In June Medical Services v. Russo, a majority of the U.S. Supreme Court struck down Louisiana’s Unsafe Abortion Protection Act—a predatory law requiring doctors who perform abortions to have admitting privileges at a nearby hospital. If left unchecked, the law had the potential to virtually eliminate abortion access across the state, leaving thousands of Louisianan-residents with no way to obtain a safe, legal abortion.
The Louisiana law argued in June Medical is identical to a Texas law struck down in the 2016 Whole Woman’s Health v. Hellerstedt case, as both required a 30-mile admitting privilege requirement for physicians. Both laws purport to protect those seeking an abortion—but were actually intended to shut down clinics and deny abortion care to those who need it most.
Low-income people, people of color, young people, immigrants and rural communities would have been most affected by the decision, as they already face the greatest obstacles when it comes to accessing health care.
And with fewer clinics, there would have been greater delays in care, larger distances to travel, longer wait-times, more time called off of work, a loss of income and higher procedural costs.
“When lawmakers in Louisiana and other states like Mississippi, Kansas and Oklahoma pass laws requiring hospital admitting privileges, they know doctors will be denied—and clinics will close,” wrote Kathy Spillar, executive editor of Ms. “These laws put women’s lives at risk and disproportionately impact women of color and poor women. This is especially cruel in a state like Louisiana that already has the highest maternal mortality rate in the nation.”
In-clinic abortion is one of the safest outpatient medical procedures, with the risk of complication lower than that of a colonoscopy, wisdom teeth extraction or tonsillectomy. So why try so hard to stop it?
Medically, there is no reason to do so. But politically, regulating abortion to a level where those seeking abortion services are being harmed is a prime example of the ways in which race, class and politics come together to create unnecessary obstacles and limit abortion access.
In the U.S., the abortion rate for Black patients is almost five times that of white. Yet as long as racial disparities continue to exist within health care and economic empowerment, Black abortion-seekers will be the ones to feel these disproportionate risks and effects.
Ms. reporter Corinne Ahrens discussed these findings and the potential effects of June Medical with Pearl Ricks, executive director of the Reproductive Justice Action Collective (ReJAC)—a network of Southern activists based in New Orleans that aims to share information, resources, ideas and human power to create and implement projects in their community within the reproductive justice framework.
ReJAC envisions a world in which “all Southerners are able to access reproductive health care without judgement and with dignity; have free access to accurate health information, resources, and organizing opportunities in their communities; and have a space to organize about issues that are important to them.”
Ricks spoke of the importance of reproductive justice within the reproductive rights movement, and of individuals having the space to make the best decisions for themselves and their bodies.
This interview has been edited for clarity.
Author’s note: The word “womxn” will be used throughout the rest of the piece because, as Pearl Ricks says: “Not all womxn get pregnant, and not all pregnant people are womxn.”
Corinne Ahrens: In context of the broader reproductive rights movement, how do you see the decision of June Medical impacting the current reproductive health landscape in Louisiana, the South and the nation?
Pearl Ricks: This case is something that Texas went through in 2016, so it was very frustrating finding ourselves dealing with the same issue in 2020. And at the same time, the precedent set in 2016 was upheld, which is great and fantastic; but does not by any means mean our fight for bodily autonomy, dignity and the right for people to do what the want with their bodies is not over.
One good thing is that if this case comes up again in another state, there will already be a precedent in place, so hopefully no other state does have to go through this. That’s the hope.
In an immediate way, the best impact is we are able to focus on protecting dignity and bodily autonomy in the state of Louisiana instead of being reactive to what will happen to the clinics. Our clinics are staying open; we do not have to worry about admitting privileges right now. …
This was a scenario that was placed in front of us, and the way I explain it to a lot of people is that its like getting a 90 percent on a test where you really wanted a 100—because you fall short in that there was no clear majority and was bound in one decision by Justice Roberts. We want to keep in mind that those who oppose each individual having control over their bodies will continue to be vocal and hands-on active in preventing bodily autonomy.
Something that is important is that providers are still able to bring lawsuits on behalf of their patients, and it is not a friendly process for folks who just want to access safe, reliable health care for abortion.
There’s so much more to do! Admitting privileges was just a sliver, and we still have multi-appointment abortions here! So yes, this battle was won, but when it comes to the war that is being waged against our bodies, that still continues.
CA: In your work with reproductive health—primarily Southern reproductive health—where do you see instances of ‘gatekeeping’ impacting individuals’ ability to access the services they need?
PR: When we’re looking at gatekeeping, … I also want to speak in terms of obstacles— because gatekeeping can happen from the inside, and obstacles can be placed at any point.
It’s really important we think about the journey an individual takes when it comes to accessing an abortion, and how many times obstacles were put in the way of their informed decision-making. And for that, we can look at Black communities, trans communities and low-income communities, and consider sexual education. Before someone needs an abortion, they are going to get pregnant, and for someone to get pregnant, someone needs to be having sex! …
So there are a lot of folks who don’t know what’s happening with their bodies, and I wanted to highlight that avoiding … obstacles starts when we can be informed about our bodies—and not only our bodies, but how they interact with the bodies of others. When that doesn’t happen, we’re going to have a higher chance of unintended pregnancy.
That portion feeds into birth control options—whether it’s financial access to birth control, the means to travel to get it, to walk into a space that provides you with birth control without the stigma of what your body looks like compared to the people running it. All of these things come into play.
And it’s also important to acknowledge there are people in Louisiana who do not know that abortion is accessible, that you can get an abortion here. That is information that is not shared openly throughout the state and throughout the South, so groups within the Louisiana Coalition for Reproductive Justice are getting that word out—because it’s not general information, and it is not told to you when it comes to pregnancy options across religions or in the classroom. And that’s unfortunate, because there are people that will continue their pregnancy and potentially give birth who did not know [abortion] is an option for them.
And even for those who may know it’s accessible, we need to look at transportation. How many people have the means to drive day after day to their appointments? And how many folks have the funds, have the means, have the workplace flexibility to miss work, to miss wages, to take care of themselves amidst all of that and not have to worry about bills?
It is extremely important when we look at access to abortion, to consider that abortion is not just an individual conversation—this is a family conversation for people who have families already and need to make decisions whether or not to have children. We look at the fact that [some] people accessing abortion do not have $400 in their bank account at any given time and have little in savings. Those are things that are important to keep in mind when it comes to barriers for accessing abortion.
And when we place stigma as a barrier, that’s the multi-tiered one—stigma of accessing abortion, period, but also the stigma of accessing abortion as a trans man. Or even finding the right folks who can walk you through pregnancy, because body dysmorphia is real, and these are important to keep in mind when we look at the gatekeeping and obstacles between individuals and essential health care.
CA: How have you seen Southern culture fuel anti-abortion stigma?
PR: I want to break down Southern culture—because there are so many parts of Southern culture that reinforce being able to do what you want with your body. And we can use the uprisings of enslaved people for that; we can use the amazing organizations that have come out of New Orleans and the South that help people gain access to information and dignity and decision-making over their own bodies.
So something that hits me very oddly is when we say “Southern culture overall”—because up until the late 1800s, after Juneteenth, after the last enslaved peoples were supposedly “freed,” after that is when abortion became illegal in the South! So abortion actually was a part of Southern culture when it served a purpose of white supremacy.
It’s really important to be specific when we talk about things that negatively impact abortion access and folks’ rights to do what they want with their bodies, specifically when you’re talking about pregnancy. I also want to say that we talked about religion as a part of it, and when it comes to the culture down here, and the culture across America really, it often leads with religion. The “In God We Trust” in our pledge—the very American way is to look to your religion to confirm your law, and not your laws to confirm your religion.
When we see populations that are involved in churchgoing—or even larger populations that aren’t—having conversations across opposing viewpoints, we get to a place where folks aren’t understanding how their empathy is being weaponized, or how their power is being weaponized by someone else.
But also when it comes to abortion stigma, I think that the largest thing is that … people in the South want to be able to access abortions—whether they ever get one in their lives or not. But who are the louder voices? Who are the ones most adamantly going out and voting? Or have the time to pay attention to all of the things happening policy-wise? And looking at populations like Black trans communities or brown communities that have to worry about basic survival, they are not able to pay attention all the time to the policies that take place on a local, state or regional level.
An example of that is a constitutional amendment that is coming up on our ballot in November—not only is it worded in a manipulative way, but it came down so quickly that when I talk to people about it, they have no idea. …
That is my long way of explaining how I like to talk about it, but abortion stigma that is happening in the South is primarily based on withholding information from those same populations. I truly believe that a lot of the abortion stigma we see in Louisiana and in the south is coming from groups that were purposefully kept from information from “the other-side” for lack of a better term.
CA: How are Black womxn and the LGBTQ+ community impacted by gatekeeping practices? And how can we continue to make changes towards liberating those burdened by stigma?
PR: Because we live in a capitalist society, the first thing I tell people is: If you have the means, donate to the people from those communities who are doing the work. People who are closest to the problem are often closest to the solution, and in America the difference between a solution and something that continues to be an issue is resources. So sharing those resources—and looking at resources in a broad way, because resources do not necessarily always include monetary things.
People can look to their local trans rights organizations, Black-led, brown-led RJ organizations that look into reproductive rights or sex work and ask those folks in their region: Where can I be of most help? Where can I be of service, so everything that I do is also supporting the momentum to what you see as to the goal?
It is important that we look to those that have been directly impacted for their leadership, and believe in their leadership and also to believe their expertise on these issues because of their lived experiences.
Along with that, I believe that conversations are important—because as I said earlier, there is an education and an information issue. Each one of us deserves the right to have access to what we need for our bodies; each one of us deserves access to make informed decisions for our bodies. We need all of that information out there, so information-sharing is going to be paramount.
Harmful policy starts because of white supremacy being inherent to our system. The folks we need to engage in voting—Black womxn, Black non-binary folks, Black gender-nonconforming folks—have been seen exponentially at the polls, and that is just the tip of the iceberg. We need to reengage folks by meeting them where they are and getting them engaged. We need to have conversations about what will impact out communities. How are we going to come together and show up? And that is the primary way I think we can show up.
Dangerous speech turns into dangerous rhetoric and then into dangerous action, that then turns into dangerous and hateful policy. It is all connected and we need to examine all parts of that path to make sure the trail is clean.