For Reproductive Freedom, Going Back to ‘Normal’ Is Not an Option

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Commentary Human Rights

For Reproductive Freedom, Going Back to ‘Normal’ Is Not an Option

Jill E. Adams

Now is the time to take responsibility for both the past and the present, and to demand change.

For continuing coverage of how COVID-19 is affecting reproductive health, check out our Special Report.

“Normal.” It’s what many of us are longing for right now—a return to life before the novel coronavirus. We miss in-person birthday parties and weekend barbecues, hugging our loved ones, and the community of our schools, gyms, playgrounds, and neighborhood pubs.

But when we think about life as we once knew it, we must recognize that, in many ways, “normal” meant surviving and thriving despite—despite systems built to maintain and perpetuate oppression and harm at the expense of marginalized people, for the benefit of a privileged few. As lawyers and advocates for reproductive justice at If/When/How, my colleagues and I have long been fighting “normal” restrictions on reproductive freedom—restrictions barring people from using Medicaid to cover abortion care, forcing young people to navigate labyrinthine barriers to abortion, criminalizing people for self-managing abortion, restricting cash aid based on family size, and taking agency and dignity away from birthing people.

Now, we see a new path forward, not just through this global pandemic but beyond it, to a world where all of us have the ability to decide if, when, and how to create, sustain, and define our families. That’s why we’ve released our COVID-19 Policy Platform, a five-demand plan dedicated to improving abortion access—especially for young people, public program participants, and those who self-manage their abortions—as well as enhancing dignity, resources, and rights for birthing people and parents.

We envision a new, more equitable “normal,” where:

  • Self-managed and supported non-clinical abortion are decriminalized and recognized as part of how people access abortion care.
  • Forced parental involvement laws are suspended (and repealed permanently); and in the interim, judicial bypass is made more accessible to ensure young people have swift, confidential access to abortion care.
  • Abortion is fully covered in emergency packages and all insurance, including Medicaid and other public insurance, now and in the future.
  • Options for birth are expanded, protected, and supported.
  • Welfare family caps are suspended and repealed permanently.

We chose these demands with intention and care because the “normal” systems we lived under before COVID-19 were not accidental or unavoidable—they were deliberately constructed to maintain the axes of subordination that benefit the most privileged. We have seen the deadly laissez-faire approach that the Trump administration has taken in its response to the novel coronavirus, and we rebuke the literally irresponsible claim that any of this, as President Trump himself has said, “is what it is.”

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Now is the time to take responsibility for both the past and the present, and to demand change. Our “normal” systems were built to uphold white supremacy, oppress women, silence LGBTQ people, keep people living in poverty, incite fear in immigrant communities, put disabled people in harm’s way, erase Indigenous people—and the list goes on and on and on.

Indeed, anti-abortion politicians—who not only want to restrict access to abortion care but who are also deeply invested in further dismantling the social safety net—have sought to exploit this pandemic for political gain. As a result, any proposed response to this crisis must center those at the highest risk of harm: people already targeted by a racist criminal (in)justice system, people experiencing poverty, and young people.

We are deeply concerned about the increased policing and targeting of people who cannot or choose not to access clinical abortion care and those who support them, especially as politicians single out abortion providers in attempts to end clinical abortion care. We also know that even with unfettered access to clinician-directed care, some people will need to, and already do, self-manage their abortions. This is especially true during the coronavirus crisis, when pregnancies are expected to rise and many people can’t leave the home because they’re saddled with caregiving responsibilities, under the thumb of parents or abusive partners, quarantined, or are immunocompromised and scared to risk exposure. Law enforcement officials and prosecutors must recognize that targeting people for self-managed abortion is both wrong as a matter of law and dangerous as a matter of public health. This recognition is critical so that medical providers can continue to focus on providing care without confusion about whether they have to report patients they believe may have self-managed their care to officials. (They don’t have to; moreover, they shouldn’t.)

Now is also the time to lift caps on cash aid to people based on their family size, to broaden Medicaid coverage to include attended home birth and to restore public insurance coverage of clinical abortion care, rather than holding hostage essential assistance to the nation at large in the service of religious and political extremism that is hostile to science, medicine, and common sense.

Already, most people enrolled in Medicaid are faced with less-than-optimal options for reproductive care; they’re denied access to abortion coverage, have limited birthing options and, in many states, denied assistance if they do decide to expand their families. In the 35 states and District of Columbia where Medicaid programs ban abortion coverage, access to abortion may be more urgent than ever, as people have lost jobs and wages, making it even more difficult to pull together the funds to pay out-of-pocket for clinical care. People who prefer to give birth at home or birthing centers to avoid potential coronavirus exposure should be able to rely on their health insurance to cover these costs just the same as it would a hospital birth, regardless of whether they rely on Medicaid or have private insurance. And, if people prefer to give birth in a hospital, they should be able to be accompanied by a companion of their choice with provisions made for the safety of their birth companions.

And at a time when unemployment is skyrocketing and food lines are inconceivably long, safety net programs like Temporary Assistance for Needy Families should be expanding eligibility—instead of rendering newborns ineligible for cash aid under welfare family cap policies in 15 states. People enrolled in public benefits programs should not be forced to do even more with even less—and at risk to their own health—during a pandemic.

This is also the time to suspend or repeal the forced parental involvement laws in 37 states and to trust young people when they need access to abortion care. While some states are taking steps to ensure young people can still go to courthouses to obtain judicial permission to end their pregnancies—an onerous requirement, pandemic or not—the smartest public health approach would be to offer virtual hearings or forgo the invasive process by granting presumptive judicial waivers and keeping young people out of public spaces frequented by the masses.

We believe that significant change to reproductive health and rights is not only possible but also probable when we acknowledge the inequity of our existing systems and approach the construction of a post-pandemic “normal” with creativity and compassion. We do this by asking people who care deeply about reproductive freedom to sign on to our petition to decriminalize self-managed abortion, for lawyers to take bold public stances supporting self-managed care and young people’s access to abortion, and for officials to use their power to help realize our vision of reproductive freedom for all.