Abortion In the USA: The Human Rights Crisis After Dobbs – A Deep Dive With Amnesty International USA
Abortion is a human right—it’s outlined in international treaties and standards that apply to the United States. But even before Roe v. Wade was overturned, the United States was not meeting its human rights obligations. Tarah Demant, National Director of Programs at Amnesty International USA, sits down to talk with us about a new Amnesty report highlighting the status of U.S. abortion access since the Dobbs v. Jackson Women’s Health Organization Supreme Court case that overturned Roe.
Because of Dobbs, and in partnership with subsequent state-based abortion bans, millions of people are facing increased barriers to abortion care. These barriers are, and always have been, disproportionately faced by different populations and communities in the U.S. Some elements that are impacting access to care post-Roe include the logistical and financial costs of travel, in-person requirements, the rise in pregnancy criminalization, and the criminalization of medical professionals and advocates. With exceptions (which do not provide as much flexibility as made to seem) stacked on top of these cases, access is incredibly difficult to achieve. Learn more in the Amnesty International USA report, accessible in the links section below.
Links from this episode
Tarah Demant on X
Amnesty International USA on X
Amnesty International USA on Facebook
Abortion Human Rights Treaties
Amnesty Report - Abortion In the USA: The Human Rights Crisis After Dobbs
The Rise of Pregnancy Criminalization: A Pregnancy Justice Report
A Deep Dive into Idaho’s Increasingly Extremist Abortion Landscape
Pregnancy Criminalization, Surveillance, and the Child Welfare System
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Transcript
Jennie: Welcome to rePROs Fight Back, a podcast on all things related to sexual and reproductive health, rights, and justice. [music intro]
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Jennie: Hey rePROs. How's everybody doing? I'm your host Jennie Wetter, and my pronouns are she/her. So y'all, happy spooky season! I am very excited. I really enjoy spooky season. I don't know, I think it wasn't something we did big back home. I, so, like my mom's big holiday that she went all out for was Christmas and, like, so many Christmas decorations. It was, like, really big in our household, but Halloween was not so much. I feel like I've mentioned before, but you know, I grew up rural so it's not like you went trick or treating in the neighborhood, right? Like, walking around my block was like five miles. So, it's not simple to go trick or treating. So, I always got excited for, like, the costumes and the party at school and I would maybe go to, like, a neighbor's house that we knew well to, like, trick or treat at their house. But there wasn't like going and walking around the neighborhood and going to like all the houses and, and doing trick or treating like that just wasn't a thing. So I think some of that missing out on it a little bit when I was a kid means I really love spooky season now. And I think it's also just like cozy fall vibes. Like I really, I like the fall and like it's cooling off and, like, being cozy with like a cup of tea and a good book and spooky reads. Like, I love all of it. So, if anybody has any spooky season recommendations for books to read, definitely send them my way because I really, I love spooky season reads, like scary stories or witchy fun stories or any of them. Like I just, I love all of it so I always make sure that that is what my reading is all October is fun spooky season reads. So, send recommendations my way. Honestly, you are always welcome to send recommendations my way 'cause I am a big reader and also just if I'm talking about books, it feels worth shouting out a new book that came out last week that I am so excited to read. Liberating Abortion: Claiming Our History, Sharing Our Stories, and Building the Reproductive Future We Deserve by Regina Mahone and Renee Bracey Sherman, I am so excited my pre-order just arrived. I cannot wait to dig into it. So just a huge shout out. Congratulations to Regina and Renee. I am so excited to read the book and just, yeah, huge congratulations. Anyway, back to spooky season. I was, I had to go into the office one day last week and I was looking through, figuring out what shoes I was gonna wear with my outfit and all of a sudden I was like, I gasped. I was just like, oh my God, it's spooky season. I can bust out these really cute Mary Jane flats I have that are black with a white skeleton foot, like, as your foot on them. They're so cute. I love them. They're like my favorite shoes that I wear for as long as I can around spooky season. And I definitely stretch that out because I really do love them. They're so cute. But yeah, spooky season shoes, so I was so excited to wear them. Yeah, just the little things to look forward to. Also exciting. Last week we found out that rePROs Fight Back is a finalist in the Signal Awards. So, It's a podcast award. rePROs is a finalist in the category for Activism, Public Service and Social Impact. And also because we are a finalist, they have a People's Choice category for these awards. So, there's like the regular awards and then there's a People's Choice version for each category. So if you want to show us some love and share some support, you can vote for us. We will make sure to include a link in the show notes, but I mean, it'll definitely be all over our social media too, as a place where you can go and vote to support re pro's, fight Back. I am so excited. I am so proud of my team. They have done such an amazing job for so long and it's very exciting to hear that we are a finalist. So just a huge, huge shout out and thank you to Rachel and Elena and Meg for all you have done to make the podcast the best it can be. And I just thank you all for your work and I am so proud of you. And yeah, congratulations on being finalists. I am, I'm so excited. And we'll let you know when we find out if we won, but until then, make sure to vote to support us. Okay, with that, let's turn to this week's interview. I am so excited to have on my friend Tarah. She is absolutely amazing. So Tarah Demant with Amnesty International, she's on to talk about a new report that Amnesty put out talking about abortion access at post-Dobbs. It's a great report, definitely worth reading. We'll have it in our show notes and I had a wonderful conversation with Tarah. So with that, let's go to my interview with Tarah.
Jennie: Hi Tarah. Thank you so much for being here.
Tarah: Hi. It is great to be back.
Jennie: So, before we get started, let's do quick intros. Would you like to tell us who you are and include your pronouns?
Tarah: I would love to. My name is Tarah Demant. My pronouns are she/her/hers, and I'm the National Director of programs at Amnesty International USA, based here in DC.
Jennie: I am so excited to have you on, not just because you're a friend and it's always wonderful to talk to you, but also Amnesty put out this great report on abortion access since Dobbs and such a great read, kind of a long read as I was, like, prepping.
Tarah: Just some light bedside reading [laughs].
Jennie: Exactly, exactly. But I thought maybe before we got into like all of the stuff in the report, I feel like it's been a while. So, maybe some new listeners aren't as familiar with, like, taking a step back and talking about why abortion is a human rights issue.
Tarah: I'd be happy to. I mean, there has been an evolution in international human rights law on abortion as there's been an evolution in international human rights law on a number of topics. There is no one abortion treaty in the way that there is like a torture treaty or a racial discrimination convention. But what we've seen in what international law has established increasingly is that all other human rights that are listed explicitly are dependent on the ability to have your own decision as to whether or not to carry a pregnancy to term. So abortion is its own right, and also all your other rights are dependent on the ability to access safe abortion. And so, previously you would have international human rights bodies weighing in when states explicitly criminalized and saying, you definitely can't criminalize. But now, we're seeing increasingly that it actually has to be a positive right. You can't just not criminalize abortion, but it is actually a positive right. And the US has signed and ratified these treaties which are obligated to protect, respect and fulfill these rights. So, protection of a right is when you protect an individual or a group from an abuse of that, right? Respecting that right is making sure that the government itself is not passing laws that restrict this right. So for example, jobs would be a terrible example, right? The opposite of respecting that right. And then the government's actually obligated to fulfill these human rights that I'm about to list. And that means not just, like, the government can't violate these rights, but they actually have to create a society in which these rights are real and true. So, it's not just enough that it is theoretically available or theoretically a human right, but actually it has to be real for people and the conditions of their lives need to be able to reach that human right. So, you know, there's a number, there's so many treaties and conventions and I'll happily list them all, but I think that what's most important is maybe to sort of talk through the human rights that folks may recognize. And folks can go to amnestyusa.org/abortionrights to see a list of treaties and conventions and international human rights law to which the United States is a party and has signed and ratified, not to mention treaties like the Convention on the Elimination of All Forms of Discrimination against Women, which the US has not ratified.
Jennie: One of very few just to, like, be super, super clear.
Tarah: We're one of less than 10 countries that have not ratified that and the rights of the child. So yeah, it's a huge stain on our reputation frankly. But even having not ratified CEDAW, we still all have the right to privacy under ratified government treaties. We have the right to seek, receive, and impart information. And that includes medical information. We have the right of liberty and security of person. We have the right to be free from torture and other cruel, inhumane, and degrading treatment, and we have the right to be free from discrimination. And those rights sort of in its most basic. And those are all in the Universal Declaration of Human Rights. A number of them have their own treaties or conventions that detail out more what they mean. And all of those are violated when someone doesn't have access to be able to make the decision for themselves as to whether or not to carry a pregnancy to term. And in some cases, when someone is forced by the government to carry a pregnancy to term, it can violate, for example, the right to be free from torture in cruel and inhumane treatment. But all these things are, I think it's so obvious to us why enforcing a person, why the government forcing someone to remain pregnant is a violation of, like, inherently of our understanding, but it is also documented in treaties that the United States signed and ratified. And so there's often this bad faith argument that there is no, there is no right to abortion and international human rights law. And that's just simply not true. Not only is abortion repeatedly brought up, increasingly in the UN monitoring. So, if you sign a treaty, what folks may not know as I adjust my glasses is that if you sign and ratify a treaty that then with the UN or an Inter-American Human Rights Commissioner or other multilateral bodies, is that there's then monitoring that happens. So for example, the Convention Against Torture, which is something the United States has signed and ratified, we are then monitored every five years to be like, how's that going? And multiple countries and organizations, you know, do investigations and they write reports and they raise concerns. So, as that has happened with the Convention against Torture, with the Convention to Eliminate All Forms of Racial Discrimination with our general review, our Universal Periodic review, which is, you know, the baseline document of the UDHR, the Universe Declaration Human Rights that ha these each happen every five years mixed up a little bit with Covid. But every five years this happens. And as that's been reviewed repeatedly, what has come up in those reviews, again of signed and ratified treaties by the United States, is that restricting the right to abortion is a violation of human rights. Not ensuring access to abortion is a violation of human rights. The disparate impact of abortion restrictions is a violation of human rights. So, this idea that will come up and increasingly as the right sort of appropriates human rights language, you and I, before we started recording, we're remembering the battle days of the, you know, in the inalienable rights convention that the US was trying to start under Trump, which was like, some rights are real human rights and other rights are not real human rights. And guess which rights are not real human rights, right? As the right flank of the political world in the United States increasingly tries to use human rights language, what they're doing is ignoring the human rights that they don't like and then insisting that actually it's a human rights argument. And that is just simply not true.
Jennie: I really like that this is how we started because it makes me think of, like, all of the conversations you're hearing about, we need to bring back Roe and, like, Roe is a clear example of that. You can have the right on paper, but you don't have access. And so, you're not meeting your human rights obligations even with Roe in place.
Tarah: That's exactly right. If we had written this report before Roe fell, many of the observations would be the same. Much of our findings would be the same. And ultimately the conclusion would be the same, which is that the United States is not meeting its human rights obligation, particularly for women and girls and people who can get pregnant, who are obviously disproportionately impacted by abortion bans. But then also like breakdowns of groups within those categories. Racialized groups, Indigenous peoples, people who live in poverty, people who live in rural spaces, LGBTQ people who can get pregnant. I mean like, so already the United States was not in compliance with its human rights obligations and what jobs did was make a bad situation much, much worse.
Jennie: Okay, well that brings us right to the beginning of the report where you outlined some of the impacts that we're seeing and, y'all, definitely check out the whole report 'cause we are gonna condense it into a half hour interview, half hour-ish interview. So, you know, just know there is so much more in there, including great little stories from people telling their experiences that you should definitely make sure to check out. Okay, so what are some of the big impacts we're seeing?
Tarah: So, this will not surprise people who listen to your podcast, who are also, like, watching the news, right? Is that because of Dobbs, now millions of people across the United States are facing obstacles to abortion care due to financial constraints, language barriers, lack of paid sick days, lack of affordable childcare and other issues, and total abortion bans or near total abortion bans, or increasing restrictions on abortion in some states mean that people have little or potentially no chance of accessing abortion services. So, the impact of this as we document is incredibly clear: bans, barriers and restrictions to abortions create fear. They create confusion and they create personal and community devastation. They have forced women, girls and people who can get pregnant to delay care--that threatens their health and life. And that ultimately these bans, barriers and restrictions have forced people to give birth against their will. And as you mentioned before, this has not been equally felt since Dobbs and it certainly wasn't equally felt before Dobbs, when Roe was still in place. So additional barriers exist in the United States, including for black and other people of color, indigenous people, undocumented immigrants, but also immigrants with documentation, transgender folks or other gender nonconforming folks who can and do get pregnant and can and do need abortion care, people living in rural areas, living in poverty. Like it's not the same impact across the United States. And that these types of barriers that already face marginalized communities now, I mean now it's a solid wall, right? What was bad under Roe is now infinitely worse under Dobbs.
Jennie: There were so many areas of impacts we could look at. So, I was thinking let's pick at, like, a couple of the ones outlined in the report and one of the ones that I think you hear about, but I think people don't necessarily think as much about is travel.
Tarah: Yeah.
Jennie: There were a couple really good stories that showed how that just increased the cost so much, which increases barriers again.
Tarah: Yeah, that's right. I mean, we have folks obviously as folks know, Amnesty International is an international organization and we've had folks across the world trying to understand what this means when, and you know, if you can't get an abortion in one state, why can't you just go to another state? One, I think many, many people don't truly understand how gigantic our country is. Yeah. I think even including us, right? Like you can't like hop into another [state] unless you live in like, Delaware is not actually super easy. Like these states are huge.
Jennie: Grasping how big it...how far you have to travel if you live in Texas...
Tarah: If you live in Texas or Alaska, right? Or any of the West. I mean, it's just so, so one just like physically and it's hard to travel and it always has been particularly for folks who face socioeconomic barriers, but one, so there's just a lack of socioeconomic ability to travel for some people. So it means that you don't get abortion care, right? The idea that you can just go to another state is only real if you have the money to travel, if you have the ability to travel, right? If you are, if you cannot cross the state border for fear of deportation, you do not have the ability to travel, if you have the ability to take time off, if you have childcare, if you need it. I mean, there's just so many financial things that go into that. And then because the United States runs a capitalistic healthcare system, which by the way itself is not in line with human rights standards, then can you afford to pay for the procedure? And like, that's like any healthcare problem. Can you actually afford to get the care you need? And those are barriers that mean people can't travel out of state. The other barriers, right, are that there is increasing criminalization. There have been laws introduced in multiple states that have gone very far and none have passed yet, but seek to criminalize moving across state boundaries to seek care. And partly because of the changing nature of abortion laws at the state level. So, for example, this report was published in July, it's already out of date with state laws because state laws are changing, sometimes in one state, multiple times a month. You know, there's just so much going on, but there's a lot of fear and confusion, understandably so by people, whether or not they can even, you know, travel out of state safely. Obviously in a state like Texas, you have the, the law that passed, which criminalizes, you know, "aiding and abetting" quote unquote, which includes if I were to drive someone across the state boundary, I would be criminalized for aiding and abetting an abortion, right? So there's multiple, there's also the financial barriers. There's also the criminal barriers. But it also is the impact of people having to make healthcare decisions that are best for them and then travel--and this is usually thousands of miles--to try and figure this out is just immense. So, the personal impact, and we spoke with, with many folks, and the goal of this report was to really show the human impact. I mean, obviously we have an extremely long and nerdy section on international human rights law, which please do read, but we really wanted to show the human impact. And so, there's one story I wanna highlight that I think helps tell this story. There was a woman in Louisiana who found out she was pregnant and was forced to spend over a thousand dollars just to travel over 1800 miles to the state of Oregon to end her pregnancy with medication abortion. And she had to do this. And I think one of the things we might also think is like, oh, medication abortion, you can sort of get it wherever, wherever you're, and that's just like simply not true. That is not accessible in that way, whether or not it's been ruled criminal yet. And the reason that she had to is she couldn't go to neighboring states where there were total abortion bans, obviously. And then by the time that she was able to figure out her pregnancy and go get denied care around in neighboring states, then it was later, much later in her pregnancy than before. And there are very few states that are gonna be able to help you depending on how far along you are in a pregnancy. And the other problem was that the states that are providing abortion care have been overwhelmed by patient need. They have, you know, it's a clinic that's been serving one community in Illinois now serves like 10 different states, and so they don't have appointments. So, she called around to multiple states that would've been closer to her and there were no appointments, and the appointments she could make to still have a legal abortion was in Oregon. So, despite the fact that Illinois is technically closer, it was not real for her. And she had to fly to Oregon and she couldn't just fly home to take the pills because that could run afoul of Louisiana's law. So, now she has to take extra time, right? Not just she has to go get these pills and have the appointment and talk with her medical provider there. But also then she had to stay in the seat of Oregon because if a complication had happened, which are of course very rare with abortion, but if a complication had happened, Louisiana would not provide her healthcare. This is someone who had enough resources to figure out where there were abortion clinics, found out she was pregnant early enough, et cetera, et cetera, and still had to go 1800 miles to seek the abortion care she needed. Which again, is like this simple procedure in the end, which is these abortion pills. So if you couple that just logistical reality with the confusion and fear that is happening, including for doctors, right? Or medical professionals or advocates who are helping make abortion more accessible. What this means is that very few people are actually able to like, "oh, I'll just travel to another state." Of course we're seeing huge numbers of people luckily who are able to do that, but there are just so many more numbers of people who are not able to do that and ultimately are forced to give birth by the government.
Jennie: Yeah. This just also makes me think of, you know, talking about the burden on the clinics that are able to take on people. You talk about the various restrictions on medication abortion and the Supreme Court last term heard a case that was challenging the FDA approval and later FDA extensions of medication abortion. And one of those would've required people to go in person to get care.
Tarah: Yeah.
Jennie: And the damage that would've done to clinics that were already struggling, if everybody that they were able to see via telehealth had to all of a sudden go in person to a clinic?
Tarah: Yeah.
Jennie: Like, would not have been able to pick up that slack.
Tarah: Well, and let's, that crisis has been averted for now.
Jennie: For now.
Tarah: That case is a hundred percent coming back to the Supreme Court.
Jennie: Yes.
Tarah: And I think we all-
Jennie: Maybe even this term.
Tarah: Potentially even this term, because the court is running on total vibes at this point, right? The court dismissed that case, not on its actual grounds of medication abortion, but because the people who brought it did not have legal standing. And what the majority opinion for the court did was lay out what it would look like to get legal standing because it is not that this incredibly politicized court did not wanna ban medication abortion or make it impossible because it's very clear that multiple justices have been placed there exactly for that reason. But this specific case couldn't do it, but another one could and likely will. So, that's the first thing. But the other thing is like as of July--again, this is our reports from July, late July, so there have been some changes--but 15 states require a physician to provide medication abortion. So, state law also restricts the ability of medication abortion. Five of those states require the patient to visit in person. So, of those 15 states where you'd have to figure out how to visit a telehealth doctor, again, if your insurance could cover it, if you had insurance, man it just gets more and more complicated. But five of those are states that require that to be in person, and these are states that don't have, quote unquote abortion bans. So, this is the burden then to figure this out for a patient is pretty extreme. And two of those states ban mailing pills for medication abortion to a patient. So a doctor cannot, a medical professional cannot mail those pills. So, you know, you see this compounding of restrictions that aren't "abortion bans," but they are these compounding of restrictions that basically serve as functional abortion bans, including in states where for some people in those states which have not quote unquote "banned abortion."
Jennie: I think the next one area to talk about is criminalization.
Tarah: Yeah.
Jennie: Nothing new, right? There was criminalization before Dobbs.
Tarah: Yeah.
Jennie: But since your report came out, Pregnancy Justice just released a report this week talking about how much it has gone up since Dobbs. Let's talk a little bit about pregnancy criminalization.
Tarah: Yeah. And I really hope people take a look at that Pregnancy Justice report. They have been doing incredible work for years on the criminalization of pregnancy and have really been sounding the alarm on what are the inevitable consequences of more abortion bans and restrictions. So, one of the long-term consequences that we were not able to chart quite yet, but we know we are gonna be able to see, and also Pregnancy Justice just released this data is the rise in pregnancy criminalization because of abortion bans and restrictions. So, it's not just a parallel track, but also as a direct result of increasing bans and restrictions. So, the impact of criminalization extends beyond people who need and want and are seeking abortion, just to be really clear, right? It's extending to people who did not seek, who were not looking for an abortion, but that their pregnancies are criminalized increasingly criminalized as well. And that, you know, there's a number of state laws that have already been doing that...it's just so mind boggling actually the criminalization of pregnancy and how it's so under just under reported and under understood or under understood, less understood than it should be. So, you know, a lot of these are fetal endangerment laws or fetal personhood laws. So, I think obviously your listeners will be aware of fetal personhood, which is the attempt to legally designate a fetus as a person that has the advantage of all the rights of a living person or a born person. And this is often done under the cloak of "protecting the pregnant woman." And it's always very obviously hyper heterosexist and cisgender specific language. So, to protect the pregnant woman, we're gonna make these fetal personhood laws. So then if there's potentially intimate partner violence, there's like an extra legal barrier there that can help or an extra legal level there that can help. The reality of these laws is that they hyper criminalize pregnant people. And so for example, like, driving without a seatbelt or if there is any drug use--and drug use is one of the highest way that pregnancy is criminalized--but it also means like if you have a spontaneous miscarriage, if the fetus has the rights and you have a spontaneous miscarriage that can of course be construed as quote unquote an abortion that maybe you sought somewhere and aren't admitting to. But also like, did you live the healthy lifestyle that you should have lived, quote unquote "should have lived," did any other factors, right? So, we're seeing this high spike, and that's what the Pregnancy Justice report showed us. The other thing that we were able to document and our reporting was with these bans comes a number of threats: prosecution, incarceration, loss of professional license for medical professionals, and even the death penalty. And I wanna be really clear about what fetal personhood means. South Carolina narrowly defeated a bill that would've charged abortion as murder. And they could do that because of fetal personhood, right? And by narrowly, I mean narrowly by like four, three or four votes defeated this bill, which would've charged abortion as murder. And in South Carolina, murder can come with the death penalty. And that is true of every state in which there are extreme bans. Every ban on abortion is extreme in which there are the most term-limited bans on abortion, either full abortion bans or with extremely limited quote unquote "exceptions." So, we're looking at not only the incarceration or the loss of professional license--obviously there's major fees always attached to these things--but also actually there is a not far future in which the death penalty is applied to abortion cases. And it can sound so hysterical to say that because it seems so bananas, but this is the absolute logical conclusion of the criminalization of abortion, right? It's being done by making the fetus a rights holder. And that therefore, if you are violating the rights of that rights holder, these are the types of obligations. The death penalty itself is also a violation of human rights, right? But it is totally used across the United States. The state of Texas is one of the highest you know, death penalty users in the world. It measures as a country right next to China and Iran, it's Texas. So, those are the types of things that we really worry about long term. And that already we're seeing the fear of criminalization and also lawsuits that are being leveraged against people or a lot of them have been against cisgender women so far in which like the partner is leveraging a lawsuit against a woman in Texas and her friends. This is an abusive relationship. She had left, found out she was pregnant, and then sought an abortion and got help from girlfriends. And the abuser in the situation is suing her. This is a court case, it's happening now. And like, these are the types of things that when we talk to people, particularly in Texas, this is very top of their mind. So, we talked to a young woman who, I mean, in this case, this is someone who worked in advocacy, who had, you know, had a college degree, had lived in an urban space, had a lot more of the things that might help her get to the information she needs. And she told us when she learned she was pregnant, that she was basically googling her healthcare to figure out what was next. And she was doing it in public libraries because she was afraid an IP address would be traced back to her, which is definitely a fear people should be clear about. Like, that is absolutely...your privacy online does not exist. She is going to these private places trying to figure out what her options are, and like she's googling healthcare and that is not a way that any medical professional would advise, or anyone who works in abortion efficacy would advise. It's like, you should be able to go talk to someone, not on the cloak of night, not worrying that the police are gonna hunt you down because of an IP address, or that someone's gonna turn over your Facebook posts like Facebook, which they did in Indiana, right? In criminalizing someone who had had a miscarriage. So that, I mean, the effects of criminalization are just vast. And they also have a real and measurable impact on the mental and physical health of people. And that's something we heard repeatedly, not just from people who were generous enough to share their own abortion stories with us, but for the people who work in advocacy. And particularly in states that have criminalized abortion fully or with like these totally minimal exceptions, which I'd love to talk about how exceptions do not work. There's just a massive, you know, mental health impact and also physical health impact. Ultimately, what it means is if you're afraid of going to jail, we talked with one woman who had children and knew that she couldn't support another child, did not want to have another child. She had gotten pregnant and she was terrified that she would go to jail. And she kept telling us, like, who's gonna take care of my children if I go to jail? Like, I can't go to jail. Who's gonna take care of my children? Like, that is her primary concern in getting healthcare is I can't go to jail. So, we heard stories like that over and over. The second thing, and I'm going on way too long about this, but it's so important, is the impact of criminalization on medical professionals and on advocates who are helping make abortion more accessible or trying to. The criminalization of physicians and healthcare providers particularly, and we were able to document so many instances of this has led to incredible impact on their physical and mental health, their ability to simply practice medicine, certainly their patients' access to care, and also then the amount of skilled medical students or services that are entering into the field of abortion and healthcare. So, if you're in a banned state and you're in medical school, you're not gonna learn abortion care, which is part of obstetrics care, right? The other thing we're seeing is that in states with bans, obstetrics and gynecologists, like OB/GYNs, are leaving those states and not just people whose only bread and butter, you know, is to make sure people have abortion care because abortion is just part of pregnancy care, right? And so, those people are increasingly leaving states with abortion bans and restrictions and new residents, medical residents, are not coming into those states. So for example, you know, we're having, we're increasing the healthcare deserts that are happening. There's an example where in Idaho, since Dobbs, 22% of its practicing obstetrics, obstetricians, pardon me, have left the state, have left the state and have created these massive healthcare deserts where maternity wards are shutting down. So, the implications of criminalization are not just felt on the individual or healthcare or healthcare systems, but actually just like medical care in general and what people can expect to get for, for medical care in general, like the shutting down of maternity wards. And Idaho is not the only example of that because doctors know that you can't actually have a maternity ward unless you can practice abortion because abortion is a part of maternity care. It is a part of the reproductive healthcare of a person, including people who are hoping to remain pregnant but can't.
Jennie: Okay. So if you want to know more about information about all the things happening in Idaho, I did an episode with Garnet Henderson that will link in our show notes talking about all of the things happening in Idaho because there's a lot. And then also if you wanna deeper dive onto pregnancy criminalization, surveillance, and the child welfare system I have an amazing interview with Lourdes Riviera at Pregnancy Justice and Dr. Dorothy Roberts. That is absolutely worth checking out, that digs deep onto those topics. Okay. So, we'll have links to those in the show notes along with the Amnesty report and other things. So, there were a couple things that talking about this made me think of. One, we should definitely go back to talk about why exceptions don't work, but also as you're we're talking about pregnancy criminalization, it also just makes me think of, again, disparate impacts. Like different people are definitely being investigated more than other people, and that is also just like worth pointing out.
Tarah: Yeah. So, I mean, let me start with the question of exceptions. So, one of the things that you'll hear from anti-rights advocates and politicians is that, "well, this isn't a total abortion ban because there are exceptions," which is one somehow that that abortion would, is somehow, like, morally better than any other abortion. Abortion is healthcare. Period. But the idea is that it's more palatable because these abortion, the exceptions are, are normally in two major categories. One is life and health of the pregnant individual, or whether or not the, pardon me, pregnancy is a result of rape, incest, or assault.
Jennie: And not all states have health, right?
Tarah: No.
Jennie: That's in the EMTALA fight.
Tarah: Yeah. This is not, to be very clear, this is not across all states, but you know, when you have people trying to be like, “oh, don't worry, it's more palatable 'cause we have these exceptions.” And there's a sort of logic to that where it's like, well, at least there's this. Let's be very clear. There is not, that exceptions do not work and they are not being used. So, whenever someone says, “at least there's exceptions,” it is not, it's not true. They're not being used. Even if they actually believe that it should be, which usually they don't, it's usually a very bad faith argument. So, one of the problems with exceptions that are lift listed for either life and/or health, which oftentimes again, you don't get both of those, which are very clearly defined in international human rights law, but is that like, it's very unclear to a doctor how much of a risk of death or how close a pregnant person needs to be to death for that exception to apply. So, you have doctors that we spoke with and there's been the Physicians for Human Rights also just put out a really good report specifically on the state of Louisiana. And they obviously have been speaking with the medical professionals for years and years. But you have doctors who are telling us, like, I don't know how close to death my patient needs to be before I'm allowed to intervene. Because if a doctor intervenes and gives the healthcare that's necessary, which is the abortion, they can be then pulled in front of a civic review and professional review board, and multiple of this could be either a civic review board, professional review board or like a criminal trial in which they then have to positively prove that this patient would a hundred percent definitely had died had they not intervened right then. "Well, Could it have been five minutes later? Could you have given one more day?" Right? And these are the cases here, they're just so cruel. These are cases where there is no question as to whether or not the fetus could survive in these cases. The fetus can't. The question is whether or not this patient is gonna die. So even the weirdly twisted logic around the so-called, like, "pro-life," which boy, I couldn't have a more Orwellian name for that the movement, like this pro-life movement is like, we're not talking about feasible pregnancies in like so many of these situations. So that's just a lie. But whether or not you are like the pregnant person, what percentage do they need to be close to death? Is 80% close enough? Is 90% close enough? Is 99% close enough? Is it the minute before they've lost all their blood? How much of their blood can they lose? Like, these are the types of decisions that doctors are literally having to make in real time. And those are the questions they're asking. And those are the questions that they have to then prove in a criminal court that therefore this was an acceptable abortion allowed for under the law. So, that's the first problem with the "exceptions" of health and life of the pregnant person. And the other thing is like they're not happening. The numbers of exception abortion, quote unquote exception abortions are in the two hands. You can count them. Like, they are not happening. And this is across years, right? These exception laws. The second part of exception laws usually rotate around if the pregnancy is a result of rape or incest. One, there's just a structural problem with this, which is: it doesn't matter how a person got pregnant, the government should not and cannot demand that they remain pregnant and force them to give birth. But these exception laws are meant to be a sort of, like, moral backlog for opposition to human rights. Say like, well, at the very least if this pregnancy was through these terrible things, and the reality is that they are not happening again, like on the under 10, like they are not happening and they're not happening for a number of reasons. But one, there's just...one, gestational limits still apply in days, right? So if a person doesn't know they're pregnant in time after an assault, if you know those of things. The second is that the reporting requirements serve as a major deterrent. So, depending on the state--and the issue is different in every state--depending on the state you either have to report to the police, you have to make a formal report. That report may or may not have to be investigated and proven true all the while you're getting further into pregnancy, right? And the majority of assault victims do not report assault for a variety of reasons. But so, the reality is that the majority of victims don't report assault. Even if they do. There's these like time delays and process delays that mean by the time they maybe get an okay by the police, whether or not they can have an abortion, it's too late because they've timed out. So again, they are not happening. So I mean, it almost doesn't matter why they're just not happening. But those are a lot of the reasons why. And that impact is, I mean, it's just so obvious who is most impacted and who is such, right? And it's also not a coincidence that higher income white cis women are gonna be able to access abortion despite these incredible barriers so much more easily than other people. So, I'd love to talk about one example particularly, which is the impact on Indigenous women and girls. And, you know, the folks that are feeling this disproportionately, there's so many different groups and everyone's stories are just so, they're so difficult to realize that people have to navigate their lives like this. I mean, all Amnesty reports tracking human rights violations, but you read these stories and you just think like, it does not have to be like this. We do not have to live like this. And so it can be very difficult just to understand the things that people have to go through just to try and access basic healthcare and be in charge of their own bodies and not be forced by the government to give birth. But I wanna uplift the case of Indigenous women and girls, and two-spirit folks, although most our investigation was on cis women, our data is on cis women, which is a major data gap. We just don't have a lot of data on LGBTQ people, particularly on trans and gender nonconforming folks and the needs that they have or the numbers of folks that need access to abortion, most folks may know of the Hyde Amendment, which is a rule that went in in 1977 that hinders the ability of particularly low income people to terminate a pregnancy. It bans federal dollars from being used for abortion. And so, if you're outside, we had a terrible time explaining this to the rest of the world, by the way. They're like, wait, why do you have to pay for healthcare?
Jennie: [Indiscernable] barrier.
Tarah: And, like, there's laws on which healthcare gets paid for? I mean, yeah, I mean it's really bonkers. The rest of the world's like, quoi? As people know, you have to pay for medical care in the United States. And what Hyde does is it means you can't use any federal dollars for abortion. So why does that matter? Well, if you're on Medicaid, which means that you hit a certain level in the poverty index, which by the way is very, very, it's very low. Like, so you are, you are at a really, really, really low place on our poverty index, meaning that you do not have access to, I mean, the numbers you're making are very, very low, is that you can't access abortion 'cause like your healthcare is paid for by Medicaid. If you are in the military, your healthcare is Veterans Affairs, right? Unless you happen to have a partner who happens to have insurance through their job, that happens to cover abortion, lots of private insurance also doesn't cover abortion, right? But it also means that Indigenous women in the United States have almost zero access to abortion because part of the United States trust’s responsibility, which folks may not be familiar with, I know that there's been some great episodes that have focused on Indigenous women on this podcast. The trust responsibility is the United States obligation to Indigenous people that the United States made directly with Indigenous people in US treaties. So not even these fancy international treaties, US treaties that directly obligate the United States to provide a number of things in this trust responsibility primarily among them healthcare. And they are provided this healthcare for the mass slaughter and movement of Indigenous people and the land grabs that happened, you know, it's still happening, frankly. But that happened throughout American history. So, these are treaties that the US drew up that they signed directly with Indigenous peoples and that obligate them to provide healthcare among other trust responsibilities to Indigenous folks in the United States. Well, guess where that money comes from? It's federal money. So, the Indian Health Service, which is the main way that this trust responsibility is operated, is through the Indigenous Health Service, which if people aren't familiar, it's kind of like the Veterans Affairs, its hospitals and clinics just run through a system, a federal system, right? That means that the Indian Health Service cannot provide abortion care. And that is for many, many Indigenous people their only healthcare. What's more is, even though the Hyde Amendment, it passed in 1977 and in 1978, it added these "exceptions," which we've just by the way talked about, which are made up. They do not work in real life, but even theoretically, right? They were added in 1978, Indian Health Service didn't offer these exceptions until 2022 in their policy, even though they were legally allowed to, there was that one year from 1977 to 1978. Again, functionally it almost doesn't matter because these exceptions don't work. But I think it shows you the sort of gap in care that happens for some populations, and in this case for Indigenous women and girls particularly, that even the exceptions in law don't get applied to Indigenous women and girls. So, you have a situation in which Indigenous people suffer the highest poverty rates in the United States. Indigenous women and girls have suffered the highest rates of sexual assault and rape. They're the least likely to have access to birth control or emergency contraception, and then cannot get access to abortion. Legally cannot get access to abortion, right? Have to figure out some other way. And I wanna uplift the work of organizations like Indigenous Women Rising, which is the sole and loan Indigenous-focused abortion fund. And I would strongly encourage folks to check out Indigenous Women Rising and if you're able to support their work, because you know, folks who are living and indigenous folks who are living with the reality of indigenous health service already have compromised care. Then the idea that then Dobbs falls and it just gets worse because the states they might have been able to journey to are now closed around them, right? 30% of indigenous folks live in the South and, and that are where we have total abortion, right? A lot of Indigenous folks, particularly who live in reservation--about some are 20, 25% of Indigenous folks live on reservation, most live in urban places-- like, they're in big country states, they're in Montana and South and North Dakota and Alaska. I mean, we're talking about thousands and thousands of miles to get to care. But even folks who live in urban settings, which is, you know, around 70, the numbers are changed a little bit, but around 71% was the last number from a couple years ago. Live in urban settings, right? But they still depend on Indian Health Service and cannot access abortion care. So, I think it's so important to understand that like this situation on abortion and human rights before Dobbs was a disaster, and it has only gotten so much worse under jobs. And this is just the first two years that we're documenting.
Jennie: I'm hoping, I'm working on having an episode with Indigenous Women Rising in the near future. So, hopefully we will hear a lot more about this issue soon.
Tarah: Yeah, I hope so. They do such incredible work and every abortion fund that's out there is doing such incredible work. And as your listeners know, go support abortion funds, go support abortion funds. It is just an unsustainable way for us to do healthcare in the United States, which is basically a GoFundMe, right? Like, an organized GoFundMe. And it's such a shaming thing. Like, how is this how we exist in the world that you have to donate for people's care? Truly we had, you know, we're a global organization, like multiple countries around the world are very interested in this issue. We have sections and activists around the world who really were like, but I don't understand. Like, how, what do you mean you have to pay for your healthcare? Like, what do you mean you have to travel? Like they, they knew what Roe was and they knew it wasn't, you know, full access to abortion and they knew it was bad when it fell, but like, there's just so many aspects of our systems that already made abortion just absolute compromised healthcare. And what does that mean? It means particularly for women and girls and for people who can get pregnant, this is a discriminatory aspect. Your freedom from discrimination is violated when a central component of reproductive healthcare is controlled by the government and not you. That does not happen to cis men. And like, that is like, that's one of the ways this violates your right to be free from discrimination, right? And it's so mind blowing that we had multiple folks don't even know the boring pieces of how many times we have to get reports checked and go through all these, like people, we have to go through all this fact finding and checking...we had reports sent back folks multiple times being like, "this can't be real, like this can't like double check this. Like, this can't be real, the statistic can't be real." And it's like, oh, it's probably actually way worse. Like, these are just the stats we have.
Jennie: You're right. It was worse.
Tarah: Yeah. Yeah. And we don't have to live like this, right? And I think that abortion funds are doing such a good job of trying to create the world in which we don't live like this, right? And that work on the ground. Other folks, I really wanna uplift, there were just so many people we interviewed and communities that were so generous but, like, the folks like the Frontera Fund, like, Sueños Sin Fronteras, which is both down in Texas--one is an abortion fund and one's abortion and advocacy sort of wraparound in the Rio Grande Valley--the work they're doing is just incredible. And I think it was very hard to document that in this report, which is really like, look at the human rights nightmare of the United States because there was also so much hope and so much advocacy and really, really incredible work that's happening on the ground. I've been in this field a long time,
Jennie: Oh my god, that feels like such a good spot to end. But we didn't even talk about recommendations yet.
Tarah: Oh, yeah. I mean, like, look, we have many, like, 12 pages of recommendations. Highly recommend that people read this report. Just a really light 150-page [indiscernable]. But look, the recommendations, I mean, they're gonna be really obvious to people. The United States government has to guarantee sexual reproductive rights for all women, girls and people who can get pregnant, period. And that includes timely and effective access to abortion. That means adopting an explicit law that protects the right to abortion. It also means that the US government needs to repeal Hyde. We need to repeal Hyde immediately and commit federal funding to subsidize abortion care, because that's what it means to make sure everyone has access to abortion. It means subsidizing abortion care or totally redoing our entire system of healthcare, which I'm also down for. But until that blessed day, it means subsidizing abortion care. The other thing is the US government needs to be investing in evidence-based comprehensive reproductive healthcare and services. One thing we didn't talk about, and I've talked so long so we can't, is we have a whole chapter on CPCs and crisis pregnancy centers, or fake abortion clinics really the damage they're doing is immense. And there's so many great organizations that are doing that work, and so I really hope that people check out, for example, reproductive freedom for all. And the folks doing so much CPC work. But the United States government is supplementing that work. And this is not like [just] in Texas, in Massachusetts, so many, many states, in Virginia, in, I mean in the states you're not thinking. Also definitely in Texas. Like, the United States government and state governments are paying for fake clinics that give non-medical false advice. They give non-medical information that are lies, that are healthcare lies. And we pay for this, your tax dollars pay for this. So, the United States government has to stop the federal and state level from doing that. And we have to remove barriers. We have to remove stigma. We have to protect providers and abortion advocates. And I think no matter which administration we have coming up, I think people need to take a real honest view about where we're going, where we have people who are being doxed, where we have people who have mobs set on them. And this isn't just an abortion, obviously immigration. This is happening a lot. Like, the people who provide this healthcare, who make sure that people can access these rights also have to be protected. So, these are like logical, these are not like, it's not rocket science what the United States needs to do, right? It's just really hard getting over these political realities in which the United States is in no way committed to human rights in this matter, but in loads of others, right? We are not a human rights forward country. Our laws, our systems of government, aren't human rights forward. And we have an increasingly rabid anti rights movement that is gaining political power despite still being in the minority. And I think that, you know, what I would ask people is like, you know the government needs to do this. You can call, you should call your senators even if you're like, they definitely agree with me, or they definitely don't. They should know that someone is still caring about this because it does matter. Like, call your elected representatives, but also at the local level. So, when we were in San Antonio, one of the things we saw was like the city council, this is in Texas, right? There is a full abortion ban and people can go to jail for providing money or a cab ride. The local city council set up a reproductive right-to-health fund that, you know, helped people with wraparound services, including what happens if they need to, you know, travel for abortion or including, you know, diapers and healthcare if they have babies. And there's just so many things that can be done on local levels. So call your local city councils and ask them what they are doing to help provide abortion care and services and reproductive healthcare in, in general, so that can happen. Give to abortion, obviously, if you can. If you have the money, you know what, everybody has a birthday, you know what everybody else likes to do for birthdays, give presents. Like, ask for abortion fund donations for your birthday in addition to the one cool gift you get, like normalizing abortion in your conversations with family, with friends, including those really difficult ones. Not putting yourself in unsafe situations, but also being brave and just not taking the baloney that you might be hearing from the faction of your Thanksgiving table in a way that you can do safely. And the other is to really, really, really uplift the work of the folks who are really in the direst circumstances, who are doing the most transformative human rights work. I really have seen in a long time and in a long career in human rights, just some of the most transformative human rights work are people who are, like, I just am trying to provide healthcare. Like, I'm just doing my best to like, do the thing that I didn't think was a human rights issue because it's just healthcare or it's just community support or it's just, you know, loving your neighbor basically. So, that I think is really important too.
Jennie: Tarah, as always so delightful to talk to you even when it's about terrible, terrible things.
Tarah: Man, the good, first of all, I love...Jen, love your podcast. I love you. I love you knowing that all the folks in this community that we're in are listening and learning more. I learned so much on your podcast. I always like- I always feel like when people listen to my episode, they're probably like, oh, this is not as good as these other ones. [laughs] But I'm so grateful for this community that learns more even when it's hard because it's so much easier just to, like, turn on TV and sort of tune out. And look, it's a joy to do this work and this report is very long. Like, it's very long, you know, skim the highlights, but it's a joy to do this work and it's a privilege to be able to document and say like, "everybody knew this was coming and here let us put on, let us put on a research glasses and say like, this is what happened." But also, we don't have to live like this. And increasingly I would encourage folks. One, I people might have heard there's an election coming and this the year of our Lord 2024, depending on when you're listening to this podcast. We're in September. The election's in November, like get involved in election work, like get involved to protect reproductive rights at the ballot. There are 10 states plus Arizona, so 11 states that have abortion and reproductive care on the ballot. Like these are states in which you can actually directly impact abortion restrictions or abortion protections as most these bills. So find out if your state is on the ballot with a ballot measure, but also vote human rights. Like, you know, we're a 501 C3. We do not weigh in on candidates. We do not weigh in on parties, but people can vote their values and like wanting people to have healthcare. It seems like it should be kind of obvious, but it's not like, go vote your value. Make sure that folks you know and love are registered to vote and that you're engaged and in these conversations to normalize abortion, to talk around the reason it matters to you and to really take that power. Like, we have a real opportunity this November and I think one of the things that's most comforting to me other than, like, the really, the work I've been talking about is like every time abortion has gone to the ballot since Roe fell it has been a victory. It's getting harder because it's getting more and more challenged at state level. I mean, it's just getting more complicated, but we know actually the majority of people think that people should be able to control their own bodies. And so, keep that in mind and in heart as we're going out and, and do whatever makes sense to you, but like human rights depends on you this November. Like, please be active in whatever way makes sense to you. And engage in that and do it with a friend. It makes it fun. Like this is, you know, Jennie, I'm trying to drag you to my stuff and you're dragging me to your stuff. Exactly. And we're gonna go talk, call people in Arizona together and it'll be great.
Jennie: Alright, thank you so much!
Tarah: Thank you so much Jennie.
Jennie: Okay y'all, I hope you enjoyed my conversation with Tarah. It was so wonderful to have her on the podcast as always. And I will see everybody next week. [music outro] If you have any questions, comments, or topics you would like us to cover, always feel free to shoot me an email. You can reach me at jennie@reprosfightback.com or you can find us on social media. We're at @RePROsFightBack on Facebook and Twitter or @reprosfb on Instagram. If you love our podcast and wanna make sure more people find it, take the time to rate and review us on your favorite podcast platform. Or if you wanna make sure to support the podcast, you can also donate on our website at reprosfightback.com. Thanks all!
Follow Tarah Demant on X here. You can also follow Amnesty International USA on Facebook and X to stay up to date on their important work.
You can find the Amnesty International USA report, Abortion In the USA: The Human Rights Crisis After Dobbs, here. To learn more about pregnancy criminalization, you can find Pregnancy Justice’s report, The Rise of Pregnancy Criminalization: A Pregnancy Justice Report, here.
The U.S. must repeal Hyde and commit federal funding to subsidize abortion care. You can call the Capitol Switchboard at 202-224-3121 to reach your congressmember and demand a repeal of Hyde.
Support Indigenous Women Rising’s work here, and if you can, donate to abortion funds here.