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Reproductive justice, different from the reproductive rights movements of the 1970s, justice emerged as a movement because women with low incomes, women of color, women with dissabilities and LGBTQ+ people felt marginalized in the reproductive rights movement, which focused primarily on pro-choice versus pro-life debates. Reproductive justice goes beyond the pro-choice narrative by acknowledging the fact that there are intersecting factors such as race and class that impact marginalized groups of women differently, and that this means not every woman has the freedom to choose what she wants to do with her pregnancy when her options are limited by oppressive circumstances or lack of access to services. Reproductive justice focuses on abortion access rather than abortion rights, asserting that the legal right to abortion is meaningless for women who cannot access it due to the cost, the distance to the nearest provider, or other obstacles. Reproductive Justice stems from the many activists and scholars who have criticized pro-choice discourses because they do not represent an intersectional view of the impacting social, political and economical issues that determine whether or not women are able to fully partake in their own bodily autonomy.

In addition to abortion access, the reproductive justice framework also includes other issues affecting the reproductive lives of women and trans people of color, including access to: contraception, comprehensive sex education, prevention and care for sexually transmitted infections, alternative birth options, adequate prenatal and pregnancy care, domestic violence assistance, adequate wages to support families, and safe homes. Reproductive justice is based on the international human rights framework, which views reproductive rights as human rights. The framework focuses on addressing how different forms of oppression intersect to impact people's reproductive lives. It centers the needs and leadership of the most marginalized people rather than the majority, asserting that reproductive oppression will not be eradicated until "even the most vulnerable people are able to access the resources and full human rights to live self-determined lives without fear, discrimination, or retaliation."

Sex education
According to The Pro-Choice Public Education Project, the US provides more funding towards abstinence-only sex education programs rather than comprehensive sex education programs. From 1996 through 2007, the US Congress committed over $1.5 billion to abstinence-only programs. When funding is not provided towards comprehensive sex education, students are not taught about how to prevent pregnancy and sexually transmitted diseases from occurring. Advocates for Youth discusses how abstinence-only education programs are not effective at delaying the initiation of sexual activity or reducing teen pregnancy. Instead, graduates of abstinence-only programs are more prone to engage sexual activities without know how to prevent pregnancy and disease transmission. Reproductive justice advocates call for comprehensive sex education to be available to all young people.

Birth control
Reproductive justice advocates promote every individual's right to be informed about all birth control options and to have access to choosing whether to use birth control and what method to use. This includes advocacy against programs that push women of color, women on welfare, and women involved with the justice system to use LARCs (see section above on forced and coerced sterilization and birth control). By providing women and trans people with knowledge about and access to contraception, the reproductive justice movement hopes to lower unwanted pregnancies and help people take control over their bodies.

Federal programs supported by reproductive justice activists date back to the Title X Family Planning program, which was enacted in the 1970s to provide low income individuals with reproductive health services. Title X gives funding for clinics to provide health services such as breast and pelvic examinations, STD and cancer testing, and HIV counseling and education. These clinics are vital to low-income and uninsured individuals. Advocates for reproductive justice also aim to increase funding for these programs and increase the number of services that are funded.

Abortion access
Advocates for reproductive justice such as SisterSong and Planned Parenthood believe that all women should be able to obtain a safe and affordable abortion if they desire one. Having safe, local, and affordable access to abortion services is a crucial part of ensuring high quality healthcare for women (and for trans and gender non-conforming people who can get pregnant). Access to abortion services without restrictive barriers is believed to be a vital part of healthcare because "…induced abortion is among the most common medical procedures in the US…Nearly half of American women will have one or more in their lifetimes." Furthermore, these organizations point to studies that show that when access to abortion is prohibitive or difficult, abortions will inevitably be delayed, and performing an abortion 12 weeks or longer into the pregnancy increases the risks to women's health and raises the cost of procedures. The American Medical Association echoes the importance of removing barriers to obtaining an early abortion, concluding that these barriers increase the gestational age at which the induced pregnancy termination occurs, thereby also increasing the risk associated with the procedure.

Minority groups experience poverty and high rates of pregnancy due to lack of available sex education and contraception. In addition, women from low income households are more likely to turn to unsafe abortion providers, and as a result, they are more likely to be hospitalized for complications related to the procedure than higher-income women are. Although abortions were made legal in the Roe v.s. Wade Supreme Court decision of 1973, many obstacles to women's access remain. Young, low-income, LGBTQ, rural, and non-white women experience the greatest hurdles in their efforts to obtain an abortion in many parts of the U.S. Obstacles to obtaining an abortion in the US include a lack of Medicaid coverage for abortions (except in the case of certain circumstances, such as life endangerment), restrictive state laws (such as those requiring parental consent for a minor seeking an abortion), and conscience clauses allowing medical professionals to refuse to provide women with abortions, related information, or proper referrals. Additional obstacles to access include a lack of safety for providers and patients at abortion facilities, the conservative, anti-choice political legislators and the citizens that support them, and a lack of qualified abortion providers, especially in rural states. Abortion access is especially challenging for women in prisons, jails, and immigrant detention centers. Proponents of reproductive justice argue that withholding access to abortion in these facilities can be seen as a violation of the 8th Amendment preventing cruel and unusual punishments. A survey presented in Contraception found a correlation between Republican-dominated state legislatures and severely restricted coverage for abortion. Many anti-abortion groups are actively working to chip away at abortion by enacting restrictions that prevent more and women from obtaining the procedure. The research concludes that full access isn't available in all settings, and correctional settings should increase the accessibility of services for women.

Hyde Amendment & Accessibility
Organizations that promote reproductive justice such as NOW and Planned Parenthood aim to provide increased access to safe abortions at a low cost and without external pressure. They advocate increasing insurance coverage for abortions, decreasing the stigma and danger attached to receiving an abortion, eliminating parental notification for teens, training more physicians and clinics to provide safe abortions, and creating awareness about abortion.

Maternity care
Researchers have found that women of color face substantial racial disparities in birth outcomes. This is worst for black women. For example, black women are 3-4 times more likely to die from pregnancy related causes than white women. While part of the issue is the prevalence of poverty and lack of healthcare access among women of color, researchers have found disparities across all economic classes. A black woman with an advanced degree is more likely to lose her baby than a white woman with less than a high school education. This is partially due to racial bias in the healthcare system; studies have found medical personnel less likely to believe black people's perceptions about their own pain, and many stories have surfaced of black women experiencing medical neglect within hospitals and dying from pregnancy complications that could have been treated. Researchers have also found that the stress of living as a person of color in a racist society takes a toll on physical health, a phenomenon that has been coined weathering. The extra stresses of pregnancy and labor on a weathered body can have fatal consequences.

Reproductive justice advocates assert the need to correct racial disparities in maternal health through systemic change within health care systems, and they also particularly advocate for access to midwifery model care. Midwifery care has strong roots in the ancient traditions of communities of color and is usually administered by fellow women, rather than doctors. Midwifery practitioners treat the individual as a whole person rather than an objectified body. Midwifery care involves trained professionals including midwives (who are medically trained to monitor and safeguard maternal, fetal, and infant health and deliver babies ), doula s (who provide emotional and practical support and advocacy to mothers during pregnancy, labor, and postpartum, but do not have any medical training ), and lactation consultants (who train and support mothers with lactation ). Midwifery model care has been shown to improve birth outcomes, but is often not covered by health insurance and therefore only accessible to wealthier people. Reproductive justice groups advocate for access to midwifery model care not only to correct racial disparities in birth outcomes, but because they believe that every woman has the human right to give birth in any way she wishes, including a home birth or a midwifery model birth at a birthing center or hospital.

Coerced sterilizations of Indigenous women in Canada
In the early 20th century, it was legal in Alberta (1928-1972) and British Columbia (1933-1973) to perform reproductive sterilizations under the Sexual Sterilizations Act. It was not until the 1970s that this legislation was repealed. However, the damage done towards Indigenous women is irreversible and has continued in the decades after the 1970s. The start of coerced sterilization began with the eugenics movement in the early 20th century and many Canadians, at the time, were in favour of this act. In Canada, it began with the idea of population control, however, it was disproportionally targeting Indigenous people, specifically Indigenous women and their right to reproduction. Many Indigenous women were not clearly informed of the tubal ligation procedure and believed it was a reversible form of birth control, when in fact, it was permanent.

A report was released in 2017 which highlighted the coerced tubal ligations which were done to Indigenous women at the Saskatoon Health Region. In the report, interviews were conducted with Indigenous women who underwent tubal ligation surgery and spoke of their experience. They said they felt, “invisible, profiled, and powerless.” Many Indigenous women stated that they felt pressured into signing consent forms for the procedure while they were still in labour or in operating rooms. This report has suggested that a nationwide study is done to accurately understand how many Indigenous women were affected by this. The class, region, and race of the individual did come into play when there was coerced sterilization. In 2017, a formal apology was given by the Saskatoon Health Region for being involved with the coerced sterilization of Indigenous women and recognizing that racism was a factor. Coerced sterilizations are still occurring in Canada, as recently as 2018. There is currently lawsuits against certain provincial governments by Indigenous women who underwent coerced sterilizations.

Migrant Women and Temporary Workers in Canada
Thousands of temporary farm workers, many being women, migrate to Canada through the “Seasonal Agricultural Workers Program” (SAWP), which is part of Canada’s Temporary Foreign Worker Program (TFWP). Researchers who have studied migrant women who enter into British Columbia, Canada through this program found that they face unique barriers that inhibit their bodily autonomy and freedom to make choices surrounding their sexual health through “state-level policies and practices, employer coercion and control, and circumstances related to the structure of the SAWP”. These women are impacted by many factors that contribute to their marginalization, including precarious legal status, lack of access to health care services, poverty, knowledge and language barriers, and job insecurity.

Utilizing a reproductive justice framework to analyze this issue, researchers shift the focus from “abortion rights and sexual freedom” to governmental processes that inhibit access for women to be able to make choices that are “safe, affordable, and accessible.” Women in SAWP are highly vulnerable due to the program’s legal restrictions, which results in a limited access to social programs or services, labour rights and health care services.

Migrant women in SAWP take part in “everyday” forms of resistance to injustices and oppression. Rather than large scale forms of protest or objection, tactics to resist these forms of oppression are more subtle. Forms of resistance for these women often involve private disobedience of restrictive regulations, informing the media anonymously of injustices, finding and accessing forms of birth control or reproductive health services even when discouraged not to do so, forging relationships and building a community as well as seeking the aid of advocacy groups.

LGBTQ+ people & reproductive justice
Access to reproductive health services is more limited among the LGBTQ community than among heterosexuals. This is evident from the lower number of training hours that students going into the medical field receive on health problems faced by LGBTQ persons. Evidence also shows that once students complete training and become healthcare providers, they often adopt heteronormative attitudes towards their patients. In addition to lower educational standards and evident clinical prejudice against LGBTQ patients, there is also limited health research that is specifically applicable to LGBTQ community.

Like cisgender heterosexual people, LGBTQ people still need access sex education, sexual and reproductive healthcare such as testing and treatment for sexually transmitted diseases, birth control, and abortion. Despite myths to the contrary, LGBTQ people can still face unintended pregnancies. Many face increased risk for certain sexually transmitted diseases, such as HIV. Access to fertility treatment and adoption is also a reproductive justice issue for many LGBTQ people who want to raise children. Likewise, prejudice against LGBTQ people is a reproductive justice issue impacting their personal bodily autonomy, safety, and ability to create and support healthy families. Self-determined family creation is a human right for all people, according to reproductive justice. Trans people share all of these reproductive justice issues; in addition, access to gender-affirming hormones is considered a reproductive issue necessary to their personal bodily autonomy. Trans people in the US, especially trans people of color, face the most severe prejudice and violence directed toward the LGBTQ community. Black trans women in particular are being murdered at alarming rates.

Economic justice and reproductive justice
Due to systemic racism, women of color in the US earn considerably less than white men and also substantially less than white women or men of color. This impacts their ability to afford birth control, reproductive healthcare, and abortion, as well as their ability to have as many children as they want and raise their families with adequate resources. Due to economic constraints, women of color are more likely than other women to feel they need to abort pregnancies they want. They are also more likely to live in poverty because they have more children than they can easily afford to care for. Women with low incomes are more likely to rely on state social supports, which often further limit their access to birth control, reproductive health services, abortion, and high quality maternity care such as midwifery services.

In 1977, the United States federal government passed the Hyde Amendment, which eliminated federal medicaid which funded abortions and reproductive services to low income women. This caused low-income women further barriers in accessing reproductive health services, and meant that they would have to “forgo other basic necessities in order to pay for their abortion, or they must carry their unplanned pregnancy to term”. The amendment results in the discrimination of poor women who “often need abortion services the most” and have “reduced access to family planning, and experience higher rates of sexual victimization”. Due to systemic racism in the United States, women of color “disproportionately rely on public sources of health care”, so the Hyde amendment impacted these women substantially.

Environmental justice and reproductive justice
Because reproductive justice is tied to community well-being, Kathleen M. de Onı's 2012 article in Environmental Communication argues that reproductive justice should be understood alongside environmental justice and climate change. Reproductive justice advocates organize for environmental justice causes because issues like unhealthy drinking water and toxins in beauty products can impact physical and reproductive health and children's health. The Flint Michigan water crisis is often cited as an example of this because a low-income community primarily composed of people of color was forced to use toxic drinking water, a situation that advocates say likely would not have been inflicted upon a wealthier, whiter community. Environmental reproductive justice was built on the premise to ensure that women’s reproductive health and capabilities are not limited by environmental pollution.

Environmental justice is a response to Environmental racism. “Environmental racism refers to environmental policies, practices, or directives that differentially affect or disadvantage (whether intentionally or unintentionally) individuals, groups, or communities based on race or colour”. The Environmental justice movement began in 1982, in Warren County, North Carolina. It was born out of protests that occurred in response to a polychlorinated biphenyls landfill, which was located in Warren County, “a rural area in northeastern North Carolina with a majority of poor, African-American residents”. Due to the potential for groundwater contamination, there was immense backlash from residents and “protesters argued that Warren County was chosen, in part, because the residents were primarily poor and African-American”. The protests resulted in 500 arrests, but the landfill was unable to be stopped.

Socioeconomic issues and reproductive oppression
It is not possible to describe every reproductive justice issue on this webpage, as reproductive justice includes and encompasses many other movements. The organization Asian Communities for Reproductive Justice, one of the key groups to define and promote reproductive justice, says that advocates of reproductive justice support a diversity of issues they consider necessary for women and trans people to make reproductive decisions free of constraint or coercion. These enabling conditions include access to reliable transportation, health services, education, childcare, and positions of power; adequate housing and income; elimination of health hazardous environments; and freedom from violence and discrimination. Because of the broad scope of the reproductive justice framework, reproductive justice activists are involved in organizing for immigrant rights, labor rights, disability rights, LGBTQ rights, sex workers' rights, economic justice, environmental justice, an end to violence against women and human trafficking, and more.