Be Heard by Nikoo Saleh Kasmai
As I entered the theater at The Flight Deck in Oakland, the smiling faces of doulas, midwives, nurses, childbirth educators and abortion counselors surrounded me. Everyone was there for the Bay Area Doula Project’s film screening of We Always Resist: Trust Black Women to honor reproductive justice work and bring awareness to the detrimental Hyde Amendment. The Hyde Amendment was passed in 1976, and prohibits federal funding of abortion through Medicaid, except in cases of rape, incest, or life endangerment.
The Hyde Amendment still stands today. What I was surprised to hear from the event’s panel members is that in Oakland, CA, as recent as 2011, there was a campaign of offensive billboards shaming black women for choosing abortion, and comparing abortion to slavery and genocide. At the helm of the effort was Issues4Life Foundation, an African-American-led, pro-life organization. That evening it became clear that the reproductive justice movement is an arena where complex race, class, and gender issues intersect. Race and class inequality are inextricably linked to the marginalization of women. One cannot be a true reproductive justice activist and not also advocate for race and class equality.
Restricting access to healthcare and reproductive education has historically been effective in subjugating women, whether or not that is always the intention. If the public feels complacent with the state of gender equality today, perhaps it’s because they aren’t aware that abortion restrictions often lead to broader healthcare restrictions that chip away at the core of women’s healthcare rights. The latest in restrictions on women’s reproductive rights occurred in my home state of Tennessee. Tennessee voters passed an amendment that expands legislative power to further restrict statewide abortions.
Conservative members are already working on three measures for 2015, including a mandatory waiting period before having a surgical abortion and mandatory counseling for any woman considering abortion. Wider restrictive measures are occurring across the country and include limiting access to health education, birth control, and family planning; cutting off funding for women-centered organizations and clinics like Planned Parenthood that provide affordable care for low-income populations; and numerous other measures that essentially make life harder for women.
Liberals and feminist organizations have described these political and legislative measures as being part of a strategic “war on women,” a wide range of efforts aimed to restrict women’s rights and perpetuate gender inequality. But for many voters opposing abortion, their reasons vary from religious conflicts to concerns regarding human life in utero. Perhaps most important, there is a lack of awareness or lack of concern for the consequences of restricting reproductive healthcare, and its role in perpetuating gender, race, and class inequality. Women of color and underserved populations who already lack access to health resources and education are particularly devastated by these restrictions.
Throughout the screening and panel, I periodically paused from writing and reached down to rub my round belly. At this time in my life I am financially and emotionally prepared to be a mother. However, if this pregnancy had presented as a significant hardship or had I found myself in different life circumstances, I may not have continued the pregnancy. I am grateful that I had a choice in the matter, and I believe that others should have that choice too.
For some, the decision to have an abortion and the choice to carry a child may seem like the exact antithesis of each other. But I would argue that they have profound similarities: both are important reproductive decisions and potential rites of passage in a woman’s life that require careful thought, informational and emotional support, and access to healthcare. Abortion is not an easy choice or an ideal outcome. But realistically, unplanned pregnancies occur for a variety of reasons, and the choice to have an abortion should not require explanation, apology or feelings of shame.
Just as women should be listened to and nurtured during their nine months of carrying a fetus to term, so too should women be tenderly cared for and supported in their journey to terminate a pregnancy. This is the philosophy at the Bay Area Doula Project, an organization, which has partnered with Access: Women’s Health Justice to provide low-cost birth doulas (birth assistants) and abortion doulas (abortion assistants) who are available to support women in whichever journey they choose.
Reproductive justice work should include the rights of pregnant and laboring women, which are sometimes lost in the medicalization of childbirth. Our rights as pregnant women are not at the forefront of discussion in healthcare today, and perhaps receive even less attention than abortion rights. In a society where a woman makes 77 cents to a man’s dollar, it is often ignored that women have the right to decide how and where to birth their child.
In our culture an obstetrician often makes unilateral decisions for the mother regarding her pregnancy care, labor and birth. But it is thepregnant woman, not the doctor, who is in charge of her pregnancy and the life of the fetus. No doubt an obstetrician or midwife’s guidance is invaluable to a woman’s prenatal care, particularly when there are complications; however, an obstetrician or midwife may be more appropriately viewed as a medical consultant and partner in the natural journey of pregnancy and childbirth.
According to ACOG (The American Congress of Obstetricians and Gynecologists), the mother is indeed the primary decision maker in her pregnancy. She has the right to informed consent and informed refusal of medical interventions. If she doesn’t want her baby to be taken away and bathed after birth, she can say so. If she is more comfortable and confident using an epidural during labor, that is her decision to make. If she is having a healthy labor and wants to give birth by squatting instead of lying on her back, it is her right to listen to her body. Often it is a mother’s intuition that guides her baby to the safest and easiest birthing route.
As women, we must listen to our intuition and demand that others listen as well. We have an innate wisdom that is irreplaceable in this world. By sharing our stories, and by expressing acceptance, empathy, and love for other women, we are enabling each other to make informed decisions that will lead to productive lives and thriving communities. It is in the depths of our histories, our challenges, and our triumphs and through our diverse voices that women learn from and draw strength from each other. Let us be heard.
ABOUT THE AUTHOR
Nikoo Saleh Kasmai, MS, L.Ac. is a licensed acupuncturist & herbalist and trained birth doula in the San Francisco Bay Area. She specializes in pregnancy and labor support and treats pregnancy-related conditions using acupuncture, herbs and maternal positioning. Most recently she was a volunteer for three years at Charlotte Maxwell Complementary Clinic, which provides free holistic care to underserved women with cancer. She is passionate about improving access to health information so that women can make informed decisions and have positive pregnancy and labor experiences.
Nikoo was born in Shiraz, Iran and grew up in New York and Tennessee. Her diverse background and experiences as an adolescent led her to an interest in the human condition. It was while working at a medical clinic in Tennessee that she became interested in medicine. She observed that our struggles with illness and pain, though challenging, have the potential to unite us in our shared experiences and align us with our truest selves. In her free time she enjoys exploring the East Bay with her husband, Chris, and dog, Lobo.
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