Reproductive Justice: A holistic Approach to Reproductive Freedom

By Ileana López-Martínez • August 10, 2021

I went to my first protest when I was 13. Tailing behind my older sister, I went to a march for reproductive rights. For the next 7 years, I dedicated much of my organizing power to reproductive rights. It wasn’t until Sandra, my supervisor at Essential Access Health, invited me to a discussion with Loretta Ross, one of the founding mothers of reproductive justice, that I was introduced to reproductive justice.  

The mainstream definitions of maternal and child health (MCH) had always left me with something to be desired. Every definition I saw from governmental organizations seemed to repeat the same goals– improving access to care, building healthy communities, and creating health equity. These goals are a great start, but without addressing the systems of oppression that create inequity within the social determinants of health, true health equity will never be achieved. In my search for a framework which explicitly named oppression as a root cause of health injustice, a mentor introduced me to reproductive justice.

Reproductive justice (RJ) is a framework developed by a group of Black women in 1994 who acknowledged that the reproductive rights movement served the interests of affluent White communities only. What began as a collective of Black women grew to be SisterSong, a multiethnic group focused on reproductive justice. Combining the ideals of reproductive rights and social justice movements, they defined reproductive justice as, “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.” Their goals are clearly aligned with those of MCH organizations, but they importantly name the analysis and eradication of unequal power systems as a necessary part of achieving health justice. 

As part of my internship with Praxis this summer, I was honored to interview Dr. Astrid Williams and Adrienne Spires from Black Women for Wellness. Dr. Williams is the Program Manager for the Environmental Justice component of Black Women for Wellness’ work, and Adrienne is the Program Manager for their Maternal Infant Health component. Black Women for Wellness is a community-based nonprofit based in South Los Angeles that is committed to improving the health and wellness of Black women and girls through a variety of programs. I was first introduced to them while attending their State of Black Women and Girls event and was inspired by the work they were doing to combat the myriad negative health outcomes and institutional barriers faced by Black women and girls. As a novice to reproductive justice organizing, learning from Dr. Williams and Adrienne was vital to understanding the practical application of reproductive justice values to organizing work.

ILM: Why reproductive justice and not rights?

“Reproductive justice takes on a holistic approach & takes into account all factors & barriers to reproductive freedom.”

Adrienne Spires: Reproductive Justice is the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities. In addition, it acknowledges how black and indigenous women’s socioeconomic status, gender, political power, and race influences their reproductive health care experiences. The reproductive rights framework is largely centered on achieving women’s individualistic reproductive freedom through the legal system and has historically focused largely on the pro-choice and pro-life debate, sex education, and family planning. Reproductive justice takes on a holistic approach and takes into account all factors and barriers to reproductive freedom. 

ILM: How does using the reproductive justice framework help guide the work of BWW?

AS: All of BWW’s programming and policy initiatives encompass all aspects of black women’s health and well-being from a cultural lens such as comprehensive sexual education, elimination of toxic chemicals in personal & hair products, addressing maternal and infant health mortality, prevention strategies against diabetes and heart disease, and voter education. In addition, BWW’s Action Project proposes legislative bills that will help counteract noted barriers to the successful health and wellness outcomes for black women and girls.

ILM: How does BWW work beyond birth outcomes to achieve reproductive justice?

AS: Black Women For Wellness's mission, vision, and  programs are dedicated to help ensure black women and girls have access to quality health options, and reside in a safe and sustainable community as a human right.  These tenets are in alignment with reproductive justice.

ILM: I've been curious about the tie between environmental justice –[the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income, with respect to the development, implementation and enforcement of environmental laws, regulations, and policies]— and RJ. Can you share more about your programs that work with environmental justice? Why did you choose to focus on it as well?

Dr. Astrid Williams: The intersection of Environmental Justice and Reproductive Justice is that Environmental Justice (EJ), like RJ, incorporates a social justice framework for advocating for social change. It seeks to reduce the inequitable environmental burdens born by people of color, women, those living in marginalized and economically disadvantaged communities. Reproductive justice also demands that the decision of whether or not to have a child, advocating for family planning rights and the right to raise that child not be impeded by the inequitable distribution of environmental burdens. In advancing Reproductive Justice, you are demanding that individuals in marginalized societies not be forced to make reproductive decisions based on the fact that their communities suffer disparate exposure to environmental hazards.

—

What I believe is most powerful about reproductive justice centered organizations, such as Black Women for Wellness, is how they go beyond the parameters of what other MCH organizations focus on. The inclusion of safe and sustainable communities in the demands for reproductive justice is the most revolutionary aspect of the framework. It goes beyond traditional narratives of individual choice. It questions the source of inequity that exists in communities of color and low-wage communities. Beyond that, it examines how this prevents them from parenting their children the way they want and deserve. Some local governments, and especially big corporations, target marginalized communities who don’t have the same resources to protect themselves as white, economically privileged communities; you can see this in the air quality, the water pollution, and even the predatory marketing of sugary beverages among communities of color. These inequities make it impossible to raise children in the environments people of color and in low-wealth communities want because they are systematically barred from controlling the conditions of their realities. As Dr. Williams explained, reproductive justice aligns itself with environmental justice, food justice, and other justice movements because of the acknowledgement of how systems of oppression affect the root causes of social determinants of health. This framework advances beyond just measuring birth outcomes to ensure that environmental burdens are not unfairly felt by systems-impacted communities. Reproductive justice goes beyond birth to think about the structures that keep them from realizing the conditions they want and deserve.

“Without a justice-oriented approach to maternal & child health, these outcomes are reduced to individualized treatment plans at the doctor’s office. The individualization of care prevents community-oriented change from occurring. It allows systemic inequities to continue.”

Notice how health care isn’t mentioned in the definition of reproductive justice. This isn’t an oversight by any means. Instead, this framework acknowledges the myriad ways in which oppression influences health before they even access healthcare. For example, studies have found that the psychosocial stressors experienced by Latino immigrants in communities that have experienced deportation raids could be related to low birth weight among children born to Latina mothers who experienced the raid. Negative health outcomes for the female partners and children of incarcerated men are especially high in Black communities that experience high incarceration rates. Without a justice-oriented approach to maternal and child health, these outcomes are reduced to individualized treatment plans at the doctor’s office. The individualization of care prevents community-oriented change from occurring. It allows systemic inequities to continue. It allows for corporations and other entities with bad intentions to continue putting their bottom line ahead of the success and vitality of our communities. It’s time to say enough is enough.

What does this mean for the future of maternal and child health?

“[reproductive justice] means working to eliminate the harmful social conditions–heterosexism, capitalism, racism, ableism, sexism, and more–which infect our systems and prevent our communities from thriving.”

Reproductive justice provides an opportunity for maternal and child health to go beyond the individualized care approach. While it may be important for clearly defined agencies and departments to exist, reproductive justice frameworks also highlight the importance of cooperation between different community groups who ultimately want the same thing: to transform their communities into equitable, healthy spaces for themselves and those they love. With this framework in mind, many organizations have done work to liberate people from institutional control, systems of oppression, and dangerous practices that prevent equitable health outcomes from becoming a reality. This means providing expectant mothers with access to birthing doulas to advocate for their rights in the hospital. It will require us to support community activists who worked to rescind the building of the Keystone XL Pipeline, which would’ve had dangerous consequences for the water, land, and health of indigenous communities whose lands it crossed. It means working to eliminate the harmful social conditions–heterosexism, capitalism, racism, ableism, sexism, and more–which infect our systems and prevent our communities from thriving. It means going beyond the birthing rooms, beyond medical interventions and diagnoses. Only then are we able to eliminate those barriers which prevent communities from caring for themselves and their futures.