As an African woman, I come from a place where sexual and reproductive health is not explicitly discussed or confronted like it is here. I’ve long struggled to understand the ways that issues and concepts like Reproductive Justice, Reproductive Health, and Reproductive Rights fit together and interact within the women’s health movement. So, I was delighted to have the opportunity, as a NWHN intern, to attend the United Nations’ 57th session of the Commission on the Status of Women (CSW57), and participate in the dialogues about these issues and women’s rights. (CSW57 was held in March 2013, at the United Nations’ headquarters in New York City.)
I am very interested in women’s health research and advocacy to end sexual violence. My career goal is to help change policies and create global networks that improve women’s status around the world, specifically on the African continent. What I learned at CSW57 is that you cannot impact sexual violence without considering Reproductive Justice, reproductive health, and reproductive rights — they are all intertwined.
These terms — “Reproductive Justice,” “Reproductive Health,” and “Reproductive Rights” — are often used interchangeably, but they are rooted in “different analyses, strategies, and constituencies.1Reproductive Justice (often just called “RJ”) is defined as the physical, spiritual, political, economic, and social wellbeing of women and girls. It merges the concepts of reproductive health and social justice.2 RJ “is based on the human right to make personal decisions about one’s life, and the obligation of government and society to ensure that the conditions are suitable for implementing one’s decisions.”2Proponents say that it “will be achieved when women and girls have economic, social, and political power and resources to make healthy decisions about our bodies, sexuality, and reproduction for ourselves, our families and our communities in all areas of our lives.”2
“Reproductive Health” (RH) specifically promotes people’s ability to “have a responsible, satisfying and safe sex life and … the capability to reproduce and the freedom to decide if, when and how often to do so.”3 RH is about helping people access reproductive health information and services — including contraception and childbirth care. Reproductive and sexual health problems (like HIV/AIDS, maternal mortality, lack of contraception access, and teen pregnancy) are much worse in low-income communities and communities of color, due to factors like the high cost of services, lack of transportation, and restrictive laws and policies. RH is about overcoming these barriers to affordable, accessible, and culturally competent services.1
“Reproductive Rights” (RR) refers to efforts to ensure people have the legal and political ability to make their own sexual and reproductive choices. The term, coined by the pro-choice movement in the 1980s, focuses on creating the legal protection, laws, and/or enforcement of laws that ensure an individual’s (usually women’s) “legal right to reproductive health care services” and information.2, 4
These frameworks — Reproductive Justice, Reproductive Health, and Reproductive Rights — encompass different aspects of the lives of women from all backgrounds. At CSW57, different organizations and groups connected these frameworks to sexual violence. Sexual violence is costly and harmful to woman, particularly for 16-to-24-year-olds, who are at a greater risk. It limits the woman’s ability to manage her life (and her reproductive health) and exposes her to sexually transmitted infections (STIs). According to Future Without Violence, girls who are abused by their boyfriends are five times as likely to be forced into having sex without a condom, and eight times more likely to be pressured to become pregnant.4
After participating in CSW57, I’ve concluded that collaboration between sexual violence prevention and reproductive frameworks is needed to address the issues of violence against women. A broad view is needed because, when it comes to these issues, no one-size-fits-all solution exists; understanding the individual’s unique personal situation is imperative when addressing violence against women. The different frameworks of RJ, RH, and RR can impact sexual violence in multiple ways — by addressing oppression, poverty and economic status, lack of social support, negative legal systems, cultural stigma against rape, immigration, and barriers to services. One can focus on one framework or another, but only by affecting all three will real change occur.
I attended CSW57 eager to learn about applying these frameworks in the international context to promote women’s health. While attending CSW57, I found myself in conversations that made me uncomfortable, because I realized that not everyone was on the same page about Reproductive Justice, Health, and Rights. For example, an older African woman asked: “Do they want our kids to get pregnant and abort the babies? I need someone to explain to me what ‘reproductive’ means.” This just reminded me that the frameworks have to be clearly expressed and the goals communicated as part of promoting them.
While attending CSW57, I realized that the heterogeneity of these frameworks can be prioritized in different ways in different countries. For example, Africa has 54 countries and countless tribes, traditions, cultures, and languages — but people tend to group Africa into one category and discount its diversity. Hence, in the African context, efforts to advance Reproductive Justice, Reproductive Health, and Reproductive Rights will vary depending on the specific country. For example, in Sudan and Congo, the major reproductive and sexual health issue might be combating violence against women, protecting women from rape, and providing access to clinics in times of conflict and war. On the other hand, in countries like Zambia and Ghana, which are more stable, the main focus might be reducing the very high rates of maternal mortality.
All of these efforts fit into the larger framework of women’s reproductive justice, rights, and health. From a rights perspective, it is important to pass laws that defend women who have been abused and encourage stern prosecution of abusers. In relation to reproductive rights, policies are needed to expand women’s access to services (like contraception and abortion) that help them avoid unplanned pregnancies and STIs. Providing reproductive health services that cater to women’s needs enables them to act upon the best decisions about their bodies. Each community and country must determine which issues are most significant to them and where they want to put their energies.
The RJ, RR, and RH frameworks all provide a lens through which to understand, and work on, women’s health problems that range from sexual violence to pregnancy prevention. In order to be successful, these movements have to be grounded in specific cultures and respond to issues that are that community’s top priority.
For more information, follow organizations like Every Mother Counts; Our Bodies, Ourselves; the United Nations; Ipas; Amnesty International; Madre; and NWHN — just to mention a few. They are taking the lead on expanding the work and conversations within Reproductive Justice, Reproductive Health, and Reproductive Rights frameworks internationally.
This article was written by: Grace Adofoli
Grace Adofoli is a graduate from University of Wisconsin-River Falls. She interned at NWHN in the spring of 2013 and plans to pursue her graduate degree in women’s health and policy. She also hopes to receive her PhD in Public Health after the completion of her Master’s.
1. Silliman J M, Undivided Rights: Women of Color Organize for Reproductive Justice, Cambridge MA: South End Press, 2004.
2. Forward Together (formerly Asian Communities for Reproductive Justice), A New Vision for Advancing Our Movement for Reproductive Health, Reproductive Rights and Reproductive Justice, Oakland CA: Forward Together, 2005.
3. World Health Organization (WHO), Health Topics: Reproductive Health, Geneva: WHO, 2013. Available online at: http://www.who.int/topics/reproductive_health/en/
4. Futures Without Violence, The Facts on Reproductive Health and Partner Abuse. San Francisco: Futures Without Violence, no date. Available online at:http://www.futureswithoutviolence.org/userfiles/file/Children_and_Famili…