If you close your eyes and envision a transformed healthcare system, free of indignities, injustices, and inequalities, what does that look like?
In my leadership role at Provide, I see so much opportunity to build a world where everyone is supported in their reproductive and sexual health decisions. Provide conducts our work through a lens of reproductive justice, which affirms that people deserve both the right and resources to exercise their right to parent and to do so in safe, sustainable communities. In Provide’s vision of an equitable sexual and reproductive health system, people receive care for their whole selves and are treated with dignity and respect.
Bodily autonomy is the key tenet of Provide’s vision. Under Roe, the conversation often focused on the right to privacy. To liberate abortion, we need to shift the conversation to autonomy and decriminalization.
Challenging Stigma and Interrupting Criminalization
Our organization was founded in 1992 with the knowledge that even when abortion was federally legal under Roe v. Wade, it was virtually impossible to access in many communities. Criminalization of pregnancy outcomes—and the violence and disenfranchisement that result—disproportionately harm rural communities, BIPOC, women, girls, transgender, and gender expansive people. Now under Dobbs, many of these laws extend their poisonous reach to the health and social service providers who might dare to support pregnant people and help them access abortion care in this hostile landscape.
Criminalization is the greatest threat to bodily autonomy and healthcare access that we currently face as a society. Anti-abortion laws undermine the fundamental humanity, rights, and autonomy of every person who has been pregnant, is currently pregnant, or who could become pregnant in the future. Fraught legal battles in states like Texas have emboldened communities to further surveil and police the choices of pregnant people to prevent so-called “abortion trafficking” across state lines. Moreover, anti-abortion laws have ripple effects that are being used to criminalize or restrict other health care, like birth control and fertility treatments.
Under these conditions, pregnancy itself has been made a cause for suspicion, surveillance, policing, and punishment. The enforcement of state-based abortion bans and other ongoing attempts to manipulate the law to enforce anti-abortion ideology intentionally fosters a culture of disinformation, fear, and confusion around abortion and other critical health care.
No one should be afraid to seek healthcare for fear of incarceration, deportation, or losing their parental rights. And yet, this fear is very real across marginalized communities, and for good reason. Because we work at the intersection of abortion and other stigmatized care, many of our trainees serve populations who have already been subject to criminalization around substance use, sex work, HIV transmission, and other circumstances.
Health and social service providers can be bridges to care or gatekeepers, playing a pivotal role in whether a person receives support or is (re)criminalized for their pregnancy decisions. Provide’s mission is to engage these compassionate providers as agents of change in resisting criminalization by both providing direct support that centers the autonomy of every single patient and leveraging institutional power to advocate for better policy.
While Provide’s work most specifically interrupts providers’ criminalizing of pregnant people through unnecessary reporting, we know our intervention is one piece of the fight to create a more liberated society, free from coercion and the carceral violence that constrains reproductive decision-making.
I hope we use the lessons of the current landscape to build a system of care that is values-based, affirming, free from stigma, culturally responsive, and administered by compassionate, skilled providers. A future where mothers and birthing people are supported and valued is a future where more of us are free to create, contribute, and thrive—to do more than survive.
