Dr. Amy Whitaker joins panel discussion on abortion care

Dr. Amy Whitaker joined IL Congresswoman Jan Schakowsky on Monday, September 21 at Personal PAC for a panel discussion about issues surrounding choice. Illinois appellate judge Laura Liu moderated the panel.

Dr. Whitaker spoke about her passion for abortion care. She also described the situations our patients are in as well as the barriers that doctors face in providing abortion care.

To learn more about PersonalPAC, check out the hashtag #‎GetPersonalWithPersonalPAC‬ on Facebook and Twitter.

Congresswoman Jan Schakwosky and Dr. Amy Whitaker

Appellate Judge Laura Liu moderates the panel

Upcoming Event: “Addressing Sexual Assault on Campus: The Power of Narrative”

Please join Ci3 this Thursday, April 30, at 7pm for a screening of the timely new documentary, “The Hunting Ground“. This film exposes the prevalence of sexual violence on college campuses and profiles the institutional and social injustices faced by victims and their families.

Following the screening, a panel will address three themes in ending sexual violence: the power of narrative and lived experience, transforming rape culture, and enhancing leadership on campus and in our communities.

Ci3 is proud to sponsor this event along with the Center for the Study of Gender and Sexuality, the Office of Multicultural Student Affairs (OMSA), and Resources for Sexual Violence Prevention (RSVP).

For more information or to RSVP, click here.


Ci3 Co-Sponsors Sexual and Reproductive Justice Graduate Student Working Conference

Call for Proposals: 3rd Annual Sexual and Reproductive Justice Graduate Student Working Conference,

May 15, 2015

Abstract Deadline: February 23rd, 2015

We invite submissions to a graduate student working conference on questions concerning sexuality, reproduction and justice. This conference is co-sponsored by the the Center for Interdisciplinary Inquiry and Innovation in Sexual and Reproductive Health (Ci3), Center for the Study of Gender and Sexuality (CSGS), and the Urban Network. The purpose of this working conference is to provide a forum for graduate students (including law students, medical students and residents) to receive critical feedback on their ongoing projects from other graduate students from across disciplines working on similar questions of sexuality, reproduction, and justice. The conference will be held May 15, 2015 at the University of Chicago’s Center for the Study of Gender and Sexuality.

The reproductive rights framework has historically focused on protecting legal rights to abortion and contraception. A reproductive justice framework views reproductive choice through both human rights and social justice lenses. While the definition has evolved over time as the movement behind it has grown, reproductive justice seeks for all people to have the social, political and economic power and resources to make decisions about their health, bodies, sexuality and families for themselves and their community. The term “sexual justice” does not have the same resonance or history as the concept of reproductive justice and this conference seeks to link the earlier reproductive agenda with larger concerns of sexuality, including sexual health and sexual rights, as primary for the construction of a just society.

This working conference will allow graduate students to present to one another work and ongoing research exploring the relationship between sexuality, reproduction, and the public sphere. Below are some suggestions for possible topics. This list is by no means exhaustive; we are interested in any submission that is related to the broader questions of sexual and/or reproductive justice, with particular interest in papers that address issues of positive, healthy sexual and reproductive lives in an urban setting or that explore how urban landscapes and sociopolitical structures intersect with the sexual, gendered, and reproductive lives of urban youth—particularly youth of color.

  • Public regulation of sexuality and reproduction
  • Construction of reproductive capacities
  • Sexual and reproductive health
  • Sex education
  • Sexuality in reproduction
  • Sexual Agency and Consent
  • Sexuality and Morality
  • Queer Sexualities
  • Sex in the Marketplace
  • Sexuality, Reproduction, and Identity
  • Social Justice and Sexuality
  • Embodiment of sexualities or reproduction
  • Coerced Reproduction
  • Violent Publics and Privates (i.e., Prison Violence, Domestic Violence)
  • Activism surrounding Sexuality and Reproduction
  • Intersections of sexuality and reproduction with economic security

Papers will be pre-circulated amongst participants, and each will be expected to have read all papers. Participants will have an opportunity to present in front of their peers and to comment in turn. We hope to put into conversation students from different fields to enrich the feedback on an issue that spans disciplinary concerns. This event will also be open to the public, who will have an opportunity to address presenters at the end of the session.

We invite proposals for papers and current ongoing research from all disciplines. Please submit as an attachment a title, an abstract from 300-500 words, your name, discipline, degree level, and email to sexualjusticeconference@gmail.comby February 23, 2015. You will be notified of paper acceptance by March 9, 2015. We expect all accepted papers to be submitted by May 1, 2015. Please email sexualjusticeconference@gmail.com with any questions.

Coercion and Reproductive Justice

An essential piece of the reproductive justice and sexual rights movement is the right of all women to make reproductive choices free from coercion.

According to the Guttmacher Institute, coercion in any form is wrong and compromises choice. Coercion violates women’s right to decide freely if and when to have a child and the right to have the government respect her decision.

The Guttmacher report condemns coercion in the form of U.S. state legislatures passing increasingly restrictive abortion restrictions to keep women from ending an unwanted pregnancy. Parental notification or consent, mandatory waiting periods, and inaccurate and biased counseling exist under the guise of “preventing coerced abortion”. Rather, these TRAP laws aim not so much to inform women about the abortion procedure, as to dissuade them from choosing an abortion in the first place.

Increasingly, these laws prevent women from making decisions about how and when to give birth, posing a risk to all pregnant women, including those who want to stay pregnant.

Roe v. Wade gave women the right to choose abortion. Roe v. Wade also gave women the right not to choose abortion.

In the United States, a dark history of forced sterilization and present day controversies about the rights of the disabled remind us that as much as women have a freedom to abortion, if she chooses to continue a pregnancy, she has the equal right to do so.

Coerced abortion occurs in many forms. In January 2014, a Florida man was sentenced  to nearly 14 years in prison for tricking his pregnant girlfriend into taking Cytotec, a brand-name version of misoprostol, which causes miscarriage. Further complicating the issue, he was initially charged with first-degree murder under the Unborn Victims of Violence Act, punishable by life in prison, but he pleaded guilty to lesser charges of product tampering. The fetus was estimated to be at seven weeks.

In 2013 in Texas, a pregnant 16 year old girl claimed her parents were pressuring her to have an abortion when she wanted to continue the pregnancy and get married. When the pregnancy was confirmed, the teenager’s father allegedly became angry and insisted that she have an abortion and it was his decision.  Texas is one of the states that requires parental or judicial permission for a minor to obtain abortion; in this case, the minor had to obtain judicial permission not to have an abortion.

Coerced abortion compromises reproductive justice and often results from broader issues such as domestic and sexual violence, birth control access and tampering, economic disadvantage, education expectations, and religious convictions. Abortion is not the problem. The prevention of choice is the problem.


Abortion & Reproductive Health Care for Incarcerated Women

orange-is-the-new-black-01Orange is the New Black returned for a second season to Netflix last Friday and continued a major plot line involving a pregnant inmate and the father of her baby, who happens to be a guard in the prison. What started as a secret romance escalated quickly due to the difficulties pregnant women face while behind bars. Legally speaking, a sexual relationship between an inmate and prison official can never be considered consensual and so the characters hatched a series of plans about how to deal with the pregnancy. Could she secretly terminate the pregnancy without anyone finding out? Could she continue the pregnancy and receive adequate health care? Could she hide the pregnancy and the true father? What happens when she goes into labor? What punishment(s) will the couple endure for their actions?

While the TV show mixes fact and fiction, it does honestly depict the reality of what happens when a woman becomes pregnant in prison or enters prison already pregnant. In addition to this ongoing pregnancy plot line, in the first season an inmate entered prison pregnant, went into labor and delivered in a hospital, and was separated from her baby shortly afterwards and returned to prison. Between six and 10 percent of women are already pregnant when admitted to a prison or jail and they can become pregnant during private visits with partners, home visits, while in work release programs, or as a result of sexual assault [ACOG]. Studies also show that approximately 14 percent of girls are pregnant when they arrive to juvenile detention.

In recognition of the prevalence of these realities, the Section published a policy brief on Abortion & Reproductive Health Care for Incarcerated Women. Although our brief focuses on Illinois policies and programs, incarcerated women in state and federal facilities across the United States face myriad barriers to receiving reproductive heath care, including abortion services. Despite having the constitutional right to have an abortion (as guaranteed under Roe v Wade), accessing the procedure while incarcerated presents many challenges, including facilities’ ad hoc responses to abortion requests and the logistics and challenges of organizing transportation and payment.

The brief also discusses the practice of shackling, prison nursery programs, and policy reforms needed to address the gendered needs of women prisoners.

Although Orange is the New Black errs on the dramatic side of storytelling, it does provide an overdue platform for discussing the basic human rights of incarcerated women who have the same rights as civilians to make decisions about their own bodies.

Policy Trends and Research Updates on the 40th Anniversary of Roe v. Wade

On January 22, 1973, the Supreme Court of the United States decided the landmark case Roe v. Wade, which established the right to abortion.  Forty years later controversy still surrounds this decision and attempts to restrict and regulate abortion care have continued. In 2011 and 2012, the United States saw more regulation of abortion care and access at the state level than in the past 40 years, making it more and more difficult for women to exercise their rights.[1]

State lawmakers are continuing to find new avenues through which to restrict access to abortion; 2012 saw trends in proposed and passed legislation that restrict insurance coverage, require provision of unnecessary procedures or misleading information to women, target abortion providers, and seek to ban abortions at later gestational ages based on theories regarding fetal pain.

Eight states now have laws that require a doctor to perform an ultrasound and show her the image or offer to do so before a woman can receive an abortion.[2] Doctors already perform ultrasounds if they are needed to provide abortion care; enacting legislation to require the procedure and viewing of the image appears aimed solely at trying to dissuade women from choosing abortion. A 2012 study researching the effects of ultrasound viewing on women seeking abortion found that women can respond differently – some women felt dissuaded, some women experienced emotional difficulty, and some women reported a better ability to cope with their abortion. Given these varied outcomes, the authors suggest that the decision to view an ultrasound should be left to the doctor and patient.[3] The leaders of five well-regarded professional physician organizations agree. Responding in part to the ultrasound mandates, they published a commentary in 2012 voicing concerns over legislative interference with the patient-physician relationship; they assert that such legislative intervention undermines the ability of physicians to give, and patients to receive, the highest quality care and medical guidance.[4]

In a large number of states, a waiting period is required before receiving an abortion. In addition, doctors must provide mandatory counseling prior to abortion; in some states, specific language must be read, including information that is not supported by science regarding links between abortion and breast cancer and mental health risks. Not only do such mandates require physicians to provide misinformation, but a study conducted in June 2012 found that 87% of women are confident about their decision to make an abortion before visiting a clinic, suggesting that blanket regulations requiring counseling and waiting periods only interfere with a woman’s ability to receive personalized care.[5]

These misleading practices can be amplified by Crisis Pregnancy Centers (CPCs), which often give the impression that they offer abortion services, but in fact typically only offer pregnancy tests and ultrasounds and are usually established expressly to discourage abortion. In a recent study, researchers contacted 32 CPCs in North Carolina and seventeen (53%) provided at least one misleading or inaccurate piece of information, including inaccurate information about links between abortion and breast cancer, mental health hazards, and infertility.[6] Scholar Joanne Rosen also discussed the public health risks of CPCs in a 2012 commentary in Perspectives on Sexual and Reproductive Health, claiming that CPCs, which operate under the notion of informed consent, are actually, “contrary to the legal and ethical standards of informed consent”, given their practices of distributing misleading information.[7]

In 2012, three states (Arizona, Kansas and Missouri) enacted new “conscience provisions,” expanding the types of entities that can refuse to provide care or insurance to patients or employees.[8] Many states already have provisions in place that exempt individuals from providing these services on moral or ethical grounds, but new measures allow insurers to exclude coverage for contraception, abortion and sterilization.[9]  As Lisa Harris points out in a recent article in The New England Journal of Medicine, these measures allow for “conscience based refusals,” but there is little legal protection of “conscience based provision” of such services.[10]

In the past year, there has been an onslaught of legislation establishing targeted restrictions on abortion providers (referred to as TRAP laws). Bills were proposed in twelve states that would place burdensome restrictions on clinics through building regulation mandates and new employee requirements. Last month, Governor Rick Snyder of Michigan signed a bill which requires clinics that regularly perform abortions to meet the same building license requirements as surgical outpatient facilities. This bill and others like it will likely result in not only the closing of many existing clinics, but will make the building of new clinics more arduous.[11] Some women must already travel hundreds of miles to the nearest clinic, as this map demonstrates. These types of restrictions will make access even more difficult.

With the passage of the Affordable Care Act and the resulting creation of new state exchange programs, many legislatures have made efforts to curtail coverage for abortion. Four states in the past year passed bills which prohibit abortion coverage through their exchange programs, while a number of other states are working toward abortion care bans both within and beyond the exchange. In addition, many states continue to pursue a ban on abortion at earlier gestational ages. Eight states in the past year saw bills that proposed abortion bans as early as twenty weeks post fertilization, which precedes the current legal viability mark.[12] These bans likely impact the most vulnerable women; in a recent study, researchers found that patients seeking second trimester abortions were often younger (age 19 and below), Black, less-educated, lower-income, had experienced more disruptive life events, and were more likely to have been exposed to intimate partner violence.[13]

A major victory for women in the year 2012 was the passage of the Shaheen provision in the National Defense Authorization Act, which provides military servicewomen and military families the same abortion coverage as other federal employees. Previously, insurance for these women only covered abortions when a woman’s life was at risk, but the Shaheen provision allows for additional coverage in the case of rape or incest.[14] This change is especially welcome given the findings of a recent study which showed a number of challenges women in the military face when seeking contraception; one third reported that they were unable to access a method they might want for deployment, certain methods were reportedly discouraged or not available for some women (including intrauterine devices and sterilization), and 41% of women requiring refills found them difficult to obtain.[15]

Looking back on 2012, we can celebrate the reproductive justice achievement in the Shaheen provision, and applaud the successes that legislatures and reproductive justice advocates had halting the passage of proposed bills that would restrict access. However, some measures did pass which limit the ability of women to obtain supportive and quality reproductive care. As we move into 2013, there are promising ways to advance the rights articulated in Roe v. Wade. Such initiatives might include efforts to preserve insurance coverage and expand public funding for abortion care, expand sexual education, promote public awareness of issues related to reproductive justice and abortion, and increase women’s access to reproductive care.

[1] 2012 Saw Second-Highest Number of Abortion Restrictions Ever. New York: Guttmacher Institute, January 2, 2013.

[2] State Policies in Brief: Requirements for Ultrasound, New York: Guttmacher Institute; 2013.

[3] Kimport K., et al. Women’s Perspectives on Ultrasound Viewing in the Abortion Care Context.  Women’s Health Issues. 2012, 22(6): e513- e517.

[4] Weinberger SE, et al. Legislative Interference with the Patient-Physician Relationship. The New England Journal of Medicine. 2012, 367: 1557-1559.

[5] Foster DG, et al. Attitudes and Decision Making Among Women Seeking Abortions at One U.S. Clinic. Perspectives on Sexual and Reproductive Health. 2012, 44(2): 117- 124.

[6] Bryant A, Levi E. Abortion misinformation from crisis pregnancy centers in North Carolina.  Contraception. 2012, 86(6):752-756.

[7] Rosen JD. The Public Health Risks of Crisis Pregnancy Centers. Perspectives on Sexual and Reproductive Health. 2012, 44(3):201-205.

[8] 2012 Year-End Report. New York: Center for Reproductive Rights, 2013.

[9] State Policies in Brief: Restricting Insurance Coverage of Abortion, New York: Guttmacher Institute; 2013.

[10] Harris L. Recognizing Conscience in Abortion Provision. The New England Journal of Medicine. 2012, 367: 981-983.

[11] Marty R. “Michigan Governor Snyder Signs Abortion Superbill into Law”. RH Reality Check, 2012.

[12] 2012 Year-End Report.  New York: Center for Reproductive Rights, 2013.

[13] Jones RK, Finer B. Who has second-trimester abortions in the United States? Contraception. 2012, 85(6):544-551.

[14] Senate Votes to Ease Ban on Abortion Coverage for Military Servicewomen; Bill Now Moves to Conference Committee” New York: Center for Reproductive Rights, 2012.

[15] Grindlay K, Grossman D. Contraception access and use among US servicewomen during deployment. Contraception. 2012, 87(2): 162-169.

Race and Reproductive Politics: An Editorial

In Race, Reproductive Politics and Reproductive Healthcare in the Contemporary United States, an editorial published in Contraception, authors Carole Joffe and Willie Parker discuss how the United States, a country marked by extreme stratification on both racial and economic grounds, has had a history of both targeting the birth rates of people of color while also fueling deep political divisions about the provision of reproductive healh services – particularly abortion and contraception.

The authors discuss their dismay at the contemporary state of reproductive politics in the United States, particularly the manipulation of racial themes by opponents of abortion and birth control.  However, they reference the “mixed legacy” of the United States history and acknowledge the complexity of alandscape “containing both liberatory and coercive possibilities, and always with particular implications for people of color in a white-dominated society.” Ultimately, the authors warn against the “manipulation of the history of race and reproduction by those involved in the [recent anti-abortion] billboard campaigns” and similar efforts which obscure “the contemporary facts of life faced by the most vulnerable black women.”

The authors note that the current climate has galvanized a countermovement of health activists  and they see hope for women’s reproductive rights. At the same time, the authors conclude that “the stakes in this “war” are inevitably the highest for the most vulnerable in our society; Parker calls on fellow health care providers “to trust women to make the good and tough decisions about when and whether to expand their families” and assure them the resources to do so.

Minors Express Mainly Negative Opinions about Parental Notification Laws

In Abortion-Seeking Minors’ Views on the Illinois Parental Notification Law: A Qualitative Study, published in Perspectives on Sexual and Reproductive Health, author Erin K. Kavanagh and other researchers from the Section of Family Planning and Contraceptive research analyze abortion-seeking minors’ thoughts on mandatory parental involvement laws and the potential impact such a law might have on a minor’s decision and level of access to abortion services. 

In-depth interviews were conducted with 30 minors presenting for an abortion at one of three Chicago-area clinics in 2010. Interviewers described the Illinois parental notification law (which was passed in 1995 but is not in effect because of legal challenges) and a corresponding judicial bypass option to the minors and asked their opinions about them. Interviews were coded and analyzed using content analysis and grounded theory methods.

The participants believed this law would diminish minors’ reproductive autonomy and potentially expose them to unwanted pressure or interference in their abortion decision. At the same time, many felt that voluntarily seeking support from a trusted adult, but not necessarily a parent, could benefit minors. The authors suggest that policymakers might better understand the impact of parental notification laws on minors’ ability to make reproductive health decisions if teens’ voices were heard in the debates concerning these laws and question whether parental notification laws best serve the reproductive well-being of minors.

Contraceptive Care in the Veterans Healthcare System

In Contraceptive Care in the VA Healthcare System,published in Contraception, authors Sonya Borrero, et al, highlight how little is known about contraceptive care within the Veterans Affairs (VA) health care system.  This study was conducted to assess the prevalence of documented contraception by race and ethnicity within the VA and to examine the association between receiving primary care in women’s health clinics (WHCs) and having a documented contraceptive method.

The authors examined data from 103,950 female veterans aged 18-45 years from the year 2008.  Attention was paid to the associations between race/ethnicity and receipt of care in a WHC with having a method of contraception.

Results indicated that a meager 22% of women veterans had a documented method of contaception during 2008. Hispanic and African-American women were significantly less likely to have a method compared to whites, and women who went to WHC’s were significantly more likely to have a method of contraception compared to women who went to traditional primary care clinics.

The authors concluded that overall contraceptive prevalance in the VA is low, but receiving care in a WHC is associated with a significantly higher likelihood of having a contraceptive method.

State-by-State Analysis of Laws that Help New Parents

In Expecting Better: A State-by-State Analysis of Laws That Help New Parents, a report published by the National Partnership for Women & Families, the authors documents workers’ rights under current state laws and the progress that states have made in promoting the economic security of new parents. An additional section discusses state policies that more broadly assist family caregivers — both parents and workers overall — in addressing the needs of their children and other family members.

The report notes that the U.S. (which does not offer paid leave protections for new parents) falls behind the 178 nations that guarantee paid leave for new mothers and the 54 nations that guarantee paid leave for new fathers. Just three national laws, addressing pregnancy discrimination, family and medical leave, and nursing mothers’ rights at work, help some new and expecting parents upon the birth of a child.

New parents must rely on the policies of their employers, but only 38% of workers have access to employer-provided short-term disability insurance and only one-tenth of the workforce has access to employer-offered paid leave to care for a new child. Significantly, workers in low-paying jobs — those with the greatest need for both job protection and wage replacement during leave from work — are far less likely to have access to either of these employer-provided benefits.

The report points out states that are doing better than others (e.g., CA and CT), but 18 states were graded with an “F” for “failing to provide a single benefit or program to help support families before and after the birth, adoption or foster placement of a child.”