Corinne Rovetti is Co-Director for the Knoxville Center for Reproductive Health in Tennessee. Alongside other services, the Center provides safe abortions. It is one of few legal abortion providers in the region.
Corinne is a human rights activist and community organizer with decades of experience. Among many other causes and groups she actively supports is Women in Black.
The Situation in the Here and Now
The U.S.A. is in serious legal, ethical and moral decline. The laws, values, principles and beliefs of freedom, equality and rights in the pursuit of happiness and independence are being diminished. Nowhere is this decline more evident than in its application to women’s reproductive and human rights.
I write this article to update those outside the U.S.A., those who are committed to global concerns regarding the status of women in the world and more specifically, in the intersection of religion with gender, sexuality, violence, race and class, on the conditions threatening U.S. women today. Given the current U.S. Administration’s policies, we here in the U.S.A. are experiencing continual erosion of reproductive rights and services. The United States of America’s willingness to exploit religion for political gain, while not new and evident throughout its history, reaches new heights of hypocrisy and abuse in the present.
The Religious Right’s obsession with women’s reproductive health is a prime example of age-old tactics to control and subjugate women. While professing vows to uphold the sanctity of life of the unborn (and disavowing the sacredness of life of the mother who is seen as a vessel) these same fanatics are drastically slashing public programs that support lives and families. Long-standing funding for contraceptive and family planning services are being eliminated from the federal budget as well as programs for food and nutritional support for families and schools, child health care and insurance and early childhood development.
Governmental assault co-mingled with religiosity, though affecting all women, disproportionately affects women of color and of lower socio-economic standing.
My credentials: I have been a long time advocate, director and provider of reproductive health services. I have been on the front lines witnessing the massive changes of what has now become a daily battle for women to access health care without the intervention of politicians, religious zealots and demeaning attitudes of health care professionals.
Women evaluating our services often express surprise and deep gratitude for not being judged or criticized in our facility. Every time I read these remarks they break my heart. What it tells me is that women’s expectations of receiving care with dignity and respect are so low that it’s not even anticipated in a supportive reproductive women-centered community! Women expect obstacles, judgement and shaming for the delivery of even the most basic of health care needs.
What is Happening
So, let me address the barriers of access to care issues in the U.S.A.
Since 2010, states have passed 338 restrictions on abortion services creating undue hardships on women and limiting access to services. Many staunch conservatives were elected to state legislatures and governorships to ensure a victory in the passage of laws upholding anti-abortion agendas. According to a 2017 Guttmacher Institute report, an organization dedicated to research and policy analysis on abortion in the U.S.A., ‘by 2016 more than half of all states had at least 4 of the major types of abortion restrictions classifying them as hostile to abortion rights. Notably, all the states in the South, along with most states in the Midwest, are considered hostile to abortion. Fully 22 states have 6 or more restrictions, enough to be classified as extremely hostile to abortion rights.’ Since January 2018, 308 new restrictions have been introduced in 37 state legislatures.
Many of the regulations are written under the pretense of safety concerns and the need to ‘protect women’. For example, imposed waiting periods of 24, 48 or 72 hours between the woman’s first visit and the day she returns for her procedure, mandated 2 office visits to receive services, imposed hospital privilege laws for physicians (recently struck down by the Supreme Court), mandated ultrasounds and requirement for the woman to listen to the heartbeat, gestational age limits, state-scripted intimidating informed consents and hospital applied regulations for free-standing clinics (also recently struck down but not before the closure of many clinics unable to comply with these expensive and unnecessary regulations. Between 2011-2014 the number of clinics fell by 6%).
There are now seven states with only one remaining open clinic. Remember the vast geographic territory that the U.S.A. covers! Many women must travel hundreds of miles…twice…to receive services, paying high transportation and often also childcare costs. Many women work low paying jobs with no benefits and experience loss of wages and sometimes loss of jobs due to missed work days, despite medical reasons being provided. Women in school or college miss classes and exams. Many women must find excuses for prolonged absences from home when they are hiding their decision from abusive partners.
Mind you, there have been no changes in reported mortality or morbidity statistics to warrant these ‘safety’ concerns. Abortion remains one of the safest medical procedures performed worldwide where legality is not an issue.
Many of the abortion laws interfere with the patient/physician relationship, dictating to physicians how they practice medicine. Most women live in states with abortion laws that conflict with science and facts and are 70% lies, legislating laws that force doctors to say things that contradict scientific evidence and the oath they have taken to do no harm to their patients. In eleven states doctors must tell patients that an abortion procedure may cause mental health problems (NO), loss of fertility (NO) and breast cancer (NO). Two states also require physicians to tell women (falsely) that the medical abortion pill, once taken, is “reversible”.
Two of Trump’s recent appointees to key roles in the U.S. Department of Health and Human Services are people directly responsible for health policy. They incorrectly insist that abortions cause breast cancer, claiming that abortion providers are in cahoots with scientists to hide the evidence of this connection! You can’t make this stuff up!
Further restrictions to access are related to financial issues. Remember, the United States has no national health care plan (except for seniors). Many people are un-insured or under-insured. Under the Obama Administration, health care legislation finally improved the insurance status of an additional 20 million people, mandating free contraceptive coverage for the first time in U.S. history. This law, the ACA (Affordable Care Act) has been under major attack and dismantled by the Republican Party (also called the GOP, ‘Grand Old Party’) and the Trump White House – despite their inability to outright eliminate it. Many plans can now deny the coverage of these services, based on religious objection.
Few states may use the available public funding programs for abortion services. Seventeen states may, but 32 and D.C. (the District of Columbia, where the capital city is located) prohibit the use except in the case of rape, incest or the endangerment of the mother’s life.
Few private insurers cover abortion services, with half the states passing laws and implementing bans for private plans to cover these services this year. The White House is pushing for further barriers.
Further restrictions are implemented under the guise of religious freedom. Conservatives are challenging and winning institutional discrimination cases based on ‘religious liberty’. This matter particularly has impacted the coverage of contraceptive services (as well as having a huge impact on the erosion of the rights of the LGBTQ community). The United States of America has become weaponized by the religious fundamentalists governing it, legislating their religious/political agenda in a nation founded on religious freedom. Regressive and hostile stereotypical misogynistic attitudes are being legislated in regards to women, their sexuality and health care access.
There are many more issues pertaining to the concerns for the reproductive health status of women in the U.S.A. This piece is limited in covering all those issues. However, there are a few more points that I would like to cover.
One is in regards to the aforementioned closure of many clinics nationwide. Many of these facilities had been the main provider of women’s preventive health services, contraceptive care and STI (sexually transmitted infections/diseases) screening and treatment. With reduced services we see exponentially higher rates of problems. The U.S.A. is experiencing a public health crisis with more than 2 million STI cases in 2016: the highest number recorded EVER. And how many more undiagnosed cases are out there, given the increasingly limited access to clinics providing services to prevent and treat STI’s? Are these undiagnosed cases contributing to the decline in the fertility rate? Are these cases contributing to the overall negative health status and birth complications women in the U.S.A. experience? (For statistics, see here.)
Which segues into another serious public health concern, the abysmal maternal mortality rate affecting U.S. women. According to the World Health Organization (WHO), 2015, the U.S.A. ranks as having the worst rate in the developed world and this is rising as other countries experience declining mortality rates. For example, the rate in the U.K. is 9.2 deaths per 100,000 women; in the U.S.A., 26.4/100,000 women. Moreover, Black women in the U.S.A. experience a 4 times higher rate of death than White women, which is indicative of more than socioeconomic factors alone. This is shown in that educated urban Black women have higher maternal mortality than rural uneducated White women. In N.Y.C. (New York City) the rate of death for black women is 10 times higher than that of the rural southern state of Georgia! Much analysis has and is being conducted addressing the implied racial bias in the delivery of healthcare in the U.S.A. (For examples, see here and here.)
Lastly, I will address recent disturbing changes acknowledging the dire erosion of human rights issues.
In 2015 a U.N. working group of the U.N. Office of the High Commissioner for Human Rights (OHCHR) completed an official ten-day visit to the U.S.A. They reported that women in the U.S.A. are lagging seriously behind in human rights and that they witnessed ‘unprecedented hostile stereotyping of women’ in the political arena with ‘increasingly restrictive legislative measures by many of the states to prevent women’s access to exercise their reproductive rights.’ The report concludes that U.S. women are becoming seriously compromised in all areas of human rights, be it issues of violence against women, incarceration, intimidation and harassment in accessing health services, deeply disturbing conditions of migrant women and their children held in detention, the disparate vulnerabilities of minorities, the poor, the elderly and disabled, LGBTQ people, migrant women – the list is long.
In a recent move, May 2018, the Trump Administration directed the State Department to censor mention of women’s reproductive rights and discrimination in its annual report on human rights; in other words, prohibiting the acknowledgement of human rights violations that pertain to reproductive rights. Passages covering family planning and contraception and abortion access were removed while minimizing sections on sexual, ethnic and racial discrimination.
In June 2018, the U.S.A. removed itself from the U.N. Human Rights Council as it had committed heinous acts of human rights abuse and violations to immigrant families and those seeking asylum in the U.S.A. by separating children from their parents and detaining them in horribly inadequate conditions in tents, cages and ‘camps’.
And then very recently, the Thomson Reuters Foundation released the report on its 2018 survey, previously conducted in 2011, assessing the 193 U.N. member states which are considered most dangerous for women in areas of healthcare, economic resources, traditional practices, risks of harassment, rape, sexual and non-sexual violence, abuse and coercion and human trafficking. 550 experts in global women’s issues conducted the survey. India ranked #1, the U.S.A. ranked #10, behind Afghanistan, Syria, Somalia, Saudi Arabia, Pakistan, Democratic Republic of Congo, Yemen and Nigeria. The U.S.A. is the only Western country represented. The survey was conducted after the #MeToo Movement which exposed the extent of harassment and rape culture in the U.S.A.
With U.S. descent into a world of alternative facts and destruction of truth-based evidence (be it human rights, climate change, the environment, scientific pursuits), in a classic textbook case of fascism and authoritative rule, the U.S.A. is rapidly slipping into dangerous realms of ever-increasing human rights violations, especially for women and minorities.
I never would have thought that in my lifetime’s commitment to working for and witnessing progressive changes in the status of women in the U.S.A., that so much could so quickly be dismantled and annihilated. We still had a long way to go but had made many great strides.
Reporting from a troubled place, I continue to work and advocate for all women and our rightful equal place in the world! We will not cease in our efforts to uphold women’s rights as human rights… and as a priority for humans everywhere on this planet.
Submitted by Corinne Rovetti FNP, APRN-BC Co-Director at Knoxville Center for Reproductive Health