4 Sep 2021
For Native American women living on tribal lands, obtaining an abortion has long been a difficult and intimidating process.
For native Texas women, this challenge was magnified after the United States Supreme Court this week refused to block the state’s ban on most abortions, highlighting the unique health disparities that native women face. have long faced and potential threats to their health, said Charon Asetoyer, executive director of the Native American Women’s Health Education Resource Center.
Asetoyer, a descendant of the Comanche tribe, fears that many indigenous women, who already suffer from the highest rates of rape and sexual assault, will not be able to find the financial means to access a safe abortion and legal outside Texas – if that’s even an option for them – or being forced to give birth under already difficult and financially burdensome circumstances. Indigenous women in the United States are more than twice as likely as white women to die from diseases caused or exacerbated by pregnancy.
“It’s definitely a whole other level of mental anxiety and cruelty that is forced upon us,” Asetoyer said. “Our right, our human right, to make this decision is taken away from us.”
The abortion-related data available through the Indian Federal Health Service, or IHS, which provides access to health care to an estimated 2.5 million American Indians and Alaska Natives, is sadly incomplete, according to activists and researchers.
Asetoyer helped lead a survey in 2002 that found that 85 percent of IHS health facilities were not complying with the agency’s official abortion policy, and in 62 percent of facilities, staff said they do not provide abortion services or funding, even in cases where a woman’s life is threatened by pregnancy.
This is in violation of the Hyde Amendment, which was enacted by Congress in 1976. The measure – whose namesake was GOP Congressman Henry Hyde of Illinois – essentially prohibits the use of federal funds. for abortion services, except for pregnancies resulting from rape or incest or if the woman’s life is in danger. Many states also require that women seeking abortions file police reports within a certain time limit.
After the Hyde Amendment was passed, the IHS said it performed 25 abortions over a 20-year period, the researchers said.
The IHS did not immediately respond to a request for the latest available abortion statistics or for comment on the process for indigenous women on tribal lands requesting abortions.
Asetoyer said the problem remains that many IHS facilities simply do not have the resources to perform abortions, or their employees mistakenly believe that all forms of abortion are illegal.
“They don’t even offer abortions under the restrictions of the Hyde Amendment,” she added.
The main IHS website does not specifically mention abortion on its “reproductive health” page, nor does its health manual mention allowances for abortions related to rape or incest.
Activists say it’s especially troubling given that one in three indigenous women is raped or attempted rape, according to Justice Department statistics from 2012.
Texas’ new abortion law is the most restrictive in the country and prohibits such a procedure once a doctor can detect a fetal heartbeat, which is typically around six weeks old and may even be before some women have realize they are pregnant. The law makes an exception for medical emergencies that would affect the health of the mother, but not for rape or incest.
Even with state law in place, native Texas women who receive care through the IHS would theoretically have more permissive access to abortion since the Hyde Amendment makes exceptions for rape or rape. incest. But IHS Texas Tribal and Urban Health Centers contacted by NBC News said they were not providing abortion services anyway.
Indigenous women seeking an abortion usually have to venture out of reservation, which can be a trying experience if the nearest clinic is in a town hundreds of miles away, requiring significant travel and expense. refundable.
Asetoyer, who resides on the Yankton Sioux reservation in South Dakota, said this had been the case in his state, where the only clinic offering abortions – a Planned Parenthood in Sioux Falls – had suspended procedures for seven months in 2020 due to pandemic restrictions. . More than 450 women had to travel out of state, South Dakota News Watch reported.
For these women, especially Indigenous women living in poverty, getting a safe abortion can be simply unrealistic, said Sarah Deer, professor of women, gender and sexuality studies at the University of Kansas and a citizen of the Muscogee (Creek) Nation of Oklahoma. .
Adding yet another distressing layer to the question of how indigenous women have historically been deprived of their reproductive rights, approximately 3,400 of them – including three dozen under the age of 21 – have been forcibly sterilized by the IHS in the 1970s. The practice was part of the federal government’s “family planning” services and was explored in the 2018 documentary “Amá” on the consequences of forced sterilization.
“To understand reproductive justice in a historical context, the government says, ‘We don’t want you to have babies. We no longer want Indians to deal with it. Your children will be taken away, ”said Deer. “The message we want to send now is that all reproductive justice in the Indian country is loaded with these really difficult issues.”
She added that because of the trauma resulting from the dismemberment of their families, there are also Native Americans who are against abortions and “could approach it through the issue of preserving children.”
In 2006, Cecilia Fire Thunder, the first woman elected president of the Oglala Sioux tribe, South Dakota’s largest indigenous tribe, defended the creation of a family planning clinic on her reservation – in response to the ban by the State of virtually all the reasons for an abortion. But this proposal was controversial and led the tribal council to depose Fire Thunder.
Asetoyer said indigenous women traditionally decide when to start a family and how many children they want to have, and for those who end up choosing to terminate their pregnancy, this should also remain their sovereign right.
“This is what is so cold about these laws: if they really have everyone’s best interests, they wouldn’t put a woman in this situation,” said Asetoyer, who has helped lead the fight in recent years. to ensure that the IHS makes emergency contraceptives available in all of its health centers.
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 Indigenous activists and scholars, including Deer, focusing on reproductive rights in Mississippi after the U.S. Supreme Court said in May it would review the legality of the state’s ban on most abortions after 15 weeks of pregnancy.
These activists plan to file a brief this month in support of the state’s only abortion clinic, the Jackson Women’s Health Organization.
As part of their preliminary research, Echo-Hawk said, they found that the IHS paid very little for abortions involving Indigenous women, “meaning that even with the high rate of rape and incest in our communities, we have no choice but to have the procedure available to us in cases where it should be. “
Echo-Hawk said that as a rape survivor, she knows how crucial it is for women to have barrier-free access to care.
She reflects on what other aboriginal women in the midst of generational poverty and burdened with having to bear a child will do.
“I think of Cecilia Fire Thunder, who once said, ‘Keep your white hands away from my brown body,'” Echo-Hawk said. “We have to make sure that we have autonomy over our bodies.”