Larry Rosenthal: My name is Larry Rosenthal. I’m the director of the Berkeley Center for Right Wing Studies, and I want to welcome you all to today’s event “Abortion Rights in 2020 and Beyond: Threats and Resistance.”
Before we get started on today’s event, I want to announce an upcoming event that the center is doing and it’s a panel discussion on my new book, which is Empire of Resentment: Populism’s Toxic Embrace of Nationalism. The event will be on Thursday, Nov. 19, at noon Pacific time, and there’s a link in the chat for the details on that. I also want to thank our co-sponsors for today’s event. These include the Center on Reproductive Rights and Justice, the Center for the Study of Law and Society, and Berkeley Law’s chapter of if/when/how: Lawyering for Reproductive Justice.
I would like to add that, as many of you know, the Center for Right Wing Studies is part of the UC Berkeley’s Institute for the Study of Societal Issues. People call it ISSI a lot. The vice chancellor of research at the University has decided to close ISSI in about nine months. We’re not sure what this means for the center. And we, the Center for Right Wing Studies, may be able to move to another institute on campus and remain functioning. I am part of a large number of people who have been, who have known ISSI over the years. We believe that closing ISSI will be a great loss not only to the center, but for the campus and beyond. And for those who feel appropriate to do so I would ask you to join me in protesting that decision. You can find information available about that at SocialJusticeFutures.org, one word, and that link, you’ll find in the chat as well. Okay.
The format for today’s event is that in the first half of the event, each of our three speakers Khiara Bridges, Carole Joffe, and Jill Adams will share some prepared remarks. I’ll introduce each one of them before they speak. Then we will have a Q&A. And if you have a question, please use the Q&A feature on zoom. And I will ask those questions on your behalf.
And with that, it’s my pleasure to introduce Khiara Bridges. She is professor of law at UC Berkeley. Her publications are many. And just to mention two books that are specially relevant here: Reproducing Race: An Ethnography of Pregnancy as a Site of Racialization and The Poverty of Privacy Rights, published in 2017. With that, welcome, Khiara Bridges.
Khiara Bridges: Thank you so much. It’s a pleasure to be here and glad that we are doing this event; it is disturbingly timely. So my remarks are going to focus on the intersection of race and abortion. So the undeniable reality is that Black people, Black people with the capacity for pregnancy, disproportionately turn to abortion services. That is, Black people are overrepresented among those who terminate pregnancies.
So take Louisiana for example: Although Black people constitute only a third of Louisiana’s population, Black women made up 61% of abortion patients in the state in 2018. States committed to eliminating abortion access have put the fact of Black people’s disproportionate reliance on abortion care to anti-choice in race selective abortion bans, which are on the books in several states, prohibit doctors from performing an abortion when the pregnant person is terminating her pregnancy because of the fetus’s race. The purported motivation behind race selective abortion bans is Black people’s over representation among those who acquire abortions. Legislators who have supported these bans have said that they are concerned that Black people’s disproportionate reliance on abortion care evidence is a eugenic plot to decimate the Black race. In essence, legislators have used the demographics of those who turn to abortion services to support criminalizing abortion.
In Box v. Planned Parenthood, the court declined to review the constitutionality of Indiana’s ban on race, sex and disability selective abortion, while Justice Clarence Thomas concurred in the court’s decision to deny certiorari, to use the occasion to recount the close relationship that Planned Parenthood founder Margaret Sanger once had with the eugenics movement. The rest of his intervention is to argue that the disproportionate numbers of Black people who rely on abortion care reveals that Sanger’s genocidal plot to annihilate the Black race is working. Perhaps intentionally, Thomas misses the actual significance of Black people’s disproportionate reliance on abortion care.
The reality is that Black women in Louisiana and across the country are living within breathtakingly constrained social conditions. They are poor, they are uninsured, they have little to no access to contraception. They have attended schools that have failed to provide them with factual information about pregnancy and how to prevent it. They face violence in a multiplicity of forms. For Black women, then, abortion is a tool that helps them navigate poverty, violence, vulnerability in the state’s abdication of its basic responsibilities to its citizens.
To suggest that abortion today recalls eugenic practices of yesteryear is the disregard the concept of self-government. Eugenics was about coercion. Abortion in Louisiana and elsewhere in the 21st century is a product of a choice. Black women are choosing a form of health care that helps them negotiate the profound constraints that limit the fullness of their lives. In fact, denying abortion access to Black woman in Louisiana is most akin to the eugenic practices of the early 20th century. Abortion restrictions and eugenic sterilization. Both deny individuals the ability to control the direction that their reproductive lives would take. As eugenicists sought to dictate the direction of women’s reproductive capacities, proponents of abortion restrictions seek to dictate the direction women’s reproductive capacities.
Now, it may be tempting to describe the statistics documenting Black people’s disproportionate reliance on abortion care in Louisiana and elsewhere in terms of autonomy and agency. It may be especially tempting to do this when we endeavor to distinguish the receipt of abortion in modern times from the eugenics movement of yesteryear. We may want to propose that while eugenicists, in pursuit of a more perfect society, insisted upon curtailing individual autonomy and agency in matters involving reproduction, while people today who are having abortions are engaged in a different exercise, they are acting autonomously and with agency when they decide to terminate a pregnancy.
Right, we may look to statistics, documenting Black people’s disproportionate reliance on abortion care, and insist that they simply describe Black people’s autonomous and agential acts. Now while autonomy and agency may be important elements to the story, it is important not to be too sanguine about how freely Black people are electing to terminate pregnancies in Louisiana and across the nation. As I said earlier, Black women decided to terminate their pregnancies within profound social constraints within poverty with a dearth of reproductive health care while lacking information about contraception and the medical facts of sex and pregnancy amid violence. Indeed, it is those constraints that oftentimes lead people to have unintended pregnancies in the first instance. So we wrongly ally the profundity of the structural violence under which Black women live if we say that their choices around abortion are a product of their autonomy and agency.
So the danger is that the language of autonomy and agency may suggest that we ought to celebrate the fact that tens of thousands of Black women are undergoing abortions across the nation at rates that far outstrip their non-Black counterparts. The truth, however, is that the number of Black women getting abortions across the nation is not a cause for celebration. Those numbers are not a triumph. Instead, those numbers reflect profound marginalization. This, of course, is a controversial argument to make. It is controversial because it problematizes Black people’s abortion rate, and any argument that problematizes abortion in any way could easily be misheard as claiming that at the end of the day, abortion is wrong.
Any argument that problematizes abortion could be easily misheard as saying that abortion is a bad act. And if it is a bad act, those of us who nevertheless support abortion have to offer that abortion is necessary because it is a necessary evil. It is a tragic thing, right, we have to argue, that we have to tolerate. But the argument that I’m making here is controversial, because it could be misunderstood as suggesting that we ought to be disturbed by these rates, because they revealed that Black women are being forced to commit tragic necessary evils more frequently than non-Black women, but that is not at all what I’m arguing here. It is that I’m asking us to conceptualize Black women’s need for abortion as a symptom of their vulnerability and marginalization.
The higher rates at which Black women receive abortion relative to their non-Black counterparts reveal that they are more vulnerable and more marginalized than their non-Black counterparts. The language of autonomy and agency belies that fact, which is to say it is possible to believe that abortion is not a bad thing. It is possible to believe that there’s nothing fundamentally immoral about abortion, it is possible to believe that abortion does not kill a tiny baby, that abortion does not end the existence of a morally significant entity, that abortion is not a shameful act, that people should exercise their abortion rights unapologetically, that people ought to feel good, indeed relieved, after terminating an unwanted pregnancy.
It is possible to believe all those things while simultaneously believing that there is something wrong with the rate at which Black women undergo abortion. We can believe all those things about abortion while still understanding that there is an injustice and likely multiple injustices underlying Black woman’s abortion rates. We can believe all those things about abortion while simultaneously becoming enraged and being heartbroken by the rates at which Black women find it necessary to terminate pregnancies. The short of it is that abortion for subordinated Black women is a product of oppressive conditions. Marginalized Black women understand the social, economic, political and interpersonal constraints under which they operate Constraints that likely again contributed to their having an unintended pregnancy in the first place, and they understand those constraints, and they conclude that it is best not to carry the pregnancy to term and the problem is that the language of autonomy and agency obscures the fact of these oppressive conditions.
If marginalized Black women are engaging in acts of autonomy when they terminate a pregnancy, that self-governing, that autonomous act, occurs within a context that has stripped the actor of her ability to govern the course and content of her life. If marginalized Black women are acting with agency when they have an abortion, that eventual act is made necessary by the lack of agency that they have in other areas of their lives.
So to be plain, understanding Black woman’s reliance on abortion as exercises of autonomy and agency conceals that their need to turn to abortion is due to racism. Black woman’s abortion rates reflect racism, not because nefarious actors with genocide on their minds are duping Black women into terminating a pregnancy. Nor do Black woman’s abortion rates reflect racism because abortion clinics are targeting Black women and Black communities for abortion care. Black woman’s abortion rates reflects racism because structural racism has led Black people to face higher rates of unintended and unwanted pregnancies. Structural racism has led people of color to bear a disproportionate share of poverty, leading them to have to rely on government programs and public benefits for their economic and physical survival.
Further, structural racism has taken the form of an incompetent social safety net that fails to provide basic necessities, including contraception and health insurance, for those who cannot acquire it in the market. Structural racism has taken the form of a policy choice not to educate students in public schools about the medical facts of sex and pregnancy, even though the known consequence of failing to provide that education is high rates of unwanted and unintended pregnancy.
What I’ve said has underscored the need to refuse to resort to describing abortion as a necessary evil. Such a framing concedes that abortion is evil, which is a conception that fundamentally misaligns with most people’s experience of terminating an unwanted pregnancy. For poor Black people in Louisiana and across this country, abortion is necessary because of the evils of structural racism. So to conclude on the abstract language that we have always used to describe the stakes of abortion, language like autonomy, agency, choice, liberty, etc. All of that language might be inadequate to describe what happens when abortion rights and abortion interface with racial inequality. Thanks.
Larry Rosenthal: Okay. Thank you, Khiara. That was extraordinary. At this point I’d like to introduce Carole Joffe, which is a great pleasure as Carole has been affiliated with the center since its inception. And this is not the first time she has presented with us. Carole Joffe is professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at UC San Francisco. She is also professor emerita of sociology at UC Davis. She’s the author of Dispatches From the Abortion Wars, published in 2010. And is the co-author of Obstacle Course: The Everyday Struggle to Get an Abortion in America, which came out this year, and frequently can be a harrowing read and with that. Welcome Carole Joffe.
Carole Joffe: Thank you, Larry. And thank you, Larry and Deborah for making this thing possible. The Center for Right Wing Studies is absolutely my favorite entity on the Berkeley campus, and it’s really always an honor to do programs with you, and thank you Khiara for really a breathtaking talk.
So much has changed since Larry Rosenthal and I first started talking about a program like this some months ago. Since we had our initial conversations, we’ve had a pandemic, we’ve had the tragic death of RBG, we’ve had the tragic nomination of Amy Coney Barrett. So the beleaguered world of abortion care has gotten even more chaotic and uncertain in the last few months. But even before these developments, for many people in this society, particularly the very poor, disproportionately women of color that Khiara Bridges referenced, even before these most recent events, getting an abortion has been very difficult, hence the title of our book, Obstacle Course.
But I do want to make something clear. As Larry Rosenthal says, our book is sort of a downer. I mean, it is harrowing, showing how hard it is to get an abortion. But as long as abortion is still legal, I think it’s really important to emphasize that because of the persistence and dedication of the women who need these abortions, and the incredible dedication of those who work in abortion clinics, I think it’s fair to say that most people who want an abortion still get it. I’d like to divide my remarks today between first reading a passage from my book, which encapsulates both how hard it is for some women to get an abortion in this country and also what an incredibly important role volunteers play in this, especially for very poor women.
Khiara Bridges and I are both referencing the poverty, so just to give you some data, 50% of all abortion patients are below the federal poverty line, another 25% are just above it, so we are really talking about a very poor pool of patients. When my co-author and I started this work, we knew that simply the ability to pay for an abortion was a tremendous difficulty, that was not a surprise to us.
What was a surprise to us, even though I’ve studied this field for 40-odd years, look at this gray hair, was simply how hard it is for many people to simply get there. I mean, forget about paying, just finding the clinic, getting to a clinic, coming up with the money to stay overnight, because so many states impose waiting periods, so let me read you a section of our book that makes this clear:
“Pat Cannon, a woman in her late 60s who lives in the South, volunteers at her state’s only abortion clinic to help patients who have trouble with transportation. While working the hotline for the clinic, Pat received a call from Keisha, an African American woman of about 30 with two children. By the time she reached out to Pat, Keisha believed she was 20 weeks pregnant, as her history of irregular periods delayed her discovery of the pregnancy. Working with a caseworker at a national organization, Pat was able to arrange funding for Keisha’s procedure and agreed to pick her up and drive her to her appointment and then return to her home afterwards. Since Keisha was scheduled for a two-day procedure and lived over an hour from the clinic, Pat also arranged a hotel room for her. That Keisha had to rely on volunteer driving and coordination from a stranger to get her to a medical appointment already put her care outside the normal bounds of medicine.
But even this anomaly did not go as planned. Pat explained, ‘After picking her up at home, I signed her into the clinic and made arrangements to pick her up after the first day procedure and check her into the hotel. I was surprised to get a call from her after only about an hour to come pick her up. She was over their weight limit, her blood pressure was too high and the ultrasound at the clinic put her at 23 weeks gestation, so she was turned away.’
“And let me remind you, one clinic in this state, the local hospitals do not do abortions, so she had to go elsewhere. While in the waiting room of the clinic, Pat immediately got on the phone with a caseworker from the National Organization she had previously talked about with Keisha. The caseworker suggested that Keisha’s best option would be a clinic in Washington D.C., so Pat cancelled her hotel room and started the drive back to Keisha’s hometown.
“On the drive home Pat reassured Keisha that she would help her figure out how to get to Washington. Over the next week, I worked with the patient and multiple coordinators and caseworkers at the National Organization to make the arrangements to get her an appointment and funding in place for the Washington clinic. The patient had to come up with additional money for the Washington clinic as well. Funding was almost the least of Keisha’s issues though. Washington was over 500 miles away from Keisha’s home. Pat considered various alternatives such as flying Keisha, but finally settled on driving Keisha herself.
“Early on a late December morning, Pat picked Keisha up from her home and drove for 10 hours straight. ‘Neither of us talked too much on the trip. She was feeling ill and slept most of the way. She was concerned about getting home in time to prepare Christmas presents for her children before they woke up Christmas morning. I told her I would get her home in time for Christmas.’
“When Pat and Keisha arrived in Washington, Pat showed her some of the sights since Keisha had never seen the White House or Supreme Court. They stayed in the hotel and went to the clinic the next morning, where Keisha was again turned away, again because of concerns about her high blood pressure, something the second clinic mistakenly had thought it could handle. Dejected, Pat and Keisha went to lunch to talk about her options and what she wanted to do. The National Organization’s caseworker suggested Keisha try a third clinic, this one in New York City. As they finished their lunch. Keisha decided to give it one last try, so the two of them checked out at the hotel and got in the car for the four hour drive to New York.
“Pat and Keisha arrived in New York that evening, about 36 hours after they left Keisha’s home. Keisha had never been to New York, so Pat drove her through Times Square en route to the hotel room near the clinic. The next morning after several hours spent sorting out payment for the procedure, Keisha was finally seen. Her high blood pressure was compounded by other medical problems, but the clinic was able to start the abortion that day with a plan for her to return the next day to finish. Once again, things did not go as planned. During the night Keisha started having contractions and began to miscarry, as sometimes occurs with an abortion at this stage of pregnancy. Pat called the clinic’s emergency number, and the on-duty nurse advised getting her to a hospital.
“Pat told us, ‘I called an ambulance. There were four EMT people and hotel security guards who came to the room. She was in the bathroom and had difficulty moving. Finally after about half an hour, they got her in a position that she could be transported to the hospital. I was able to ride in the ambulance with them,’ The hospital staff quickly cared for Keisha’s medical emergency.
“After the hotel released Keisha the next morning, Pat picked her up and immediately started the 12-hour drive back home. ‘It was a hair-raising ride with storms, torrential downpours and high wind advisories. We made it to her home at one minute past midnight on Christmas Eve, so it was technically one minute into Christmas Day; I kept my promise to her.” And more importantly, through all the efforts of caseworkers, EMTs, abortion providers and hospital staff to treat Keisha’s medical problems, Pat said, ‘I truly believed we saved a life that week.’”
So for me, there’s two take-homes from the story. You know, one: the extraordinary dedication of Pat, I mean, a woman in her late 60s willing to go on this kind of three-day odyssey, which I think speaks to the best of people, just the humanity to help a stranger, someone she’d never met. The second take-home, however, is that COVID makes this kind of activity very problematic. Being in a car with someone for all these hours, sharing a hotel room with her, that’s not going to happen during COVID.
The other thing I want to say about this incident is even though it speaks to what I’ve said is the best of humanity, is this a way to do health care? What about the Keishas of the world today? I mean, even bracketing COVID, what about the Keishas of the world who live in a community where there doesn’t happen to be a Pat? I mean, this woman would have had all kinds of medical problems, would not have gotten her abortion, the one clinic in her state could not do it. So this is not a way — as admirable and as moving as the kind of dedication people like Pat show — this is not a way to do healthcare.
I’d like to share with you some research in progress. So here are some of the challenges of COVID for abortion care. This summer, I’ve been talking to abortion clinic directors across the country. And now in some ways they have the same problems that all healthcare institutions have had. I mean, it’s how do you do health care when you’re terrified your staff will get sick, when your patients are terrified they’ll get sick. It has not been easy for anybody, but abortion being abortion, there’s always an extra element of difficulty.
So some of you might remember, it’s not on the slide, but some of you might remember that, as soon as COVID happened, a number of red state governors announced abortion is not essential health care, we’ve got to shut down clinics. Abortion uses too much PPE, which is not true. I spoke to a doctor in Texas who told me where it was like ping pong, that you know, the clinics are closed. No, never mind. They’re open. No, they’re closed. I spoke to a doctor in Texas who told me we had patients in our clinic that morning. We were getting ready to give them their abortions, the phone rang, our lawyer said never mind you can’t do it. Ultimately, it was straightened up.
Okay, so I’m not going to go through all these because of time, but I do want to point you out to the second point on the slide. Telemedicine obviously has been incredibly important in healthcare in general, but a number of states, 17 states, do not allow telemedicine for abortion. This is ridiculous. Virtually all the clinic directors I spoke to said to me, “We encourage medication abortion.” Medication abortion, of course, is the form of abortion where the patient takes two pills, as opposed to having a procedure. Obviously, this tremendously minimizes personal contact between provider and patient.
So medication abortion has been incredibly important during this pandemic. It’s also brought to the fore, and perhaps later our lawyers can speak to this, that one of the medications used in this regime is called mifepristone. Mifepristone is incredibly safe. It’s been used in this country for 20 years with an incredible safety record. However, again, because of abortion politics, it is regulated under a very strict protocol from the FDA called the Risk Evaluation Management Strategies known as the R.E.M.S, which means, to cut to the chase, that unlike other medications that can be picked up at your local drugstore, unlike other medications that can be mailed to you, the ACLU on behalf of the American College of Obstetricians and Gynecologists and several other organizations, including, by the way, Sister Song, and it was very nice for me, as an observer of this world, to see a group like Sister Song join with ACOG in this kind of lawsuit.
Anyway, a judge in Maryland said yes, during the pandemic, just as we are loosening the restrictions on other drugs, yes, patients now can be mailed this medication, the Trump administration, without missing a beat, has appealed to the Supreme Court. We don’t yet know the outcome of this.
Larry Rosenthal: Thank you, Carole. You know, you’ve conveyed so much both in the book and in your talk about the extraordinary difficulties. And finally, I’d like to introduce Jill Adams. Jill Adams is the executive director of If/When/How: Lawyering for Reproductive Justice. In addition to her advocacy and her policy work, she has taught law, public health and public policy students here at UC Berkeley. She is executive editor of Cases on Reproductive Rights and Justice, published in 2015, which is the first legal textbook on the subject. Welcome, Jill Adams.
Jill Adams: Thank you, Larry. I’m going to share some slides now. So thank you again for that introduction. All of the work I present today and my availability to be here are the results of the brilliant passion and devotion of all of my co-workers at If/When/How.
For those who don’t know us, we are the leading edge reproductive justice legal organization, on the frontlines representing people in crisis, reshaping laws and making sound policies. As we build a stronger progressive base of legal stakeholders connected to these issues and to one another, we work in service of the vision of reproductive justice set forth by Black Indigenous Women of Color 25 years ago. We apply five modalities to put an end to five forms of reproductive oppression at the heart of our strategic initiatives. Our modalities are organizing, training, legal services, litigation, and policy advocacy, and our strategic initiatives aim to improve access to abortion for people who self manage, young people, and public health insurance beneficiaries. We also strive to increase resources, dignity and rights for birthing people and parents receiving public assistance. And we are a nationwide network of lawyers, activists and law students with chapters now on 110 campuses throughout the country, including right here at Berkeley Law, my beloved alma mater, home of the one and only CRRJ and site of one of our organization’s flagship chapters, which I had the honor of co-founding in 2004.
And as happy as I am here to be here with you all today, I cannot ignore the devastating backdrop of state violence against Black people with impunity, a raging pandemic that showcases the structural racism in our systems, and the tragically timed passing of the champion who leaves behind not just a hole on the bench, but a gaping chasm, big enough for nearly all of our civil rights to fall through. The new vacancy on the Supreme Court imperils Roe v. Wade’s already tenuous hold. Justice Ginsburg was a bulwark for the rights to equality, bodily autonomy, liberty and dignity that form the nexus of reproductive rights.
The court and the country need the next justice to honor these national values and guard against further incursions on our freedoms. However, if Judge Amy Coney Barrett is appointed, it’s probable that the 6-3 anti-abortion majority on the Supreme Court will seize one of the next abortion rights cases winding its way up to the court as the chance they’ve been waiting for, and what Chief Justice Roberts signaled in his June Medical concurrence, to overturn Roe or to decimate it to the point that states have carte blanche to restrict the right however they choose. In either of those scenarios, more people will need to self-manage their abortions outside the medical system.
As we’ve observed throughout time and across countries, making abortion illegal doesn’t end the need for it, and I understand that there are many questions, some confusion and perhaps a little angst about people self-managing their abortions. I hope that after my remarks in this conversation, you’ll feel more comfortable engaging in conversations about SMA, self-managed abortion, particularly because you’ll know where to point people who need resources and support, and I hope you’ll feel the same righteous rage we do about getting people locked behind bars or about people getting locked behind bars for taking care of themselves and self determining their reproductive lives.
So today, we’ll briefly cover self-managed abortion, including who does it, what they do and why, how people get ensnared in the criminal system, what’s different during the pandemic, and close with just a few resources and opportunities to take action.
So self-managed abortion occurs when someone ends their own pregnancy outside the medical system. Self-managed abortion is as old as pregnancy itself, and it can be safe and effective, so long as people have access to accurate information, reliable methods and confidential backup medical care, in the rare event it’s needed.
What methods do people use to self-manage? Research shows that in approximately equal numbers, the majority are using herbs, vitamins, teas, or other botanical remedies, and abortion pills. The same ones Carole Joffe discussed, the same they would receive at a clinic but purchased at pharmacies online or overseas, or from foreign NGOs, and occasionally given to them by loved ones who may have the pills on hand.
How common is self-managed abortion? Well, SMA is inherently difficult to document and track given the private nature of the practice. Nevertheless, some social scientists have conducted studies to better understand the phenomenon including its prevalence. Dr. Abigail Aiken of the University of Texas studied requests for abortion pills from a foreign NGO called Aid Access, and some of those results are showcased here on the slide. The largest and most comprehensive study to date of SMA was headed by one of Dr. Joffe’s colleagues, Dr. Daniel Grossman at UCSF, and included a nationally representative sample of 7,000 women of reproductive age. The results indicated that approximately one in 10 abortions in the U.S. is self-managed. Some researchers believe SMA has been on the rise for a long time, prior to the pandemic and is partly responsible for the rapid decline in the clinical abortion rate the last few years.
Why do people end their own pregnancies? Well, there are many, many reasons why people do so; I’m going to highlight just a few. First, the most commonly cited reason is that people cannot afford clinic-based care. We just heard what it takes to reach a clinic and to get that kind of care, and so some of the barriers are due to a lack of insurance coverage of abortion, and all of the attendant costs of travel, childcare, overnight accommodations and more. Clinic-based care is also inaccessible for some people due to mandatory waiting periods, parental notification requirements, or clinic protesters who may endanger patients by outing them to employers, family or partners. Others may prefer community-based or self-sourced care because they distrust the medical system or wish to avoid repeating negative experiences they’ve had in the past, particularly related to their size, disability, race, HIV status or gender expression. The ability to incorporate a spiritual or traditional practice may be important to someone; they may come from a country where self-managed abortion is the norm and therefore what’s familiar and comfortable. And finally, people who’ve had prior experiences of pregnancy, miscarriage or abortion may feel they know their bodies well enough to take care of themselves and know when to seek help, if needed.
How safe is his self-managed abortion? Well, as we heard Dr. Joffe discuss, medication abortion has an exceptionally high safety profile. The National Academies of Science, Engineering and Medicine published a report in 2018 confirming this well-known fact. And data from years and years of self-administered abortion with pills in other countries demonstrate high safety and efficacy rates particularly early in pregnancy. Complications are exceedingly rare and the most common among them is that a person remains pregnant, but that can usually be remedied through a second dose of medication.
With the advent of abortion pills, then the primary risks of self-managed abortion in the U.S. are not physical. They’re legal, contrary to outdated tropes about SMA. In 2020, it isn’t coat hangers we have to fear; it’s handcuffs. Tragically throughout the United States, people have been investigated, arrested and some even jailed for ending their own pregnancies. They’ve also arrested those supporting someone who ends their own pregnancy.
You may wonder how this can be. After all, the right to abortion is protected by the Federal Constitution and enjoys even greater protections under some state constitutions. Self managing is within that right. Despite this, people who end their own pregnancies may risk unjustified arrest and imprisonment under a variety of misuse laws. In purple, you can see the five states that have laws prohibiting self-managed abortion, and those laws are outdated and arguably unconstitutional. In the vast majority of states that don’t have any laws addressing self-managed abortion, we see overzealous prosecutors misusing all sorts of other laws that were never intended to apply to a person who ends their own pregnancy.
These prosecutors are criminalizing people, not according to what the law says, but in spite of what it doesn’t say. The types of laws often misused include fetal harm laws that lack exemptions for the person carrying the fetus, pre-Roe v. Wade criminal abortion statutes, drug possession and other related laws, child abuse, abuse of a corpse and antiquated throwbacks to the days when illegitimacy was a concern, such as concealment of a birth. As you can see, basically they throw in the whole kitchen sink.
Courts reviewing such prosecutions have generally sided with the people who’ve ended their own pregnancies, dismissing these charges, but that hasn’t stopped prosecutors who are politically motivated to punish people who have abortions. And criminalization of self-managed abortion, like all forms of criminalization in the U.S., affects some people more than others because of their identities, their circumstances and where they live.
First, criminalization is discriminatory. People who are already suspected, stigmatized and surveilled more are more likely to be criminalized. Second, it is discretionary. The state actors who come into contact with people who have self-managed are often determining what happens next. Do the police view it as a crime? Do prosecutors think they should go after someone or find a way to do it? Do social workers think this is something they have to report to law enforcement. And finally, it’s very circumstantial, whereas one person may have the resources to buffer, trustworthy confidants, and the benefit of the doubt that keeps them from getting criminalized, another person may be exposed to law enforcement by someone they know, suspected by someone from whom they seek help, are surveilled because of their race, religion, source of income, and therefore more likely to get ensnared in the criminal system’s net.
And I want to take a moment to be very clear that no state requires health facilities, health care providers, social workers or anyone else to report the patients to law enforcement for having self-managed an abortion. And yet in many of the known prosecutions, that’s exactly how people have come to their attention. While investigating people who intentionally terminate pregnancies is an improper use of state power, these laws are also problematic because they’re likely to result in the arrest and prosecution of people who suffer from spontaneous miscarriages. It’s difficult if not impossible to discern the difference between a prompted and a spontaneous miscarriage. This baseline of uncertainty leads prosecutors to grasp for criminal intent, using factors such as a person’s feelings of ambivalence about their pregnancy, previous visits to abortion clinics and knowledge of their menstrual cycles. Arbitrary enforcement is a near certainty, as law enforcement rely on stereotypes and stigma to discern innocent from guilty pregnancy losses.
So to recap, when self-managed abortion is criminalized, it impacts: A) People who ended their own pregnancies in places where no law prohibits it, B) Mothers, partners, friends and other loved ones who helped someone end their own pregnancy, and C) People who suffered pregnancy losses that were not intended. The surveillance of pregnant people’s behavior will only worsen if self-managed abortion and pregnancy loss continue to be criminalized. Marginalized communities will suffer the most from this repression and suspicion: immigrants, Black, Indigenous and people of color, youth, trans, nonbinary and gender non-conforming people, and low-income communities will be disproportionately impacted for a variety of reasons.
First, these groups face higher barriers to clinical abortion care and have more motivations to opt for non-clinical care. Second, due to structural inequalities and disparities in health care access, members of these groups tend to have more adverse birth outcomes or pregnancy outcomes that would bring them under suspicion. Third, they tend to be forced into more interactions with government agents, whether they’re social workers, welfare officers, immigration officials, school officials or police officers. And finally, it’s been well documented that Medicaid participants are more likely to come to the attention of law enforcement for pregnancy-related issues. And Black, Indigenous and people of color are many times more likely than are white people to be targeted for arrest and state violence.
To limit arrests, we put information in people’s hands through our confidential free helpline [844-868-2812]. They can call to learn about their legal rights regarding SMA, and if someone calls us who’s been threatened with criminal investigation, been arrested or served a warrant, we provide representation, co-counseling or consultation with their attorney, or referrals for advice and representation to our network of criminal defense attorneys. We’ve also been working to launch a legal defense fund to help defray the costs of bail, lawyers, experts and more for people who’ve been unjustly criminalized for SMA.
During the health crisis, we’ve experienced an unprecedented number of helpline calls; the need for people to access abortion, including self-managed abortion is likely to increase as long as the pandemic goes on. Pregnancies are likely to increase as people lose jobs, money and health insurance, interfering with contraceptive access. Intimate partner violence is increasing. People are trapped in abusive relationships facing both state-imposed and abuse or generated barriers. They’re going to need abortion care that is as discreet as possible. And clinic-based care is likely to become more limited, whether through state prohibitions on provision, like Dr. Joffe mentioned, or through reduced clinic workforces. And also getting access to pills has become more challenging as shipping and movement across borders is strained. So as a result, people may be delayed in self-managing or use methods that can expose them to greater risk of complications.
As we’ve seen from the shameful efforts of abortion opponents to use this crisis as an opportunity to limit abortion access even further, we have no doubt that opponents will not hesitate to use the criminal system to strike out at people who need abortion care. And the authorities won’t strike out at people uniformly, they’ll target certain groups as usual. We’re seeing the structural racism that plagues the criminal legal system being mirrored in the health care system. Evidenced by the disparate risks and outcomes of COVID-19 for communities of color, it’s unfortunately likely that in the midst of a health crisis, Black, Indigenous and people of color who have unintended pregnancies are facing the triple threat of lacking access to trustworthy health care, needing to maintain social distance to stay safe from exposure, and being at greater risk of criminalization for self-directing their health care.
This may all seem bleak, I know, but rest assured there are efforts underway to change things for the better. For one, we at If/When/How are coming at this injustice from every angle we can. Beyond the legal services I’ve described, we’re also working on offensive and defensive sides of litigation and legislation. We’re articulating novel theories and scholarship and case briefs. We’re training law students and lawyers throughout the country and helping to shift the culture in ways that normalize and destigmatize self-managed abortion. And there are things you can do to help.
So first, please sign our petition [tinyurl.com/decrimSMA], you can find it by searching change.org and self-managed abortion. Please also share it with your networks. And law students when you graduate, you can sign our lawyers’ letter, advocate for a resolution by the American Bar Association, and join our RJ lawyers network to volunteer your time and talents to this cause. We welcome all of you.
And finally, another thing we can all do is fiercely hold a vision of a better future, far beyond this moment, beyond this mess, when all people can access the resources and exercise the rights they need to thrive. When it comes to the future of abortion care, let us collectively envision and realize the day when people have access to the full array of abortion options and can choose which is right for them. The real agency, not the constrained agency within a context lacking agency that professor Bridges discussed, because everyone deserves to self-determine reproductive lives free from discrimination, coercion and violence. Thank you.
Larry Rosenthal: Thank you, Jill, thank you very much. I think that, the questions you raise, were very little or relatively less public knowledge. And I think it’s extraordinary the work you’re doing there. At this point, we’re going to get questions from our viewers, but I’d first like to have the panel talk among yourselves and ask questions of one another. And maybe I can begin that myself. And I’m struck, as I said, it’s the morning after the first debate and in that debate, there was a shout out. President Trump shouted out to the proud boys. We are living in a moment when the fact and the threat of militia violence is at a level we haven’t seen before. One notes that violence around abortion, which was, it seemed to have been at a much greater level years ago is not something that’s talked about a lot. In this atmosphere, where militias are now taking their marching orders from high in the government, from the president, is there any threat of renewed violence around abortion, which is in any way related to the rise of the militias?
Carole Joffe: I can speak to that. Right after Trump got elected in 2016, abortion clinics reported an increase in harassment, vandalism, threats, I mean, the same stuff they’ve always had, but more so. I think part of the reason we don’t hear too much about it is because it’s become so normalized. In the old days when abortion first started, you know, a firebombing of a clinic or vandalism, that was newsworthy. Now, I mean, the ante has been raised so much, if someone isn’t shot, and fortunately, we haven’t had an actual killing since 2013, if I’m remembering correctly, in Colorado Springs, but yes, there’s always threats to abortion providers.
Let me just give you one very quick, bizarre example of the times. In North Carolina, a clinic in Charlotte, which has been, you know, particularly targeted by antis for years, a protester came up to an elderly volunteer who was standing outside the clinic and she, the protester was a she, coughed on the gentleman and said, “Haha, I have COVID.” I don’t know if she really had COVID, and I don’t know, I never heard what happened. But the protesters are always there. They’re now swarming over the parking lot. A lot of clinics now are having patients waiting in their cars in the parking lot. Escorts for the most part, not there because of COVID. The antis are there. They’re swarming all over the parking lot. They are not practicing social distancing. So yes, the threat of violence is always there.
Larry Rosenthal: Okay. Are there things that any of you would like to ask one another? If not, I’m intrigued by so much of what was said. Jill Adams referred to legal theories, and, in the upcoming battle to save or undo Roe v. Wade, we’re going to get perhaps novel theories for undoing Roe v. Wade, and what theories are people who are pro-abortion developing to contrast that? On the side of that, I was struck by the argument, the Clarence Thomas argument, actually making it into Supreme Court decision talking about eugenics, and is that a possible way into the novel legal theory, which may be induced for taking down Roe v. Wade in the Supreme Court that is in our future?
Khiara Bridges: I can start off by answering that question. So these reason-based abortion bans, abortion bans that attempt to police people’s reasons for terminating a pregnancy, prohibiting abortions that are motivated on account of the disability status of the fetus or the fetus’s race or sex. These are definitely novel interventions into the conversation.
So typically, abortion regulations have taken the form, especially since Planned Parenthood v. Casey, have taken the form of trap laws for these targeted regulation of abortion providers. These were the laws that were at issue in Whole Women’s Health, and then June Medical. So these were laws that sought to close clinics, essentially, by making it impossible, essentially, for persons who perform abortions to be permitted to perform abortions, because they needed admitting privileges and also it made it incredibly expensive for abortion providers, the facilities, to meet the requirements of the law, so they have to become ambulatory care centers.
So this was kind of the approach that anti-abortion laws were taking: TRAP laws, Targeted Regulation of Abortion Providers. Before this sort of wave of laws, we saw restrictions on abortion take the form of informed consent provisions. And so you know, my favorite, which means my worst, is South Dakota, which required providers to tell a person terminating a pregnancy as part of the informed consent process, that abortion was terminating the life of a whole separate, unique living human being. So these were efforts to convince pregnant people that their fetuses were essentially tiny babies, and therefore that abortion is murder.
And then other sort of regulations of informed consent process took the form of ultrasound viewing laws, so you had to be given the opportunity to view your ultrasound. And so those are, so informed consent laws, as well as TRAP laws were kind of the forms that abortion regulations were taking. These reasons-based abortion bans, they’re just new, they’re novel. And you know, I have to give it up to the creativity of the anti-abortion folks, like their creativity is endless. And what reasons-based abortion bans do, would be to chip away at Casey’s holding.
Casey says that it is impermissible to have a categorical ban on abortion, prior to viability. It was very clearly laid out in Casey that a categorical ban is impermissible. What reasons-based abortion bans do is erect the categorical ban prior to viability if people are trying to terminate abortions for particular reasons. And so if these bans are upheld, which Thomas clearly signaled that he was very amenable to it, and I also should note that before Box v. Planned Parenthood got to the Supreme Court, it went through the Seventh Circuit. The Seventh Circuit on set en banque, to review, or to sort of suss out the constitutionality of the laws. There were several judges in dissent, including Frank Easterbrook, who found the legal argument that defending the constitutionality of these bans, he found it persuasive. So if these bans are upheld, and it’s looking possible that the Supreme Court will review the constitutionality of the bans at some point, then they will definitely represent a solid attack on Casey, but I should also note that these are incremental, these are, all these laws are, so TRAP laws, informed consent regulations, all of these are sort of incremental steps to overturning Roe v. Wade.
I believe that if the Supreme Court has a solid majority, a 6-3 conservative majority of folks who have articulated their skepticism of Roe v. Wade and their willingness to overturn that, incremental steps will no longer be necessary. It’ll be a straight-on attack on Roe v. Wade, and then we’ll leave it to the court to either overturn it altogether or to strip it so greatly that it’s essentially rational basis review, we’ll be left with.
Jill Adams: Agree with everything professor Bridges said, and I want to lift up a piece from my colleague, Farah Diaz Tello, in the most recent American Bar Association publication where she’s looking at this subject, and she’s tying together the current state of Roe and the very eviscerated 14th Amendment due process clause interpretation, the undue burden standard, and what that means when you look at it through the lens of the criminalization of pregnant people for various acts, including self-managed abortion, so I highly recommend that reading.
Larry Rosenthal: Great. Well, thank you. Let me move on to some questions from the viewers. And I combined a couple. The first one asks, in a general way, issues that have been covered a lot, but assuming that the president gets his way and his nominee for the Supreme Court is placed on the High Court and the court rolls back Roe v. Wade, what would be the recourse of American people to be able to exercise their rights to make their own decisions regarding reproductive rights at that point? And I would add to that, by reversing Roe v. Wade, does the court or will the court take into consideration those unwanted pregnancies, the children of those unwanted pregnancies, who will still have to be financially cared for? And who will take on that responsibility?
Jill Adams: So basically, what would be, you know, what would be people’s recourse? Well, there are state protections. There are some state constitutions: The federal constitution provides a floor and state constitutions can go above that for added rights and protections for their residents. And many states do, in fact, protect reproductive rights beyond what the federal constitution does. So that’s one.
Again, as I just talked about extensively, people are taking matters into their own hands and reclaiming agency and communities are caring for one another. It’s already happening and that’s because I think it’s important, as much as we want Roe to remain intact, we have to acknowledge that it hasn’t been enough for decades, in order for legions of people in this country to be able to actually exercise the rights enshrined in it and that’s because of all of the restrictions that have been put in place. Some of them almost immediately after the case came down, and one in particular I want to highlight is the Hyde Amendment, which is a federal congressional action taken every year during the budget approval process, wherein they prohibit federal Medicaid from covering nearly all abortions and about 35 states actually follow suit with their own state Medicaid plans. That means that people living in poverty and low-income people are forced to pay out of pocket for again, the services plus all of the attendant costs, which can be prohibitively expensive for people whose incomes are low enough to qualify for Medicaid. And that’s just one example of the situation and why, yes, we want to retain Roe and we want to build upon Roe, and we can go beyond the 14th Amendment due process clause to do that, because the right to, for example, bodily autonomy and medical decision making, equal dignity, which was something that, Justice Ginsburg wrote about, and it also came out through Obergefell, the marriage equality case, for there are elements of the First Amendment, the Fourth Amendment, the Eighth Amendment that we could explore, and where reproductive rights live within those protections, as well. So we want Roe to remain, and it’s already insufficient to cover everyone’s needs, and there are other ways to shore up protections as well.
Carole Joffe: If I can just answer the second part of that question. In one word, I mean, the questioner asked, you know, will the children who are born because the woman was not able to get an abortion, one word: no. I mean, there’s a saying you hear frequently, it’s attributed to former congressman Barney Frank, for the anti-abortion movement, “Life begins at conception and ends at birth.” I mean, a lot of social scientists have done studies, you know, correlating the voting records of so called pro-life politicians and their records on, social provision, social welfare programs, and it’s disjointed. So the simple answer is no, unfortunately.
Larry Rosenthal: The questioner asks, “Telemedicine is a great idea but the U.S. has a huge digital divide and again, poor rural women are the ones most likely not to have high speed internet access. How do we make sure we account for this issue when advocating for abortion health practices?
Carole Joffe: I note that this question is from my beloved colleague, Natalia Deeb-Sossa, who’s a sociologist at Davis, and Natalia, you’re right. That is a real problem. Again, bracketing COVID, pre-COVID, some of the local abortion funds can be very helpful, even if you don’t have internet access yourself, a fund can help you get what you need, you can come in use their internet. So there are institutions in place that have tried to address this. If we really had time to go into it, some of the abortion access funds in the South, in particular, are extraordinary. I mean, they’ve expanded abortion care to reproductive justice more broadly, helped people with a variety things in Mississippi and Alabama in particular. But COVID, of course, makes all this more complicated.
Larry Rosenthal: We have the question: Doesn’t the language of “reproductive justice” capture the institutional and systemic racism experienced by women of color, as well as the poverty and lack of comprehensive sex education that might create the conditions for unwanted pregnancies? This has been addressed, but I think the question is important. So could somebody respond to that?
Khiara Bridges: I can take this one on. So, absolutely, reproductive justice is a framework that was first articulated in the 1990s by feminists of color and their intervention during that time, it was to note that the language of reproductive rights failed to capture the multiplicity of things that make rights meaningless, and so we’ve been, we have been fighting for formal rights, the formal right to an abortion, but one’s race, one’s class, one’s disability, one’s immigration status, one’s age made it very difficult, if not impossible, to secure the reproductive rights that, and I should note that the folks who have been though the primary advocates for reproductive rights, the energies that were spent were from white feminists, and so they were concerned about the issues that affected them and the issue that affected them was that the states were making it difficult for them to access an abortion in the market.
So abortion rights essentially prohibited the state from making it impossible for people to buy the services that they needed in the market. So reproductive justice framework comes along and says, “That’s super awesome if you have the funds with which to pay for abortion services in the market.” But if you’re indigent, if you live in rural communities where even if you had the money, though, the facility is so far away from you that it sort of triples, quadruples, the expense of an abortion, right. Abortion rights become meaningless when we sort of consider how other axes of identity like race, like class, like disability status, intersect.
The other thing, the other intervention of the reproductive justice framework was to broaden the universe of concerns. So again, the concerns that motivated class-privileged white women led, the only sort of reproductive oppression that they were experiencing was their inability to purchase these abortion services in the market. However, when you do not have class privilege, when you do not have race privilege, when you don’t have the privilege of immigration status, that’s not the universe of reproductive oppression.
So it wasn’t just the inability to not have a kid, but it was also the ability to have a kid, for sterilizations are happening today. Right? We just discovered that in ICE detention centers that coercive sterilization is still going on, right? So it’s not just people were, are being, people without privilege, are just being denied the ability to not become parents, rather, they’re being denied the ability to become parents, and then of course, they’re being denied the ability to parent the children that they have. Right?
So again, let’s go to the border and look at how we’re separating families. Removing a child from the parents’ custody, it’s not just taking place at the border, but it’s also taking place within the family regulation system, the child welfare system, right? These are the issues that impact folks without class privilege and race privilege. And that’s what the reproductive justice framework intervened into the language of reproductive rights to center.
That being said, to get to the question, does the reproductive justice framework capture the systemic and institutional racism that produces higher rates of unintended pregnancies among Black folks? Absolutely, the reproductive justice framework is the best framework for capturing institutional and structural racism, it’s necessary to name it though. It doesn’t happen automatically, right?
And so the point of my talk today was to name institutional and structural racism as the forces that lead to these statistics that we see across the nation. And also, the point of my intervention today was to say, in response to, I would say the celebratory mode that some supporters of abortion rights have taken to defending abortion rights for those without privilege. I think we ought to celebrate the fact that the folks can use a tool to navigate these constraints, but I also think it’s incredibly important to name the constraints, to acknowledge the constraints and specifically name them as structural racism and that was the offer that I made today.
Larry Rosenthal: Great. I have a question addressed to Jill Adams, which asks, “You demonstrate how efforts to stop women from doing the so called harm of self-managed abortion. State officials do harm through criminalizing pregnant women. I wonder if you’re thinking about your work through a construction of harm framework?”
Jill Adams: It certainly comes up in discussions, and I think the idea of harm reduction is popular, particularly in other countries and in an international context, where we certainly draw lessons from advocacy, lessons in service delivery, in the self-managed-abortion realm, in particular, and I do know there are physicians who’ve been operating in Peru, in particular, who have gone into some extra-legal space by answering to a higher moral authority than the law in order to make sure that people have what they need to take care of themselves and end pregnancies if they need to and that is very much under a harm reduction lens.
But it’s an issue of live discussion, because maybe this is sort of the premise of the question, different people have different attitudes toward what constitutes harm, and where is the harm and I very much relate to everything that professor Bridges just said, where do we assign harm? Harm is not in an individual’s circumstance, or one person’s decision-making or how that gets affected. The greatest harms are wrought on a structural level or happening in an institutional and systemic level. The systems are what perpetuate the inequity and what limit people’s opportunity and then rob them of dignity as they’re just trying to live their lives.
And so that’s where we think the greatest harm is or as the person asking the question, named, you know, the system criminalizing people, that’s what’s harmful, but it’s all the other circumstances as well, so to, again, to underscore so much of what professor Bridges just said, a person having an unintended pregnancy is not in and of itself a harm. Abortion is not, in and of itself, a harm. Self-managed abortion is not, in and of itself, a harm. But it’s also not necessarily an act of pure empowerment in any of those cases or real volition.
Because, you can take, for example, somebody who discovers that they’re pregnant, and maybe they want to have that pregnancy, and they’re a person who relies on cash assistance, and they discover in their state that there’s a welfare family cap, and they already have someone in their family who’s receiving aid, and so if they were to carry this child, this pregnancy to term and have a child, that child would be rendered ineligible for aid, and they know that they can’t possibly take care of a family, a larger family on the same very small amount of funding and so maybe they reluctantly decide, “Okay, well, then I’m going to have to terminate this pregnancy,” and they seek out care.
And maybe they run into a parental notification requirement that adds extra obstacles for them or maybe they discover that they live in a state where the state Medicaid program doesn’t cover abortion care, so then they’ve got to figure out how to pay for this out-of-pocket, and they go through all the trials and tribulations to try to save the money, make the money, pull it together and by that time, they they find out that their state is one of these that my co-presenters have mentioned, where there’s a gestational ban, and it’s too late, and they’ve got to go out of state. And you can just add on, add on, and then at that point, they’re left with very little recourse but to take care of that matter themselves.
And to be clear, most people are self-managing early in pregnancy safely, effectively, privately, we never hear about it, but if things have progressed to to a later stage in pregnancy, and the attempt to self-manage an abortion, and there’s a medical complication, well, then they end up maybe having to seek emergency medical care, and then somebody decides to call the cops on them, and then they get hauled off and they go to jail and they’re taken away from their kids and then maybe they lose their parental rights and on and on and on. Like, this is the reality of people trying to get the abortion they need in 2020 in the United States. And so is, where does harm come in? Everywhere. And so are we all trying to reduce harm? You bet we are.
Larry Rosenthal: I think we have run into our time limit. We have two minutes, and so we’re going to ask you to be very brief to a question, which doesn’t attract brevity, but here we go. How do we make systemic change to the system of care, in particular, to abortion care, so that it is more humane, inclusive and affordable? What can each one of us start doing today? And we have two minutes.
Carole Joffe: Let me take 40 seconds of that two minutes to share that voting is crucial, especially for those of you on this call who are not Californians where we know Biden will win. As scary as the Supreme Court is, a Biden administration will make a difference. Who becomes a deputy assistant secretary of population affairs, who becomes the commissioner of the FDA, who becomes the head of CDC, all these bureaucratic posts bear directly on abortion care and what’s permissible and what’s not. So as terrifying as the court is, a Biden administration can do things through executive orders that can make the difference.
Khiara Bridges: I will build on Dr. Joffe’s points by just saying if we do secure a Biden-Harris victory, that’s just the beginning. We now have the opportunity to do the work that we need to do to produce a humane society. We don’t have the opportunity right now, but if there is a Biden-Harris victory, we now have the conditions of possibility for doing the work. The Hyde Amendment still exists. There is no federal funding for abortion even in cases that will maim a pregnant person and that applies to Medicaid but also the Indian Health Services, so Indigenous people are being coerced into parenthood. I also want to mention that family cap system, Jill mentioned family caps, the freezing of the size of an indigent family is supposed to act to disincentivize childbearing. Those exist in, I think, 16 states right now. We have to repeal those, but also we have to stop separating families. The child welfare system, the family regulation system, is a system of violence, and in a Biden-Harris administration, we ought to turn our attention to creating systems of support, not systems of punishment for indigent people who need help. So that’s just two to three other things I wanted to add to the conversation.
Jill Adams: I’ll say pass the Breathe Act; pass the Each Woman Act; get rid of Hyde and overturn Harris v. McRae, the Supreme Court case that upholds it; decriminalize self-managed abortion; improve young people’s access to abortion care; ensure birth justice for all people, and abolish welfare family caps. That’s a start.
Larry Rosenthal: Marvelous, and that’s a finish. Your answers to this vast question, briefly, are pretty amazing, but all of the presentations have been extraordinary today, and I want to thank you all for doing this. I want to thank our viewers, both from me personally and on behalf of the Center for Right Wing Studies at UC Berkeley. Thank you. Good afternoon to everybody.