How Texas abortion law is undermining Native American women’s reproductive justice

For indigenous women living in tribal areas, abortion has long been a difficult and daunting process.

For indigenous women in Texas, that challenge became even greater after the U.S. Supreme Court refused this week to block the state ban on most abortions, highlighting the unique health disparities Indigenous women have long faced and potential Underscoring threats to their health, said Charon Asetoyer, executive director of the Resource Center for Native American Health Education.

Asetoyer, a descendant of the Comanche tribe, fears that many Indigenous women, already suffering from the highest rates of rape and sexual assault, will not be able to find the funding to have a safe and legal abortion outside of Texas – if this is an option at all – or be forced to give birth under already stressful and financially strained circumstances. Indigenous women in the United States are more than twice as likely to die from diseases caused or exacerbated by pregnancy.

“There is certainly a whole different level of psychological fear and cruelty that is being forced upon us,” said Asetoyer. “Our right, our human right to make this decision, is being taken from us.”

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Abortion-related data, available through the Indian Federal Health Service (IHS), which provides access to health care for approximately 2.5 million Alaskan Indians and Native Americans, is pitifully incomplete, say activists and researchers.

Asetoyer helped in a 2002 survey that found that 85 percent of IHS health facilities were not following the agency’s official abortion policy, and 62 percent of facilities said staff said they did not provide abortion services or funding, even in cases in which the woman’s life is endangered by pregnancy.

This is in violation of the Hyde Amendment passed by Congress in 1976 on incest or when the woman’s life is in danger. Many states also require women seeking an abortion to report to the police within a certain period of time.

After the Hyde Amendment was passed, the IHS said it had performed 25 abortions over a 20-year period, according to researchers.

The IHS did not immediately provide the latest abortion-related statistics available, but confirmed in a statement that the funds “can be used to pay for or otherwise provide abortion services to women under the Hyde Addendum”.

The agency also said it “does not prohibit employees from providing information about local doctors or clinics that offer these services”.

Asetoyer said the problem remains that many IHS facilities simply do not have the resources to perform abortions or their staff mistakenly believe that all forms of abortion are illegal.

“They don’t even offer abortions under the restrictions of the Hyde addition,” she added.

The main IHS website does not mention abortions on its reproductive health page, nor does its health manual refer to allowances for abortion related to rape or incest.

Activists say this is particularly worrying given that, according to 2012 Justice Department statistics, one in three local women was raped or attempted rape.

Texas’ new abortion law is the most restrictive in the country, prohibiting such a procedure once a doctor can detect a fetal heartbeat, which usually takes about six weeks, and possibly even before some women realize they are pregnant. The law makes an exception for medical emergencies that would affect the mother’s health, but not for rape or incest.

Even if state law is in place, native Texas women cared for through the IHS would theoretically have more permissive access to an abortion, as the Hyde addition provides exemptions for rape or incest. But IHS tribal and urban IHS health centers in Texas contacted by NBC News said they still don’t offer abortion services.

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Local women seeking an abortion usually have to venture out of the reservation, which can be a stressful experience when the nearest clinic is in a city that can be hundreds of miles away, requiring high travel and expenses.

Asetoyer, who lives on the Yankton Sioux reservation in South Dakota, said this was the case in her state, where the only clinic offering abortions – a planned parenting in Sioux Falls – will commence procedures in 2020 due to pandemic restrictions paused seven months. More than 450 women had to leave the state, South Dakota News Watch reported.

For these women, especially native women who live in poverty, safe abortion can just be unrealistic, said Sarah Deer, a professor of women, gender, and sex studies at the University of Kansas and a citizen of the Muscogee (Creek) Nation of Oklahoma.

To add another worrying level to how native women have been denied their reproductive rights in the past, about 3,400 of them – including three dozen under 21 – were forcibly sterilized by the IHS in the 1970s. The practice was part of the federal government’s “family planning” and was examined in the documentation “Amá” in 2018 about the consequences of forced sterilization.

“To put reproductive justice in a historical context, the government says, ‘We don’t want you to have babies. We don’t want any more Indians to look after your children,'” Deer said. “The message we want to send now is that all reproductive justice in the Indian land is fraught with these really difficult problems.”

She added that due to the trauma resulting from their family divisions, there are also Native Americans who oppose abortion and “may get out of the issue of having children.”

In 2006, Cecilia Fire Thunder, the first woman to be elected president of the Oglala Sioux Tribe, the largest indigenous tribe in South Dakota, advocated planned parenting on his reservation in response to the state banned virtually all grounds for abortion. But this proposal was controversial and led the Tribal Council to indict Fire Thunder.

Asetoyer said Indigenous women traditionally decide when to have a family and how many children to bear, and those who ultimately choose to have an abortion should remain their sovereign right.

“That’s the cold-blooded thing about these laws: if they’re really in everyone’s best interests, they wouldn’t put a woman in this position,” said Asetoyer, who has helped fight for the IHS to provide emergency contraception in all health centers to disposal.

Abigail Echo-Hawk, executive vice president of the Seattle Indian Health Board and a member of the Pawnee Nation, was among a group of prominent Native American activists and academics, including Deer, who focused on reproductive rights in Mississippi after the US Supreme Court in May said it would examine the legality of the state’s ban on most abortions after 15 weeks of gestation.

These activists plan to mail a letter this month in support of the state’s only abortion clinic, the Jackson Women’s Health Organization.

Activists hold signs at a rally for abortion rights at the Supreme Court in Washington to announce Dec.Caroline Brehman / CQ-Roll Call, Inc via Getty Images File

As part of their preliminary research, Echo-Hawk said, they found that the IHS paid very few abortions with indigenous women, “which means that even with the high rates of rape and incest in our communities, we have no choice of method available when it should be. “

Echo-Hawk said that as a rape survivor, she knows the importance of women having barrier-free access to medical care.

She thinks about what other indigenous women who are plagued by generational poverty and overwhelmed by having a child will do.

“I think of Cecilia Fire Thunder who once said, ‘Get your white hands off my brown body,'” said Echo-Hawk. “We have to make sure that we have autonomy over our bodies.”