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Keep Your Stigma: Latina/o Youth Need Real Support

12:54 pm in Uncategorized by RH Reality Check

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Written by Marisol Franco for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

What comes to mind when the words “pregnancy,” “Latina” and “teen” are used in the same sentence? You may be surprised at how reality differs from current narratives about Latinas/os and adolescent pregnancy and parenting.

Consider Desiree and Angelica, two single Latina moms now in their thirties. Desiree was 17 and pregnant, and contrary to popular belief, her life did not end. Her son is now 12 and she recently received her Bachelor’s degree in Organizational Development. Angelica was 19 and pregnant. Her son is now 18 and receiving acceptance letters to his top choice colleges.

These success stories are rarely heard of, not because they are rare, but because in the last century, societal norms have changed to deem adolescent parenting “bad” and “teen pregnancy” a social problem. If adolescent pregnancy is so “bad,” why are Desiree, Angelica and their children doing well? Are they exceptions or the rule? The truth is many adolescent parents, children, and families do equally well compared to their peers, particularly when provided with strong social and functional support. The myth of the Latina/o “teen pregnancy problem” has buried these stories. Moreover, the dominant frame used in efforts to reduce adolescent pregnancy has, in part, caused these stories to be seen as even more uncommon, as it ascribes support for young families as social and economic “costs” and depicts young parents as social pariahs.

California Latinas for Reproductive Justice (CLRJ) released its latest issue brief, Supporting Latina/o Youth: Strengthening Latina/o Young Families and Communities, specifically to counter conventional narratives on Latina/o adolescent pregnancy and parenting. CLRJ’s brief critically examines the dominant perspective on adolescent childbearing which focuses almost exclusively on preventing adolescent pregnancy.  Supporting Latina/o Youth adamantly rebukes this approach which further stigmatizes young parents and does nothing to resolve the contextual issues that lead youth to become parents, or provide support for youth who do become parents.

Has CLRJ concluded that we must desist in supporting “teen pregnancy prevention” programs? To answer that, we ask: how did Desiree and Angelica fall through the prevention cracks?

There are myriad reasons why adolescents become parents including wanting to be a parent, lack of access to contraceptives, lack of access to comprehensive sexuality education, and lack of opportunities. Working with youth to delay childbearing and parenting is not inherently wrong, however viewing youth sexuality in a vacuum of “prevention” does not meet the needs of Latina/o youth. Similar to adults, half of youth pregnancies are unintended. In other words, half of youth pregnancies are planned. Acknowledging that youth sexuality is a normal part of development and that some youth will become sexually active as adolescents compels us to think beyond preventing pregnancy. Efforts to address adolescent pregnancy and parenting must expand to address youth’s sexuality and social needs holistically.

In a misguided attempt to support youth in avoiding the perceived “negative consequences” of adolescent parenting, the dominant prevention frame centers on changing individual behavior, which has both intentionally and unintentionally categorized pregnant and parenting youth as a social problem and a “drain” on society. Young Latina/o parents are stereotyped as unsuccessful, irresponsible and unfit caregivers. This punitive strategy of blaming young Latina/o parents and categorizing them as “costs” further stigmatizes the community while ignoring the social, economic, and political factors that shape their lives and behavior.

It is time to address Latina/o youth sexuality in a manner that considers the broad context of young Latinas’/os’ lives.  CLRJ work examine the various health, educational and socio-economic inequities that must be resolved to meet Latina/o youth’s needs.

It refutes myths like: “Adolescent parents are more likely to become poor.” In fact, Latina/o youth – pregnant, parenting or not – are experiencing persistent poverty. Thirty-five percent of California Latina/o youth are living in poverty. Nearly 60 percent of adolescent mothers are already living in poverty at the time of giving birth. Low-income youth make up around 38 percent of young women aged 15-19, and account for 73 percent of adolescents who give birth.

We need to change the dialogue. Instead of focusing on individual behavior and blaming youth, policymakers and advocates must address the institutional factors that influence behavior and create holistic programs that reflect this reality.

Like other parents, Desiree and Angelica made many sacrifices along the way to “make it.” Desiree struggled to work, support her son, and go to school. Angelica’s family supported her as she worked hard to provide for her son on her own. We know not all pregnant and parenting youth experience the same outcomes. Some experience discrimination at school being pushed out into alternative schools for pregnant and parenting students. Some cannot obtain childcare, which similarly to older parents, impedes them from securing good jobs, or attending school or job training. Many fathers have even less resources to support their parenting.

Providing Latina/o youth support and resources to parent does not enable them to become adolescent parents, it provides them with their legal right to the same educational and economic opportunities as their peers. Young parents are part of many Latina/o families’ reality, and they contribute to California’s socio-economic fabric. Pregnant and parenting youth must be treated with respect and dignity, recognizing that they too form part of our state’s future.

As attacks intensify on women, immigrants and anyone who is not a rich, white, heterosexual, conservative man, the vociferous response in defense of women’s autonomy and health has omitted any discussion about healthy sexuality, acquiescing to conservatives that sexuality is inherently bad. The same can be said in the case of adolescent childbearing and parenting. To many, discussing adolescent pregnancy and parenting among Latinas/os is often an unwanted reminder that youth have their own sexuality. By distorting this issue into a widely “palatable” public health prevention framework, we have undermined the conversation around healthy youth sexuality and pigeon-holed the approach to one that is punitive.

In order to address adolescent pregnancy and parenting in the Latina/o community and beyond, we must collectively start to change the discourse and norms to include youth sexuality and health needs from a perspective that acknowledges young people’s rights to education, access, autonomy and opportunities.

!Si, se puede!? For Latinas and Other Uninsured Women, Gaps Remain in Access to Birth Control

9:46 am in Uncategorized by RH Reality Check

Written by Kimberly Inez McGuire for RH Reality Check. This diary is cross-posted; commenters wishing to engage directly with the author should do so at the original post.

It’s about time we had some good news. It’s been a long, hot summer in DC and a rough year of partisan attacks on women’s health in Congress and around the country. Like a cool rain after a long drought, the Department of Health and Human Services (HHS) recommendations that birth control be covered without co-pay brought welcome relief to women around the country.

A refreshing example of sound policy informed by scientific and public health experts, this decision will have profound ramifications for many women and families, and may have special resonance for Latinas, immigrant women, and others who continue to face multiple barriers in accessing birth control. So, that’s the good news.

The not-so-good news? We’re going to need a lot more rain before this drought is over.

In honor of Latina Week of Action for Reproductive Justice 2011, I’m going to celebrate the HHS recommendations, while at the same time keeping in mind the unfinished work of ensuring access to contraception for all Latinas, including immigrant women.

It is not my intention to undersell the importance of the HHS decision. On the contrary, for too long, a woman’s ability to pay for birth control has determined whether and when she can prevent pregnancy, and including birth control as no-copay preventive care is a big step in the right direction.

And for Latino communities, economic relief of any kind cannot come soon enough. A new study by Pew shows Latino families have been hit hardest by the recession, accounting for the largest single decline in wealth of any ethnic and racial group in the country. These recent economic losses compound longstanding wealth and health disparities experienced by Latinas and their families. For Latinas who do have insurance or will be able to get it under the new exchanges, not having to pay out-of-pocket for their birth control could be transformative: leaving a little more money in the bank each month to help them with rent, tuition, buying groceries, and taking care of the children they already have.

But—and this is a big but—nearly four in ten Latinos is uninsured. And it probably comes as no surprise that lack of insurance is just one of many roadblocks Latinas encounter when they need to access health care, including contraception.

The Spanish phrase “!Si, se puede!” has long been used by Latinos the world over as a political rallying cry—and the two very different meanings of this iconic phrase may be instructive in examining the complex picture of Latinas’ access to reproductive health care. On the one hand, “Si se puede!” means “Yes we can!” an appropriate statement of celebration in the wake of this recent victory. (As in, “Thanks, Secretary Sebelius! Si se puede!!”) On the other hand, “Si se puede…” can also mean “IF she can…” and this conditional statement hints at the obstacles that remain. IF a Latina can get health insurance, IF she can make it to a provider’s office who can provide culturally-competent care in her language, and IF she can obtain and fill her prescription, THEN she will be able to fully enjoy the benefits of no-copay birth control.

For some women, that’s a few too many “ifs.” In addition to being less likely to have insurance, some Latinas, particularly immigrant or Spanish-dominant women, do not know where or how to find safe and accessible reproductive health care in their communities. Immigrant Latinas may be particularly vulnerable to unscrupulous “providers” who offer substandard care or misinformation. Just last week, reports surfaced that a counterfeit emergency contraception (EC) pill had been targeted to Latinas in the US. Other women may be experiencing contraceptive coercion, a form of intimate partner violence where a partner restricts a woman’s access to her birth control pills or refuses to use condoms. So even in a world where birth control is covered and hundreds of Planned Parenthood and other health clinics do provide quality care, some women could still slip through the cracks.

How can we reach the women who may not reap the benefits of the no-copay birth control decision? We can start by giving them more highly-effective options that do not require a provider’s supervision. Removing the age restriction on Plan B® emergency contraception would be a great start, and bringing a daily birth control pill over-the-counter also shows promise. If a woman of any age (or her partner, for that matter!) can pick up her EC or monthly pill pack with the rest of the shopping, more women will have birth control when they need it. (Intrigued? To weigh in with your thoughts on an over-the-counter birth control pill, you can fill out this survey.)

Every woman also needs better education about the full range of birth control options available to her. When unplanned pregnancy does occur, women need access to a full range of services: abortion care, prenatal care, and adoption counseling. Finally, reproductive health care does not exist in a vacuum: women also need social, educational, and economic opportunities, freedom from violence and coercion, and resources to care for their children and loved ones.

For many Latinas, the world I’ve just envisioned is still a long way off.

Our vigilance is needed to make sure that we build on all our victories by continuing to fight for more and better options for women. Just as every woman has different life circumstances that help determine what kind of birth control is right for her, each woman faces different barriers to accessing that birth control—including the need for insurance coverage and many others as well. We need more policymakers to take a cue from HHS Secretary Sebelius, and help create a world where every Latina “se puede,” where every woman has the support, education, and options she needs to plan pregnancy, care for her family, and care for herself.

Economy and Politics Leave Young Latinas Struggling to Afford Birth Control

7:11 am in Uncategorized by RH Reality Check

Written by Destiny Lopez for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

In the United States, Latinas are the group that would most benefit from the push to provide no-cost birth control to all women – because they are among the ones least able to afford birth control. According to a recent survey commissioned by Planned Parenthood Federation of America, Latinas in their prime childbearing years, ages 18 – 34, are more likely than all other young women to use prescription birth control methods – like the Pill – inconsistently because they cannot afford the insurance co-payments.  Inconsistent use of birth control lowers its effectiveness. 

As a Latina leader on reproductive health care, I know that young Latinas are the women most likely to have struggled with the cost of prescription birth control at some point in their lives.  These women ― our sisters, cousins, co-workers, friends, and mothers ― are balancing mortgage and tuition payments with putting food on the table for their families, not to mention paying for their own health care. Lacking sufficient resources to pay every bill, they will sometimes save money by not taking their birth control as prescribed. 

As the economic downturn drags on without relief for low-income women, this precarious financial juggling act has become increasingly harmful to women’s health. The doctors and nurses who staff Planned Parenthood health centers have seen a growing number of patients who must choose between basics like rent and health care costs such as monthly health insurance premiums and prescription co-payments. Read more

My Transnational Contraception Story

6:57 am in Uncategorized by RH Reality Check

Written by Susana Sanchez for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

Luckily for me and my family, we always had health insurance in my native country. Since the 1940s, Costa Rica implemented a public health insurance system that insures most of its citizens. Even though my country’s health care system has been highly rated, it has flaws that have to be fixed. Nonetheless, I do not remember seeing my family or friends worry about getting sick or going to the hospital because they would not have money to pay the medical bills, they simply went to see the doctor or went to the emergency room. I recall my mother choosing a private gynecologist of her choice to obtain her prenatal care when she was pregnant with my sister. I remember how my aunt got a surgical removal of an ovarian fibroma through the public health care system and did not have to pay any co-payment or deductible. I also remember all my aunts getting prenatal care and delivering without worrying about paying medical bills at the public health care system. As I was still young, I did not need any reproductive health care while I lived in Costa Rica.

After graduating from high school, I got a scholarship to attend medical school in Cuba. My scholarship included health insurance coverage. Before I started to be sexually active, I was able to talk about my reproductive health and contraceptive methods with a family doctor, and was able to choose a contraceptive method without being concerned about paying for it because they were very inexpensive. I remember how I felt uncomfortable with the injection and was able to talk with a doctor about it and simply change to birth control pills. In addition, I could have gotten a legal safe abortion at a health clinic free of cost if I had needed it. There is no stigma attached to abortions, most Cubans consider it another medical procedure, which would have been a relief coming from a deeply Catholic country. I even got an appendicitis surgical procedure free of charge at a Cuban hospital!

My experience with health care had led me to take health insurance for granted and consider health care as a human right. What a shocking experience it has been to come to the U.S. as a penniless international student! It never occurred to me that the world’s most powerful country had a health care system that excludes the most vulnerable populations.

Luckily, I have been healthy in the US up until now, so I have only needed medical care for my reproductive health. However, even getting good quality reproductive health has been quite a challenge. For the first time in my life, I found myself uninsured and worst; unable to even obtain health insurance. Gynecologists are out of the question because I simply cannot afford to pay for their services. I have had to attend community health centers and Title X funded clinics. First, it is hard to get an appointment due to the high demand that these clinics have. Second, perhaps the intersection of my race and class has influenced how I have felt I have been treated at these clinics. Sometimes I have felt as if I am asking for handouts or that staff has a patronizing attitude. Once, I was not able to obtain the birth control pill of my choice because its price is unreachable for me ($90/package).  Overall, I am barred from getting good quality reproductive health due to my immigration status and social class.

My experience may point out to a system failure rather than an individual experience, the overstated fact that people of color, especially immigrants, have unequal access to health care.  I am not the only person struggling to get good quality health care, many Latinas, whether U.S. citizens, legal permanent residents or undocumented women, lack health insurance or received limited health care services.

Statistically speaking, Latinos are an under-served community disproportionally affected by laws and policies. The community is rapidly growing and in 2006 accounted for almost 15 percent of the total U.S. population.

The list of sexual health care disparities of Latinas could be longer; however, this short list illustrates Latinas’ disproportionally lack of good quality reproductive health care and how even though most Latinas are foreign-born policies have prevented low-income immigrant Latinas to get to health care.

  • In 2007, there were 30.1 million adult Latinos in the country, and adult Latinas made up 48 percent of them.
  • It is estimated that about 52 percent of Latinas were born in countries other than the U.S.
  • In 1996, the federal government passed a law that prohibits legal immigrants to obtain Medicaid and Medicare coverage during the first five years of U.S. residency, and undocumented immigrants are ineligible for Medicaid excluding for emergency services.
  • The recent signed into law health care reform prohibits undocumented immigrants from buying health insurance policies out of their pockets in the exchange system.

As reproductive justice advocates, let’s continue having an active role working to decreasing health care disparities to ensure that our community gets better and more health care access. During this week of action, let’s get renovate our energy that there is a lot to get done!

Why I’m Not Celebrating the Pill

6:56 am in Uncategorized by RH Reality Check

Written by Bianca I. Laureano for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

I’ve mentioned before that hippie immigrant Puerto Rican parents raised me in the US. One of the messages that was transmitted to me as a young Puerto Rican woman growing up was that the birth control pill kills Puerto Rican women. And it did.

Excuse me if I do not partake in all of the celebration of The 50th Anniversary of The Pill because from my perspective it is still very much a reminder of the exploitation and violation of human rights among Puerto Ricans (and Haitians, and working class women in general) that continues today. Ignoring this reality is easy. Yet, it is a part of my, our history that I can’t simply forget or overlook. If I choose to ignore this history I also choose to ignore the history of activism by members of my community that has helped to create change at an institutional level. Ignoring this reality and history also perpetuates the ideas that historically oppressed communities are not important in the work we do today.

There are some things I’m not ready to ignore or forge and many of those are the power of language. The adjectives used to describe members of my community are horrifying. I don’t care if it was how people spoke “in that time,” they were and remain inappropriate. To describe our homeland as “slums,” “jungles,” and our community as “undesirable,” “genetically inferior,” and “ignorant” is defendable?  The ideology “that the poor, uneducated, women of Puerto Rico could follow the Pill regimen, then women anywhere in the world could too” is not condescending to you? Don’t be fooled. There was almost nothing that was “female controlled” or “empowering” about being a part of the trial for many participants, especially after they realized they were taking a medication that they did not know was not approved.

I remember reading the book Sexual Chemistry: A History of the Contraceptive Pill over a decade ago when I was in graduate school. The conversation we had as a group about the book shocked me. While I was sickened by the overt ethnocentrism, classism, ableism, xenophobia, and racism, other classmates were mostly intrigued by what the history was in the US. It was an extremely painful book for me to discuss with a group of 99 percent White people who viewed the history of my community as less than and Othered as fascinating. When I realized a yam in Mexico was a part of the early production of the pill and how the US obtained it, the inclusion of animal products that included pork and how some communities do not consume this product for various reasons, I was floored. Some classmates rolled their eyes at me as if I was making something out of nothing. To this day I’m surprised those people are now working within my community. I hope they have learned something over these ten years about the ways their thought processes isolated the people in the community they now try to provide services to. Engaging in these conversations continue to hurt.

Often, when I bring up this topic, I have people who say to me “but that was the ‘norm’ back then.” Just because it was/is the “norm” does not automatically make it “right.” Others have said to me “Look at how many people and families the pill as helped.” As if the lives of the women who were injured, died, or experienced some major side effects during the trials makes that ok. Who is thanking them? Who is remembering them? Then there are the “We need more of a biomedical model and not just a social one.” I don’t disagree, I just think that a biomedical model can also recognize how the field is constructed and given value by a society that gives it value (and money). I also think a biomedical model can be one that does not completely ignore a community response. Just because it has more money behind it does not make it better than other models. 

On anniversaries such as these, I ask that we all take a moment and think about the people who have been directly impacted negatively during trials, especially when historically discussions are not comprehensive and exclude us. Also think about how pharmaceutical companies are still engaging in some questionable actions and continue to purchase land in Puerto Rico, which does bring jobs to the island, yet those jobs are not always permanent.

All these talks about Puerto Rico and our status, do people really think that big money corporations want to lose the ability to work in a “foreign” country with a completely different approach to taxes? Think about it and consider doing some research on your own.

Worried About Women of Color? Thanks, But No Thanks, Anti-Choicers. We’ve Got It Covered.

6:22 am in Uncategorized by RH Reality Check

Written by Miriam Perez for RHRealityCheck.org – News, commentary and community for reproductive health and justice.

This article is part of a series appearing on RH Reality Check, written by reproductive justice advocates responding to recent efforts by the anti-choice movement to use racial and ethnic myths to limit women’s rights and health. Recent articles on this topic include those by Pamela Merrit, Gloria Feldt, Kelley Robinson, and Maame-Mensima Horne.

At first glance, it’s nice to see the anti-choice community pretending to care about communities of color. But within a few minutes, the skepticism sets in. What’s really behind these tactics, coming from a group that is majority white, middle-class and Christian? In the end, we know this isn’t actually about women of color and their well-being. It’s a sensationalist attempt to pit women of color against the reproductive rights movement. Classic divide and conquer.

Women of color within the reproductive rights and justice movement have brought light to the policies (often perpetuated by our own government, medical providers and researchers) that serve the mission of population control within our communities. We’ve fought back against the connections and alliances with those in the environmental rights movement who blame the challenges of resource scarcity on women of color and their family size.

We’ve fought back against governmental policies like welfare family caps and limits on access to certain types of contraception over others. We’ve fought with the reproductive rights community to get them to care about these issues and how they affect our communities—and we’ve won.

We’re fighting for access to contraception, to abortion, to options for childbirth and parenting. And now we’ll fight the racist and paternalistic logic behind the eugenics arguments being made by anti-choicers.

In the Latina community, we’ve dealt with all sorts of attempts at controlling our families. In addition to welfare family caps and abusive immigration policies, we’ve also got a long history of sterilization abuse. The height of this was in the 1970s, when Dr. Helen Rodriguez-Trias and others discovered that doctors and residents at a Los Angeles hospital had sterilized hundreds of Mexican women, without their knowledge or full consent. We’re talking women being asked to sign consent forms in languages they did not speak, being lied to and told that the procedure was reversible, or being offered sterilization in the midst of labor.

The result of this was a major organizing push by CESA—Committee to End Sterilization Abuse–to enact federal informed consent laws for sterilization. They won, and in 1976 these laws were enacted, mandating processes for informed consent, waiting periods for sterilization consent, and forms that had to be in the patient’s language, among other things.

But the fight did not end there. We’ve also dealt with a campaign to bring the population growth in Puerto Rico to zero—which actually worked in some cities, according to the documentary La Operación. Sterilization promotion was the primary tool here as well.

These days, the abuses are less obvious and more insidious. When I worked with pregnant Latina immigrants in Pennsylvania, I saw their options limited by the technicalities of their emergency Medicaid coverage. They could get sterilized, for free, right after their deliveries. But if they wanted the pill, the shot, or some other short term birth control? They were out of luck.

But what we know is that reproductive justice isn’t just about freedom from coercive sterilization. It’s also about access to a full range of reproductive technologies, whether that’s birth control, sterilization, abortion or even childbirth. Rodriguez-Trias understood this, which is why she formed CARASA a decade after CESA. CARASA, the Committee for Abortion Rights and Against Sterilization Abuse, understood that women needed options across the spectrum of reproductive technologies in order to truly achieve reproductive freedom. It’s clinics like Planned Parenthood that provide vital services to low-income Latinas, many of whom are uninsured.

Latinas and other women of color don’t need to be protected by paternalistic ideologues motivated by a political agenda that disregards the needs of women of color and their families. So thanks for your concern, anti-choicers, but I think the women of color advocates working within the reproductive justice movement have got it covered. We’re working in those clinics you attack, we’re helping to shape policies and provide services in our communities, services that allow us to decide what our needs are.

We know whom we can trust to make decisions about family creation: women themselves. We don’t need limits on what services we can access. And we don’t need your ideological bullying.

The next time one of your crisis pregnancy centers, one of your dramatic billboards, or one of your bogus pieces of “sex and race selection” legislation actually works to support women through whatever choice they make for their families—we’ll talk.