Category Archives: Reproductive Justice

After Cyber Monday Comes #GivingTuesday

Reproductive Justice Champions support a wide range of Maine Family Planning services and programs.

Tomorrow, November 28, is Giving Tuesday, a global day of giving that offers folks the opportunity to support their favorite charities amidst holiday shopping and deal-scoring bonanzas.

We hope you’ll participate in this altruistic activity by donating to Maine Family Planning. In particular, we urge you to consider our Reproductive Justice Champion monthly giving program. By committing to a monthly donation, you help us provide comprehensive reproductive health care to women, men, and teens across Maine. You help us empower teens to make healthy decisions through our Best Practices sexuality education curriculum. You help us advocate for your rights in Augusta, in Washington, D.C., and in courtrooms. You help transgender Mainers, rural Mainers, low-income Mainers… You get the picture.

And we need your support now more than ever. With a hostile administration in Washington, D.C., family planning providers like us have a target on our backs. From affordable birth control to abortion access, the Trump administration is waging a multi-pronged attack on women’s health care. Loyal friends like like you help us fight back.

Donate here.

‘We Can’t Be Complacent’: Thoughts on Transgender Day of Remembrance

Trans Day of Remembrance vigilToday is international Transgender Day of Remembrance, a day where we honor those whose lives were lost in acts of anti-transgender violence. According to the Human Rights Campaign, 2017 has already seen at least 25 transgender people fatally shot or killed by other violent means—and the vast majority were transgender people of color. “While the details of these cases differ, it is clear that fatal violence disproportionately affects transgender women of color, and that the intersections of racism, sexism, homophobia and transphobia conspire to deprive them of employment, housing, healthcare and other necessities, barriers that make them vulnerable,” HRC declares.

GLAAD has more about the history of TDOR here; a number of vigils are taking place around Maine. A memorial was also held in Portland on Sunday evening.

Maine Family Planning offers Open Door trans health services to folks at our clinics in Waterville and Lewiston, and statewide through our groundbreaking telemedicine technology. We are thrilled to also be on the cusp of expanding in-clinic services to additional locations in 2018. Soon, clinicians in Belfast, Bangor, and Fort Kent will also be able to offer trans health care on-site. This is an important deepening of our organizational commitment to reproductive justice. As Cazembe Murphy Jackson wrote today at Rewire: “It is so important for trans people to be included in the conversations about reproductive justice. ”

Jackson said:

We must reflect on our struggles and ensure that all of us have the ability to decide if, when, and how to become a parent, on our own terms. I believe this is at the core of reproductive justice: In order for any of us to have a taste of reproductive justice, it must be available to all of us. We must honor trans people as we are, while we are here, in every expression of our gender identity and reproduction. Honoring our resilience is resistance and remembrance.

To mark TDOR, Maine Family Planning nurse practitioners (NPs) Meredith Hunt and Sara Hayes—who manage the Open Door Program in Waterville and Lewiston, respectively—offered these reflections on the transgender health services they offer and their impact in Maine communities.

Meredith Hunt:

I really enjoy providing transhealth services.  It feels good to have such a direct impact on improving people’s lives. I love when I can see the happiness in someone’s face when I say “Yeah, I can help you with that.”  I also love that my patients in the Open Door Program really like coming in.  Many of them have told me that it is the only medical appointment to which they look forward.  I think what we are doing is so important and I see the impact in the community first hand. It is not just young people coming to see us. I have several patients who are over 50 and are so happy to finally have a place to go where they are accepted as who they truly are.

I will be attending the Transgender Day of Remembrance (TDOR) services in Waterville this year.  I have attended the ceremonies in Portland in the past.  When they read all the names of the transgender people who have lost their lives in the past year, I can’t help but get emotional.  It is just so wrong and heartbreaking.  I hope that by providing the services we offer, that we in some way are making the lives of transgender people in Maine better.

Sara Hayes:

I am very proud of our trans program at MFP.  We currently have roughly 100 trans patients who Meredith and I are helping through this process and I absolutely love my trans practice.

Working with trans folk to get their inner and outer selves in balance is incredibly rewarding.  Going through puberty as a teenager is especially rough for trans people and together we go through it again, but this time getting the hormones right. I love hearing about and seeing the physical changes my trans patients go through and their excitement is catching, for sure.

I’m also pretty excited that we are expanding the number of MFP NPs doing trans care. We have patients coming to us all over the state.  Meredith and I can do visits via telehealth at any of our sites but I think it is important that we expand our on-site trans care options as well. Julie in Belfast has been getting up to speed and thanks to a MeHAF grant, we are getting Priscilla from Bangor and Christina from Fort Kent trained as well.  My dream is that before too long, trans care is going to be available at all sites with any of our NPs.

Trans folk, especially trans women, have been the targets of violence and derision for forever.  I have been doing trans care for almost 5 years and I hear from my patients that they are getting more support from their families and friends than trans folk have in the past. But for many, safety and support are not a given. The Transgender Day of Remembrance is not only a tribute to those who have tragically lost their lives because of other people’s hate and intolerance, but it is a reminder to all of us that we can’t be complacent about safety because unfortunately trans people are still and will continue to be targeted. Especially since the current administration in Washington is just adding fuel to sparks of intolerance and ignorance that will ignite into violence, not only against LGBT people. but also against minorities, women, and low-income people.

Reflections on Listening to Feminist Leaders

Here is a dispatch from intern Casey Rogers. Casey is a senior at the University of Maine, studying social work, and is spending this academic year as a field practicum student with Maine Family Planning.

Earlier this fall, I had the fortune of attending the Maine Women’s Summit on Economic Security. When I first read about the summit, I was excited for the opportunity to hear two amazing women speak on their experiences in leading major social justice movements in the U.S. The first of these powerful women is Alicia Garza, a co-founder of the Black Lives Matter Movement. During her talk, Garza reflected on her experiences that led to Black Lives Matter, and I was moved by her strength, eloquence, and wisdom. It’s important to note that Black Lives Matter is a movement that was started by three Women of Color, and one that fights for all Black people, including women, queer and transgender people, poor people and immigrants. The second speaker is the amazing Loretta Ross, a professor at Hampshire College and co-founder of the SisterSong Women of Color Reproductive Justice Collective. Reproductive Justice is a movement also founded by Women of Color, and one that merges reproductive rights and social justice within a human rights framework.

Loretta Ross

Loretta Ross, a co-founder and former national coordinator for SisterSong Women of Color Reproductive Justice Collective, in Augusta last month.

Both leaders centered feminism and intersectionality, and what these concepts mean to them, in their discussions. Garza commented on our need to redefine feminism to better address intersectionality, as feminism is not about just one issue. Looking through an intersectional lens means recognizing that we all have many aspects to our identity:  our race, sexuality, gender, and socioeconomic class. It also means analyzing how these aspects intertwine, and how we may experience power and privilege in some ways, while experiencing powerlessness in others. A lot of what Garza said about intersectional feminism strongly resonated with me. I believe, both as a future social worker and as an individual, that you cannot look at one aspect of a person’s identity and expect to understand the bigger picture. When Garza described intersectional feminism as “transformative” and the “feminism that could free us all,” I was very much on board. Loretta Ross brought another perspective to the table. Ross prefers the term “justice feminism,” adding that “intersectionality is a process, human rights are the goal.” Ross calling herself a justice feminist reflects her feminist goals, while practicing intersectional feminist analysis better describes the process.

Garza and Ross are two powerful women in the fight for racial and reproductive justice. However, while they share some common goals, the process or paths they take may differ due to many factors, including being from two different generations, growing up in different areas, and, of course, being two different people with unique experiences. I felt that Ross touched on this well when she said, “If I only worked with people whose minds worked just like mine, I’d have a movement of one.” As a social work student, I’ve had discussions with my classmates on our tendencies to assume the people around us think exactly as we do. In reality, while we may have common goals surrounding justice and social growth, we may also see different paths to these ideas. A strong point to take away from Ross’s discussion is not to debate what “type” of feminism or advocacy is the best, as the energy spent doing so only takes away from the goal, whether your goal is getting certain policy passed, or changing the dialogue around a social issue. As Ross put it, “calling each other out on not being ‘woke’ enough is not helpful.” She discussed our need to change the dynamic from “calling out” to “calling in.”

It’s easy to write someone off because they are not on the same page, or they said something wrong, or because they come from very different experiences. However, when we’re put in a situation where we can “call in,” we may be surprised by the change we are able to make. This fall, as part of my internship, I participated in outreach work with the Mainers for Healthcare Campaign. When I started, my supervisor and MFP’s Community Organizer, Cait Vaughan, went through a canvassing training with me. Cait explained that while many interactions will be positive, that might not always be the case. She then gave me a piece of advice that really stuck with me, which is that people may say things that feel like they’re coming from a place of anger, when they may actually be coming from a place of fear, or having misinformation. It’s easy to react to anger with anger, but if we are able to stop and ask questions instead, we are also then able to meet the person where they are in how they are honestly feeling. Weeks and several canvassing shifts later, I have had a few of these interactions with folks where someone made a cringe-worthy comment, and while it was difficult not to feel upset, I did my best to engage with them and ask questions.

With all of this said, I feel it is also important to note that we are not always able, nor are we ever obligated, to “call in.” While I agree with the notion of leaning in and asking questions when we are able, call-in culture should not come at the expense of sacrificing one’s values. We should always leave room to allow ourselves to draw a line and exit a conversation if someone really is coming from a place of anger, hate, or aggression.

Being able to attend the Maine Women’s Summit on Economic Security and experience Alicia Garza and Loretta Ross’ talks was an amazing and inspiring opportunity. Seeing so many strong women from Maine, the country, and the world was a wonderful experience to take away from my field placement with Maine Family Planning. It gives me hope for my community and excitement to go out and work with some of these amazing people in my career.

We’re Still Fighting

#ImStillFighting

I’m Still Fighting image via Physicians for Reproductive Health

Today, we celebrate Maine’s historic vote to expand Medicaid (MaineCare). The margin of victory (59 to 41 percent, as of this writing) and geographic distribution of votes (supportive communities stretched from towns bordering Canada all the way to southern Maine) clearly demonstrate that Mainers believe access to health care shouldn’t depend on where you live or how much money you earn. Tuesday’s vote means more low-income folks will benefit from a full range of critical health care services, including family planning and reproductive care, and thus brings us closer to realizing our overlapping goals of reproductive and economic justice.

But we’re still fighting. 

First, we must ensure that our elected officials act on the will of the people. Already, Gov. Paul LePage (R) is snubbing Maine voters, declaring Wednesday that his administration will block the expansion until the program “has been fully funded by the Legislature at the levels [the Department of Health and Human Services] has calculated.”

That’s not right—or legal.

According to Talking Points Memo:

Mainers for Health Care, the organization behind the campaign to expand Medicaid, said despite LePage’s bluster, he can’t stop the expansion train without violating state law.

“Under the state constitution, 45 days after the legislature reconvenes, Medicaid expansion will become the law of the state,” the group’s spokesman David Farmer told TPM. “According to the statute, the Department of Health and Human Services has 90 days after that to submit an implementation plan to the federal government, and the implementation itself will take place in mid-August of 2018.”

As Maine Family Planning community organizer Cait Vaughan reminded supporters in an email today, “we’ll need all of you to show up and make sure state legislators follow through on Medicaid expansion.”

Meanwhile, we must remember that until women can use their Medicaid coverage for all the medical services they need—including abortion—this victory remains incomplete. And so we’ll continue our battle to overturn the state’s ban on Medicaid coverage for abortions.

We’re fighting because the right to an abortion is meaningless if low-income or rural women can’t access one.

It’s appropriate that we participated today in the #ImStillFighting “tweetstorm” organized by Physicians for Reproductive Heath, marking one year since Election Day 2016—a year that has seen a wholesale assault on reproductive rights, the family planning safety net, and women’s health care.

See why other, like-minded organizations are Still Fighting, below:


New Abortion Data: A Clarion Call to Family Planning Advocates

On Thursday, the Guttmacher Institute released a new analysis published in the American Journal of Public Health, giving insight into US abortion trends.

The data is fascinating and Maine Family Planning views it as a clarion call to continue and expand the work we’re doing in our clinics, in court, and in our communities.

The report from Guttmacher shows an overall decline in the US abortion rate between 2008-2014. Despite the 25 percent decline, abortion is still a common procedure in this country; one in four American women will have an abortion by age 45. Deep disparities remain among different demographic groups, with abortion increasingly concentrated among poor women and a long history of racism and discrimination contributing to differences in the abortion rate according to race and ethnicity.

These findings underscore the important work Maine Family Planning is doing to increase contraceptive use and abortion access around the state, as well as how much is at stake amid political attacks on reproductive health care nationwide. We see a declining abortion rate as a victory only if it is rooted in advances in comprehensive, affordable reproductive health care and the political and social conditions to support reproductive self-determination for everyone. Unfortunately, at least some of the recent decline can be attributed to politically-motivated & medically unnecessary state-level abortion restrictions that prevent women in many states from accessing care when they need it. Additionally, it’s clear that quality health care services remain financially out of reach for some Americans, rendering them unable to effectively plan pregnancies. As the hostile Trump administration continues its assault on health care, we fear these factors will only become more pronounced.

Our focus remains on empowering women to avoid unintended pregnancies via highly effective contraceptive methods, to be able to access abortion when they need to, and to make decisions based on their own visions of the families they want. Maine Family Planning is battling on many fronts to achieve full access to reproductive freedom: From offering comprehensive prevention programming in schools and long-acting reversible contraception (LARC) in our clinics; to providing innovative abortion care via telemedicine; to fighting in court to expand Medicaid coverage for abortions and overturn Maine’s burdensome law prohibiting nurse practitioners from providing abortion; to working with like-minded groups on the upcoming Yes on 2 vote to make Maine the first state to expand Medicaid by referendum. Guttmacher’s latest statistics prove that our work remains vital and necessary.

Fighting for Medicaid is a Feminist Issue

Did you know that 1 in 5 American women in their reproductive years receive health insurance through the Medicaid program? In fact, Medicaid is a lifeline for nearly half of women in that age group who are below the federal poverty line, and nearly a third of Black women in that group (compared with 16% of white peers). Did you also know that LGBTQ+ people disproportionally experience poverty compared to heterosexual and cisgender people, making them more reliant on Medicaid for health care? Did you know that the Medicaid program covers care expenses for 51% of all births in the United States?

In this political moment, one of the country’s largest health care programs—designed to improve access and quality of life for low income people and those with disabilities—is under attack on both federal and state levels. Last month, the proposed American Health Care Act (AHCA) passed a vote in the House and stands to go up for a vote in the Senate. One of the many dangerous components of the AHCA is its targeting of the Medicaid program, which is an essential health care safety net for low income people, as well as a key facet of our nation’s family planning effort. Medicaid allows coverage for family planning services without copays, or penalties and red tape for choosing one type of contraceptive over another. The AHCA’s proposals to shift to a block grant or per capita cap structure for Medicaid would shift more costs to states, which would end up putting more costs on poor patients as well as their providers.

Unfortunately, Maine is also experiencing more localized attacks on our state Medicaid program, known as MaineCare. Maine is one of 19 states that have yet to expand Medicaid under the Affordable Care Act (ACA or Obamacare), due to Governor LePage’s multiple vetoes of this effort. Now, through a waiver application process, the Maine Department of Health & Human Services (DHHS) is attempting to enact rule changes that would place even more barriers to health care before poor and disabled Mainers, and result in potentially thousands more losing MaineCare coverage. Luckily, Maine’s “state plan amendment” has allowed for Maine Family Planning clinics to extend free reproductive health care services to low-income Mainers who are otherwise not eligible for MaineCare. However, the DHHS proposal to eliminate retroactive coverage would have negative effects on our ability to continue offering this service to people who fall through the cracks of our current health care system.

Opponents of these changes spoke passionately at a public hearing in Portland yesterday. One advocate with Homeless Voices for Justice—Dee Clarke—asked blatantly, “Why are you trying to hurt us?” Several mothers, including Clarke, spoke about raising their children on MaineCare, which allowed them to care for their families in the best way possible while facing the daily challenges of living in poverty. A nurse midwife spoke against the proposed $5,000 asset test as one change that would punish many women seeking prenatal care whose families operate small businesses. As she so poignantly put it, “You can’t sell off your small business or farm to afford prenatal care.”

Both the data and human stories make it clear:  Defending and expanding Medicaid is a feminist issue with major implications for women and LGBTQ+ health. The political attacks on Medicaid are fueled by classist stereotyping and stigmatizing of poor people, and the harm disproportionately falls on poor women. Cutting Medicaid means rolling back access to reproductive health care as well. It means more unplanned pregnancies, less healthy pregnancies, and more sick mothers and babies. Progressive Maine organizations are fighting to expand MaineCare this year, and Maine Family Planning is joining them. We continue to fight every day for the well-being of Maine women, teens, and LGBTQ+ people.

If you’d like to learn more about how to get involved in this effort, contact Community Organizer Cait Vaughan at 207-480-3518 or at cvaughan@mainefamilyplanning.org.

Self-Induced Abortion – Questions & Resources

In light of ongoing legislative attacks and widespread uncertainty about the security of abortion rights and access, conversations and resources addressing self-induced abortion (SIA) are increasing. We at Maine Family Planning want to serve as a resource for pregnant people in Maine who are considering their options with regards to an unplanned pregnancy.

It’s important to note that pregnant people have always found ways to terminate pregnancies—whether with the assistance of healers and caregivers, medication or natural remedies, or in a clinical setting like a doctor’s office or family planning clinic. MFP provides a safe and supportive clinical setting for anyone seeking to exercise their legal right to abortion. We offer both aspiration and medication abortion. We strive to be a trusted community-based resource that respects our patients’ dignity and unique needs, while providing education and counseling, in addition to reproductive health care services. It is our sincere hope and highest goal that all individuals living in the service areas of our 18 clinics who need abortion care will feel comfortable seeking out the compassionate professionals at MFP.

We also acknowledge the reality that barriers to accessing abortion exist across the country, and in Maine. Especially noteworthy are lack of public insurance coverage for abortion care, minimal private insurance coverage for abortion care , transportation, work schedules and child care needs that make scheduling appointments challenging, as well as abortion stigma. Some individuals have experienced trauma at the hands of medical providers, and thus lack trust in such institutions. For others, the antagonism of protestors is an insurmountable barrier. Even when clinics like ours provide excellent, nonjudgmental care—there are many reasons why someone might not be able or comfortable seeking out an abortion in such a setting, including a strong personal desire to control their own experience.

When people discuss SIA, they are often referring to self-administering of the pills mifepristone and misoprostol. Some women are acquiring such pills online and self-inducing at home or another location, often with trusted loved ones and caregivers present. Some women have faced legal persecution for such practices, or for the purchasing of pills—so we want people considering this method to both be aware of resources for accurate information on SIA, as well as the potential legal consequences.

Women face difficult—and sometimes seemingly impossible—choices each day in navigating management of their fertility. We know that desperate individuals can resort to self-harm and violent attempts to end pregnancies that they do not wish to carry. MFP advocates and organizes daily for the rights to bodily autonomy and self-determination for women and anyone who can become pregnant. This often means opposing legislative measures that attempt to unjustly surveil and criminalize pregnant people, and advocating fiercely for safe abortion access. We believe in responding to inquiries and concerns from Maine women with scientific and evidence-based answers. We encourage you to reach out to us, as well as seek accurate and feminist sources of information in doing your own research.

Here are some additional resources on SIA and pregnancy options:

Destigmatizing abortions:  the word, the act, and our reaction.

When and how did the word “abortion” become as abhorrent as a cuss word?  Even the whispered word can silence a room.  I know.  I’ve done it.  Who do we blame?  The “fake news” the “alternative facts” the “something-else-in-media-today”?!  With all the finger pointing flying around our legislative bodies maybe we need to look inward?  Maybe we need to let the trickle down trickle right to our doorsteps much like the spring rain.

Will making the word more mainstream help us?  Using it more in daily vernacular?  How about a challenge?   Humanize the word.  Think of the women, families behind the word.  Not all reasons for abortions are the same, think more like snowflakes.  All different, but all make snow.  All reasons for abortions are different – financial, life goals, timing, needs, wants, desires – but all make up the collective of abortions.

I am here to help.  At Maine Family Planning we ask women to share their stories.  Here is a handful:

“I love and adore the children I have and it’s my responsibility to make (the) right choices for them, without this service I could not accomplish this.”

“At 40 years old, faced with an unwanted pregnancy I made the choice to abort.  My choice – how lucky I am to have that choice and be taken care of by the most compassionate staff.”

“I am a single mother with two children who is struggling to just get by.  We live at a shelter and have no income.  I have been taking birth control and hadn’t had any problems.  I got pregnant with this child while using my pills.  Due to my situation, I decided that I would not be fair or right to bring this child into this family and to also take what little we have away from my two girls.  I truly feel that this abortion was the right choice for me at this time.”

“I came for my abortion and the protesters didn’t have any impact on me.  I had my procedure done due to medical reasons.  It was my choice and I do not feel guilty at all.”

“Some people say it’s not a choice; it’s a right but when you’re in a spot you need to do what you have to.  Trust us, it’s not easy but this world has its ups and downs.  You don’t know my reason.  I’m sure everyone has one and only God can judge you.”

“I am so thankful for having the right to choose.  Protesters and others don’t take into account the negative cycle of events that often occur when so many children are brought into this world by parents who are not mentally, financially, or emotionally prepared.”

“The thought of someone else making a decision about my body/my pregnancy is a very unsettling feeling.  It’s my body, my life, my choice.  America is the home of the free.  It’s my right to decide what happens with my body.”

Seven.  Seven stories to help you humanize an essential piece of women’s reproductive rights.

Maine Family Planning is committed to preserving all aspects of women’s reproductive rights and we are here for you.

Why we need Title X, Abortion Care & Maine Family Planning:

The Title X Family Funding Program gives federal funds to centers—including Maine Family Planning!—that provide services such as contraception, cancer screenings, STD testing, and much more. Enacted in 1970, it was designed to provide quality family planning care to low-income or uninsured persons who may not be able to afford it on their own. With funding from Title X, they can get the care they need at little to no cost. In 2013, it was estimated that
Title X-funded centers served 4.6 million clients nationwide (Guttmacher Institute 2015).

In 2014, approximately 20,000 Maine women received contraceptive services and supplies from
Title-X funded programs (Frost et al. 2016). Without funding from Title X, it’s likely that these women may not have received the contraceptive care they needed. Using contraceptive methods
such as birth control can have benefits in addition to preventing pregnancy such as regulating periods, preventing menstrual migraines, reducing acne, and relieving symptoms of polycystic ovarian syndrome (PCOS). So don’t let people fool you—there are MANY reasons to start using a contraceptive method beyond pregnancy prevention, and contraception services aren’t the only
services provided by Maine Family Planning and other Title X-funded centers.

Due to the Hyde Amendment (FMI HERE), no federal funds can be used for abortion services.  Maine is also a state where Mainecare coverage does not include abortion care.  Maine Family Planning believes that abortion care is a KEY piece of women’s health.

There are bound to be some people in your life saying they do not support a woman’s right to choose unless she has been sexually assaulted or if she will be harmed bringing a pregnancy to term. Often, people view abortion as a last resort, something that should only be considered when there’s nothing else to do. This creates the feeling of taboo, shedding a negative light on those who receive abortion care. Abortion shouldn’t be considered a last resort; it should simply be viewed as another option.

Everyone should have equal access to abortion care, no matter the reason for seeking abortion care, whether it’s sexual assault, harm to the mother, not wanting a child, not being able to afford another child, or any reason at all. The decision is valid; the choice resides with the person who’s pregnant, period.

Some of those people in your life who don’t support abortion may be participating in 40 Days for Life: a group that pickets at Maine Family Planning’s Augusta office every year. Consider fighting back—against them and the stigma surrounding a woman’s right to choose—by participating in our Pledge-A-Picketer campaign HERE.

Maine Family Planning also provides physical exams, pap smears, breast exams, transgender health care, and immunizations! Title X-funded family planning centers are essential for low-income or uninsured women—and men!—who may not be able to afford these services otherwise. It’s not just abortion and birth control; it’s so, so much more.

This is a guest post by Adam, one of Maine Family Planning’s student interns.  Adam is pursuing a degree in creative writing. When he’s not writing for class or for Maine Family Planning’s blog, he’s petting cats.

Sources:
Contraceptive Needs and Services, 2014 Update, Frost JJ, Frohwirth L and Zolna MR, 2016.
< https://www.guttmacher.org/report/contraceptive-needs-and-services-2014-update >

The Role of Reproductive Freedom in Ending Domestic Violence

The right to determine what happens to our own physical selves has everything to do with our safety and wellbeing.  Attacks bodily autonomy are central to the issue of domestic violence. The behavior of those who commit domestic abuse is rooted in the belief  that they have the right to make decisions about every facet of their partners’ lives, including their bodies.

Survivors tell us that their abusers, using a wide range of coercive tactics, dictate what they wear, when and what they eat, where they go, who they see, when they sleep, and whether they can hold their children in their arms. They tell us they are not allowed to say “no” to sex, and when they do they are assaulted. They tell us they are grabbed, touched, hit, kicked, stroked and held in ways they do not want, and which they are unable to repel. In short, abusive people systematically work to strip survivors of their autonomy and their ability to make choices for themselves without risk of retribution.

Often, abusers focus on their partners’ reproductive health as a means of maintaining control over their partners’ lives. This is called reproductive coercion, and it particularly—though not exclusively—impacts women, for whom a pregnancy can make the difference between breaking free of and being connected to their abusers forever, through shared parenting if not through the relationship.

Women tell us about preparing to end the relationship, having painstakingly put together plans for starting over—a place to go, some income, childcare and transportation—when they realize they are pregnant. Maybe he tampered with her pills, or maybe he poked holes in the condoms, or maybe he raped her. No matter the tactic, with a new baby all of those carefully laid plans are often rendered unworkable. Some women tell us that this happened to them more than once: “It’s like he always knew, just when I was getting ready to go.”

Others tell us about how their abusers kept them from ending a pregnancy, sometimes physically keeping them from going to a clinic for an abortion, sometimes showing behavior change that lasted only until the baby was born. And still others tell us about how their partners supported them, even encouraged them, to get an abortion—and then later used the knowledge of the procedure as a weapon, blackmailing and shaming them with it. Abusers are often perfectly willing to capitalize on the social stigma associated with abortion, as doing so allows them to isolate their partners even further.

Reproductive freedom matters for survivors of domestic violence. It matters because it is an essential part of safety planning around reproductive coercion. It matters because the ability to become pregnant leaves women vulnerable to abusers in a very specific set of ways, and women need to be able to manage that vulnerability in whatever way works best for them.

Reproductive freedom also matters because the belief that anyone other than a woman herself has the right to control what happens to her body is a key part of the culture than condones abuse in the first place. At the core, it is an abuser’s belief that his rights take precedence over hers that drives his behavior, and his belief has been culturally supported for millennia, in laws that treated women and children as property and gave men the final say over their lives.

In just one example, it was only in 1985 that raping one’s spouse was finally outlawed in Maine. Before that, our laws maintained that a husband’s right to his wife’s body was absolute; that once she was married, she had given up her right to choose when and if to engage in sexual activity. But by 1985, our understanding had evolved. We saw that women have the right to decide for ourselves what happens to our bodies—and that right must be recognized and upheld under the law.

The same understanding needs to be applied to our discussions around reproductive freedom.

Access to a full range of reproductive health care, including abortion, not only helps survivors counteract the abusive tactics used by their partners, but it sends a message of accountability to abusers, as well. Because a culture that insists that only a woman can decide what happens to her body is one that will be able to stand beside survivors and affirm, “Your body is yours, and no one else’s, and we will support you in keeping it that way.”

Used with permission by MCEDv and also appeared on the MCEDV Voices Blog March 7, 2017