institute published a study on timing and reasons for delay [PDF] as well. They broke the process into more steps, and measured median time for each. 

-From the last menstrual period to suspecting pregnancy: 33 days (which makes sense if you imagine the average 28-day cycle then add about a week for your first missed period); it was a week longer for minors than for adults (which also makes sense if you consider how irregular most young people's cycles are)

-From suspecting pregnancy to confirming pregnancy (pregnancy test or sonogram): 4 days

-From confirming the pregnancy to deciding to have an abortion: zero days

-From deciding to have an abortion to first attempting to obtain abortion services (calling to make an appointment): 2 days

-From first attempting to obtain abortion services to obtaining the abortion: 7 days

...So that's 48 days right there (and that's just adding up medians, meaning half of women have a longer delay in each of these steps), yet I think somehow a lot of people hear "seven weeks" and think that's a really long time to "wait." I saw an actual published writer write that abortions should only be legal up til six weeks because "forty-two days is plenty of time to decide to have an abortion." Reality to actual published writer, please come in. 

58% of women reported that they would have rather had the abortion sooner, and these women were asked about the reasons for the delay they experienced (women could give multiple reasons). Most commonly, these respondents said: 

-It took a long time to find out about the pregnancy: 36%

-It took a long time to decide to have an abortion: 39%

It took a long time to make arrangements: 59%. Poor women were about twice as likely to be delayed by difficulties in making arrangement. (This includes money, referrals, appointments, transportation, judicial bypass for minors, legally required waiting periods, etc.) 

Patients mentioned a lot of other reasons, including:

-As partial response to Frances Kissling's question, 0.2% stated they found out late about a fetal anomaly (but this isn't broken up by trimester or week; I still think the later abortion patients she was asking about would give this response more often). 

-Only 2% said they "didn't think it was important to have it earlier." (Granted, this doesn't include possible similar answers from the 41% of women who didn't say they'd have rather had the abortion earlier, but I imagine a lot of those 41% had theirs quite early. I wish I could see a full data set on this.) 

I highly recommend reading the rest of this article because it has a section on qualitative findings from in-depth interviews that I just couldn't do justice here. Among other things, it shares the words of women who "knew right away" that they were decided on seeking an abortion, and of  women who found it a "hard decision" and took longer to feel firm in their choice.** 

*

What about demographic characteristics? Poor women with no insurance coverage for abortion, black women, and young women are likely to have later abortions than other women. However, being poor and lacking insurance coverage disproportionately co-occur with being black and being young. In some studies, each of these effects persists even after controlling for the others; in other studies, they confound one another and only the poverty/insurance effect remains significant. 

I think you can guess what I was going to say about all that. To make a long story short: justice in healthcare access must include attention to reproductive matters. If you care about making a more just society, please express support for public funding for contraception and abortion; donate to your local abortion fund; work to reduce stigma against both abortion and pregnancy; combat racist, ageist and classist stereotypes of appropriate motherhood; and learn about domestic violence and sexual assault prevention. 

**If you want to read more about abortion decision-making, here are some articles to try [unfortunately a few only give the abstract for free]: 

2010: Kjelsvik M. Pregnant and ambivalent. First-time pregnant women’s experience of the decision-making process related to completing or terminating pregnancy – a phenomenological study. 

2005: Finer LB et al. Reasons US women have abortions: quantitative and qualitative perspectives.

1985: Faria G, Barrett E, Goodman LM. Women and abortion: attitudes, social networks, decision-making.

1984: Friedlander ML, Kaul TJ, Stimel CA. Abortion: predicting the complexity of the decision-making process. 

(And if anyone can find the following in English, let me know:) 

1999: Tornbom M et al. Decision-making about unwanted pregnancy.

1990: Ytterstad TS, Tollan A. The decision process in induced abortion. 

Racist Patients

"I'm just not used to all the N**gers touching me"

Recently we had a minor from the Deep South travel to the clinic where I work. I work in a clinic whose staff is a majority women of color and two-thirds of our doctors are also people of color. It was obvious from early on in her visit that this woman was slightly uncomfortable. I am one of two white staff members, and the other was out on vacation during this patient's two-day visit. She seemed scared and obviously responded to me better than anyone else despite the fact that I am not a clinical staff member. After being sedated she didn't want help getting dressed or getting to the recovery room, because it meant more people of color touching her. The patient's health and safety has to be our number-one priority regardless of her overt racism.

White women often come into our clinic and inadvertently direct their eyes at me when they ask questions, even though the woman of color standing next to me might be the person with the best answer to their question. Its often difficult to balance validating my co-workers' knowledge and ability with the desire to make the patient comfortable no matter how prejudiced or ignorant she might be. We have lots of women travel here from many places, including rural areas where overt racism is alive and well. I don't believe there is ever a justification for white people to use the "N" word. Really no one should, but that's a complex issue that I don't feel equipped to analyze.

The other women in the clinic where I work were appalled by this patient's overt verbal racism, and so was I. And there are so many other white patients who don't use such overt language to assert their racist attitudes. So often white women ask me questions, or try to get answers from me, or in some way validate my authority over other staff members. I find it really hard to figure out how to respond in those instances. I want to challenge other white people to realize the way racism operates in very inadvertent ways. I want them to realize racism is embedded in the assumed validation of my authority over a woman of color who has worked in the clinic for 20+ years.