The Rapidly Changing IVF Landscape

By: Agbo Ikor, Policy and Advocacy Director & Rachel Utz, If/When/How RJ Fellow

What is IVF? 

There are many types of assisted reproductive technologies that can help a person get pregnant. Some of the most common forms are: Intrauterine insemination, where healthy sperm is collected and inserted directly into a uterus when a person is ovulating; cryopreservation, freezing of eggs, sperm, or embryos; egg or embryo donation; and gestational carriers, aka surrogacy.

IVF is a term that has been used quite frequently in the past month. In vitro fertilization, IVF, helps with fertilization, embryo development, and implantation so a person can get pregnant. It is one of the more widely known and used types of assisted reproductive technology (ART). IVF uses a combination of medicines and surgical procedures to help sperm fertilize an egg and then help the fertilized egg implant in the uterus. A person going through IVF treatment will begin by taking medication that makes several eggs mature and ready for fertilization. Next, a doctor takes the eggs from the body and mixes them with sperm in a lab to help fertilize the eggs. Finally, they implant the fertilized eggs into a person’s uterus in hopes that the egg attaches and implants to the uterus, which results in pregnancy. 

A major concern of IVF and lack of access to fertility treatments, is the great financial burden. A report from 2015 estimated the median cost for a round of IVF treatment was over $19,000. One round of IVF includes the medicines, procedures, anesthesia, ultrasounds, blood tests, lab work, and embryo storage. 

There are significant racial and socioeconomic disparities among fertility patients accessing care. In a recent analysis it was found that there are no differences in infertility rates by race/ethnicity, education, income, US citizenship, insurance or location of healthcare but that there is difference between who is accessing fertility care. The majority of individuals accessing services were white, highly educated, and had income levels > $100,000. Additionally, Black and Hispanic birthing people attempted to conceive longer before seeking treatment and reported more difficulty getting appointments, taking time off work, and affording fertility treatment. In a recent analysis it was found that there are no differences in infertility rates by race/ethnicity, education, income, US citizenship, insurance or location of healthcare but that there is difference between who is accessing fertility care. 

While cost alone is a major barrier for people seeking fertility care, there are significant inequalities for the LGBTQIA+ communities seeking care. While health insurances may help cover the cost of fertility treatments, they may exclude couples that are not “having heterosexual sex”. Only 14 states provide coverage on private insurance plans for fertility health care, but only three of those 14 states have fertility insurance laws that inclusively cover LGBTQ people.  Further, some insurances will require a person to be diagnosed with ‘infertility’ in order to qualify for coverage of fertility treatment. They will consider a person being infertile after failing to become pregnant after attempting for at least 12 months of intrauterine insemination – paid out of pocket- before insurance would kick in to pay.

Lawmakers Roles in IVF  

Lawmakers and legislators have the most say in reproductive rights. It is no surprise that many legislators are working overtime to ensure abortion and other reproductive care ceases to exist, by any means necessary. In the last few years, the concept of fetal personhood has been pushed and has become law in many states. Fetal personhood statutes give fetuses, and sometimes embryos, the same legal rights as people. More than a third of US states have these types of laws. Fetal personhood laws can be used to prosecute pregnant persons for miscarrying or potentially undergoing necessary medical procedures. Many insurance companies will also use extremely gendered terms, this language can exclude hopeful trans and gender expansive  parents. 

A recent court ruling has pushed IVF to the forefront in the past few weeks. The court ruling came from the Supreme Court of Alabama and recognized embryos as “extrauterine children” after an IVF treatment center was sued by expectant parents. The case came forward after the parents of the embryo tried to collect damages under the Wrongful Death of a Minor Act, leading the courts to identify whether an embryo is a child. In coming to their conclusion, the Justices used a lot of religious rhetoric including a line, “We believe that each human, being from the moment of conception, is made in the image of God, created by Him to reflect His likeness. It is as if the People of Alabama took what was spoken of the prophet Jeremiah, and applied it to every unborn person in the state.” The court largely used theology to back up their decision rather than outlined legal precedent. 

Many questions arose after this opinion was released. Patients and providers were concerned about liability and possible criminal implications if they discarded embryos that were not viable or if they had a genetic defect. In Louisiana, the disposal of embryos is prohibited, they must be stored indefinitely or donated to a married couple.

Following  this ruling, three of Alabama’s major IVF providers paused services. After this court ruling, there were major concerns regarding anti-abortion rhetoric and issues that could arise in a post-Roe landscape. It raised the question about the thousands of fertilized eggs across the country and whether they would need to be preserved indefinitely. IVF clinics routinely discard unviable and leftover embryos, a practice which could have led to charges of involuntary manslaughter or homicide under the new legal precedent. This ruling, coupled with the fetal personhood laws, has many reproductive rights advocates concerned that halting and getting rid of IVF may be the next target. 

In the aftermath of this ruling, many states have taken steps to protect and enshrine IVF and other fertility care treatments into their state constitutions. In early March, Alabama lawmakers were successful in passing IVF protections. Alabama State Legislature passed a bill granting civil and criminal immunity for in vitro fertilization service providers and receivers. Alabama governor, Kay Ivey, signed the bill into legislation an hour after she received it. This specific bill moved really quickly, essentially as a stop-gap measure to allow fertility treatments to resume. The bill was originally intended to define personhood but the language was removed to ensure it would move smoothly. 

What Happens When IVF is no longer available

Fertility care and other assisted reproductive technologies are extremely important and necessary for creating families. Without IVF and other fertility treatments, many families will not be able to have a child. 

Like many other issues plaguing this country, inaccessible fertility care can disproportionately affect already marginalized communities. IVF is widely used by queer couples because they have fewer options than straight people and depend greatly on access to fertility care to start a family. Many queer people already face barriers because of the language used in health insurance to determine whether they will cover fertility treatments. Alabama, for example, also makes it more difficult for LGBTQIA+ couples to foster or adopt, leaving very few options for starting a family. The Affordable Care Act prohibits discrimination in the healthcare sector based on sex, but the Trump Administration eliminated these protections through regulatory changes and without the explicit protections, LGBTQIA+ patients may be denied healthcare, including fertility care, under religious freedom laws.

Additionally, if states begin banning IVF, lower income couples will likely be unable to travel outside of the state to access the fertility care that they need in order to start their families. IVF is also used to test embryos for genetic abnormalities that increase the risk of miscarriage and stillbirth, if IVF care is no longer available then this testing may not be either. People are growing hesitant to harvest and store their eggs because of the uncertainty surrounding storing this genetic material. Single parents also often struggle to access fertility treatments because of the language used to define infertility. 

There are major contradictions with fetal personhood and IVF treatments in the laws. It is confusing for legislators to fight really hard to protect IVF but on the back end they are promoting fetal personhood. Many anti-abortion ‘advocates’ are in favor of protecting IVF. This is contradictory  in the fact that a fertilized egg is considered a child for abortion purposes but they want to allow IVF to continue. This logic is extremely disingenuous, legislators should not pick and choose when they want their rules to apply, especially rules based on theology rather than law. Even if Georgia legislators work to protect IVF, Georgians will still face problems when trying to access IVF and other fertility treatments. Protecting IVF is only part of the battle, albeit the most pressing at the moment.  

IVF in Georgia

Georgia is not immune from fetal personhood statues and has many legislators working to ban abortion altogether. In Georgia, a law was passed in 2019 called the Living Infants Fairness and Equality Act. It defines a ‘fetus’ as a person at around 6 weeks gestation, when cardiac activity can be detected. This aligns with Georgia’s 6 week abortion ban. Georgia also allows other fetal “protections”, under a new law Georgia residents can choose to claim a fetus as a dependent on their taxes. Anyone who claims an “unborn dependent” on their taxes is eligible to reduce their taxable income by $3,000 per fetus. This is another way for the state to extend fetal personhood. 

Many states have been trying to get ahead of the impending IVF restrictions. In Georgia, legislators are working across the aisle to protect IVF access. Georgia Sen. Elena Parent is the lead sponsor on a bill that was introduced on February 29th. This bill relates to general provisions of health, “so as to provide that a human egg or human embryo is not considered an unborn child, a minor child, or a person for any purpose under the law.” Even with this, more clarification is needed because of how this may interact with Georgia’s law relating to fetal personhood. Sen. Parent said, “Our code is riddled with all kinds of places where there are question marks, and therefore, we need this strong, very clear, very simple statement that embryos outside of the uterus are not children.” Democrats from both chambers held a press conference to encourage the majority party to act on just bills that would protect access to IVF and contraception, including condoms, birth control pills, and IUDs. There is pushback from some legislators, saying that the issue is in Alabama and does not exist in Georgia. 

Many Georgia lawmakers have been speaking about IVF protections following the Alabama court ruling. However, with Georgia’s own fetal personhood law in effect, lawmakers must contend with their own dissonance and–perhaps unintended–outcomes of that policy. When states grant personhood to embryos, when they codify that “life begins at conception” this is the result. And while we’ll continue to call on legislators to take away the barriers to abortion and support the bodily autonomy and dignity of all Georgians, we hope that any IVF protections that pass will also remedy its current inaccessibility in Georgia. As of now, Georgia does not have IVF protections or measures to support IVF access such as mandated insurance coverage for IVF and other fertility treatments. We hope that legislators who wish to protect IVF also wish to make it more attainable for our communities. 

At SPARK, we are working on a campaign to increase IVF access. Our ‘Fertility Access Campaign’ was created to guarantee equitable and non-discriminatory access to fertility care for all residents of Georgia. Be on the lookout for more information on this campaign and ways to be involved! 

CLICK HERE FOR FULL STATEMENT WITH RESOURCES

From the River to the Sea – The Genocide in Palestine is a RJ Issue

By: Rachel Utz, If/When/How Reproductive Justice Fellow

What’s Happening in Palestine? 

Israel has been relentlessly bombing and attacking Gaza in Occupied Palestine with airstrikes and bombardments since October 7th, 2023 under the guise of finding “terrorists”. 

The history of Palestine and Israel is not as complicated as some wish to portray. Between 1918 and 1947, the Jewish population in Palestine increased from 6 percent to 33 percent. Palestinians became alarmed and tensions rose, leading to ”The Great Palestinian Revolt”  from 1936 to 1939. During this time, Zionist organizations continued to campaign for a homeland for Jews in Palestine and armed militias started to attack the Palestinian people. The Nakba took place in 1948, leading up to Israel’s creation. The Nakba, meaning catastrophe, describes the mass exodus of more than 750,000 Palestinians that were ethnically cleansed from their homes by Zionist militias. To sum the history up, Israel and their militia have remained in control of Palestine since, using horrible military tactics and holding countless Palestinians in “prisons”. The size of Palestine has shrunk dramatically, the size of Gaza, home to about 2.3 million Palestinians, is about the size of Detroit, Michigan. 

In response to Israel’s occupation, a group called Hamas was founded in Gaza in 1987. Hamas stands for the Islamic Resistance Movement. On October 7th, Hamas launched an attack in Israel. Hamas killed hundreds and took hostages. Hamas spokesperson Khaled Qadomi told Al Jazeera that the group carried out its military operation in response to atrocities that Palestinians have faced over decades. This attack is what Israel is using to try to justify the current Palestinian genocide. Israel has refused to ceasefire, despite the fact that Hamas has offered, many times, a return of the hostages. 

To date, nearly 30,000 Palestinians have been murdered and over 67,000 have been injured by Israel and its occupation forces, with millions being displaced. These numbers do not even include the hundreds or thousands still stuck under the rubble. 

Why it is a Reproductive Justice Issue

The racist ideology behind Zionism contradicts reproductive justice at every level. Reproductive justice is based on a human rights framework which operates to uplift all relevant issues, meaning also those outside of the United States. A main underlying cause to many RJ issues is white supremacy and colonialism, issues that are very closely associated with the Zionist movement. RJ was created to uplift all of the barriers that Black and Brown birthing people are faced with and it was created to center the most marginalized in our societies, because all oppressions impact our reproductive lives. The pillars of Reproductive Justice state that, (1) we have the right to have children; (2) we have the right to not have children; (3) we have the right to raise our children in healthy environments; and (4) we have the right to bodily autonomy. Each of these rights have been violated in Palestine. 

Outside of many Palestinians being brutally murdered, the living conditions in Palestine have become absolutely unbearable. Israel is actively blocking food and other aid from entering the Gaza strip, effectively starving thousands, and this is a war crime. Israel officials have made it clear and public that they aim to deprive civilians of Gaza of food, water, and fuel. 

Because of the ongoing bombing and ground airstrikes from the Israel Defense Force (IDF), countless lives have been taken. Many of these innocent lives have been Palestinian children. Children (18 and under) make up almost half of the population in Gaza. Palestinian parents are forced to bury their children, witness their children have surgeries and amputations with no anesthesia. Children are sometimes given gauze to bite on to reduce the pain. Those surgeries and wound dressings are only able to happen assuming they can find a functioning hospital that has not been bombed or doctors that have not been murdered. There are only 8 functioning hospitals left in Gaza out of the 36 that there used to be,as of December of 2023. Since that time, many more have been attacked and countless doctors and medical personnel killed. 

Many menstruating Palestinians were taking menstruation-delaying pills because of the dire and unsanitary circumstances. There is an obvious lack of access to period and menstrual products, so many were left with using scraps of tent and other fabrics in place of sanitary pads. Gaza journalist, Bisan Owda, spoke directly on this issue. She said period supplies are nearly impossible to find. Many menstruating folks are forced to use strips of cloth that they can’t wash due to the significant lack of water, they improvise and use plastic bags, and “if they’re lucky enough”, they use cut up diapers. In an interview with a hospital worker, Bisan uncovered that there are “numerous instances of fever directly linked to vaginal yeast infections, arising from inadequate hygiene and absence of feminine products”. Because of the unfathomable amounts of stress, suffering and anxiety, many are now getting their periods multiple times a month.

When thinking of all the pregnant people in Gaza, it’s important to think in depth about the lack of access to extremely important prenatal and postnatal care. In October, it was estimated that there were at least 50,000 pregnant people in Gaza. Mothers in Palestine are miscarrying from stress, there is a shortage of blood to treat postpartum injuries and surgeons have performed C-sections with no anesthetic. Health care workers report a 300% increase in the miscarriage rate among pregnant people in Gaza since Israel’s attacks began. Additionally, malnutrition and dehydration have exacerbated the risk of maternal deaths. “There is no doctor, midwife, or nurse to support women during labor. There is no pain medication, anesthesia, or hygiene material when women give birth,” said Hiba Tibi, CARE’s Acting Deputy Regional Director for the Middle East and North Africa. Very shortly after the IDF and Israel began their mass destruction, many global health groups raised alarms that there was nowhere safe for pregnant people to give birth. This has only gotten worse.

In the first 100 days of the genocide, approximately 17,000 women gave birth. Maternity, trauma, and emergency care services are highly limited and the deaths of at least 310 medical staff, hundreds of attacks on health facilities, and a lack of supplies are further exacerbating an already impossible situation. At health centers, pregnant women are only admitted “when fully dilated and are dismissed within a few hours after giving birth, due to the overcrowded facilities and extremely limited resources.” One hospital, Al-Emirati field hospital in Rafah, was initially designed to receive 30-40 outpatient consultations from pregnant women on a daily basis and is now handling 300-400 cases daily. The hospital has just one operating room and is designed to have two to three c-section deliveries per day, now delivering 20.

 C-Sections, a surgery involving cutting through tender skin and muscle, are being performed without basic medical supplies or anesthesia. And the many people forced to undergo emergency c-sections also face cesarean wound infections due to lack of clean medical tools for the procedure. An article in Jezebel outlines the story of a woman going into labor and was turned away from the hospital because the delivery rooms were full. She was forced to give birth to her son in a bathroom close to her tent and her son died while she was giving birth. Many newborns are dying from “lack of sterile environment and specialized staff. 

This being a reproductive justice issue is not the only reason people should pay attention. These are human people, people experiencing such a significant loss that we can never fully grasp. Entire family lines have been completely wiped out. Not only is this a humanitarian crisis, our American tax dollars are funding this genocide. The United States has sent billions of dollars in weapons to kill Palestinian civilians. 

Reproductive Justice rights have been completely stripped from Palestinians. Palestinian women and birthing people have no place to have children, they are forced to remain in an inherently dangerous environment, forced to raise their surviving children in an active genocide, and they are afforded no bodily autonomy and no privacy. Newborns are dying, hospitals are not available, diseases and infections have taken over. This is one of the most significant reproductive justice issues many of us will see in our lifetimes. 

Most Recent Updates & What to do next 

To make matters worse, many countries, including the United States, have pulled their funding from the UNRWA. The United Nations Relief and Works Agency for Palestinian Refugees, UNRWA, provides healthcare, relief, and other services to the people in Palestine. This is the main supplier of food, water, and shelter during the war on Gaza and because of this loss of funding, they may be forced to suspend its work.

During Super Bowl Sunday, a date where many Americans were slated to be “distracted” by the big game, Israel and its IDF took the opportunity to unleash one of the most violent attacks to date in Rafah. Rafah was supposed to be the ‘safe zone’, the area in Gaza that innocent Palestinians were told to flee to. Half of Gaza’s population is already crammed into Rafah. During the brutal attack, one hundred and sixty four innocent people were killed and another 200 were wounded. These are the types of things zionists and Israel sympathizers will ask you to believe are justified. At the time these attacks were happening, Israel was airing an advertisement at the Super Bowl, painting themselves as the victims.

Many people are still choosing to turn away, to ignore the death and the violence. Palestians on the ground are asking that we watch and that we educate and that we continue to post about this genocide. The least we can do is to talk about the significant losses so many have experienced, and to bring awareness. Staying silent is NOT an option. If you are interested in attending rallies in solidarity with Palestine, visit this website: https://www.gazaispalestine.com/protest

Call your representatives and demand a ceasefire. Read and learn as much as you can about the ongoing genocide so you can advocate for a ceasefire and encourage others to demand, not only a ceasefire, but also demand an end to the occupation of Palestine. Here is a link for reaching out to your legislators: https://ceasefiretoday.com/

Know that when a ceasefire finally happens, the fight is not over. Homes, places of worship, hospitals, and schools and universities will need to be rebuilt. Many will be searching under the debris and the rubble, looking for the bodies of loved ones. We must keep these in mind and never stop paying attention. 

One more important thing to note is that the Black and Palestine liberation movements are closely intertwined. Many Black activists and icons have been speaking out about Palestinian liberation for decades. I encourage each reader to do their research and learn why all of our struggles are connected. There are some great books on this topic, including Freedom is a Constant Struggle by Angela Davis. 

“If we say we abolish the prison-industrial complex, as we do, we should also say abolish apartheid, and end the occupation of Palestine!” – Angela Davis

We will not stop until we see a free Palestine, from the river to the sea. 

CLICK HERE FOR THE FULL STATEMENT WITH RESOURCES

Stop Cop City: A Repro Justice Fight

Rachel Utz, If/When/How RJ Fellow

What is Repro Justice? 

Reproductive justice is broader than just obtaining access to abortion care. It partners reproductive rights with social justice issues and it stands on four major tenets: 1) the right to bodily autonomy; 2) the right to have children; 3) the right to not have children; and 4) the right to parent our children in safe and healthy environments.

Audre Lorde said, “There is no such thing as a single-issue struggle because we do not live single-issue lives.” RJ dissects how the ability to birth and parent children is linked directly to conditions of our communities, and these conditions are not just a matter of individual choice. 

RJ was created to uplift all of the barriers that Black and Brown birthing people are faced with and it was created to center the most marginalized in our society, because all oppressions impact our reproductive lives. 

What is ‘Cop City’?

“Cop City”, also known as the “Atlanta Public Safety Training Center”, is a mega police training center that will be built in the Weelaunee Forest, known as one of the “four lungs” of Atlanta. Building this facility will cause mass destruction to the forest. The City of Atlanta has leased 381-acres of the Weelaunee Forest, stolen Muscogee land, to the Atlanta Police Foundation for a police military facility funded largely by corporations. The center will cost around $90 million, utilizing tax dollars and the money from private donors. 

The facility will include shooting ranges, plans for bomb testing, and will practice tear gas deployment. The plans also include military-grade training facilities, a mock city to practice urban warfare, explosives testing areas, dozens of shooting ranges, and a Black Hawk helicopter landing pad. 

City officials claim that this facility could improve policing but it has seen major pushback from community members, abolitionists, environmentalists, and community organizers against police brutality. Atlanta has already begun to demolish parts of the forest and clear debris and states that it will begin its first phase in late 2024. 

Why is ‘Stop Cop City’ an RJ Fight?

RJ doesn’t ignore the social issues that are not directly linked to reproductive care. 

Firstly, Cop City is an environmental justice issue. Environmental justice is necessary in order to parent our children and raise them in a healthy environment. Cop City is going to require a major deforestation effort – jeopardizing our climate and further making it difficult to raise our children in a world they deserve. Atlanta has the highest percentage of tree canopy of any major metropolitan area in the United States, a very unique and extremely beneficial part of this city. 

A major key in protecting a city from the drastic effects of the climate crisis, is keeping and planting more trees. The Weelaunee forest in Southeast Atlanta helps to filter rainwater and prevent flooding, which we should note as important because many areas in Atlanta flooded only weeks ago after a heavy rain. Trees also reduce energy usage, remove air pollutants, filter stormwater AND cool hot city streets by providing shade and releasing water vapor. 

This past summer is one of the hottest on record for Atlanta. Since 1977, the summer temperatures have been on a steady rise each year. On average Georgians experience about 37 days that are 90 degrees or higher, but this summer Georgia experienced at least 47 days of 90 degrees and above. On a global scale, July 2023 was Earth’s hottest month on record. Because on a national scale nothing is done about the climate crisis, the least we should be doing is protecting the forests that we do have. To clear acres of forest for Cop City, would significantly reduce the benefits that they provide. 

Secondly, we are already living in an overly policed state. Police do not protect us, police don’t usually prevent crimes, but they do terrorize Black and brown communities. RJ fights for bodily autonomy and the right to parent in safe communities. Police are doing the opposite of creating safe communities. 

City officials claim that Cop City will help boost recruitment efforts. It is a known fact that police terrorize, and are ever so present in, Black and brown communities at higher rates. The facility will be built in a predominantly Black and low-income area, the very communities that are more likely to be overpoliced in the first place. The completion of Cop City will only increase their presence because of its recruitment efforts. We do not need more police in our streets. With a higher police population, we also need to be hyper aware of the criminalization of pregnancy. It is a very real possibility the state, and therefore the police, may be more attentive to pregnancy outcomes and more violent because they will have more power to be present in more spaces. This could cause less Atlantans to seek medical care for fear of being criminalized. 

Not only are the police going to be further militarized at the Cop City facility, but the facility will also have a mock city that mirrors an “urban landscape” and will be instructing the police on how to approach those spaces as well. The facility will utilize military tactics, training the police to interact with Atlantans in a highly militarized fashion. Having police patrol a city while having a militarized mindset is extremely concerning.  

Additionally, current policing practices have a profound effect on public health, both mental and physical. Evidence from a 2020 study shows that residing in a neighborhood where lethal policing has occurred makes individuals more likely to have high blood pressure and other disease risk factors. Mental health is also deeply affected, even without physical violence. Police surveillance, police stops, and verbal harassment have substantial public health impacts. These encounters are linked to heightened depressive symptoms and higher rates of trauma, anxiety, and posttraumatic stress. Youth of color who are exposed to either aggressive police practices or indirect police contact exhibit lower educational performance. We deserve to thrive in our communities, both physically and mentally. 

Reproductive Justice is the right to raise your children in a safe and healthy environment. An over policed city is not safe. Militarized police forces are not safe. The real and drastic effects of the climate crisis are not healthy. Stopping Cop City is a Reproductive Justice fight. 

Stop Cop City, WEEK OF ACTION: November 6-13 in Atlanta. Visit https://stopcop.city/news/ to learn more and join the fight. 

CLICK HERE FOR THE FULL STATEMENT WITH RESOURCES

A Message From SPARK RJ NOW! – GA HB 481 | Sister Song v. State of GA Ruling

This morning, we learned that the Georgia Supreme Court released their ruling on case Sister Song v. State of Georgia, and have decided to allow the six week abortion ban to remain in effect, forcing birth upon Georgia residents. You can read a summary of the opinion HERE. We are frustrated, we are sad, but we remain determined and unwavering. 

Georgia’s House Bill (H.B.) 481 took effect shortly after the U.S. Supreme Court overturned Roe v. Wade abortion protections last year. Following its enactment, this forced birth bill has been involved in litigation with this opinion being the latest in what has been a lengthy battle. This is a dangerous law and will continue to cause harm to communities already marginalized. As Georgia has one of the highest maternal mortality rates in the country, a rate even higher for Black birthing folks, the state’s concern should be toward making sure pregnant folks have all the resources they need, including abortion access.  

Although these arguments did not prevail, this case will continue through the courts. It has been sent back to the trial court of Fulton County to determine whether this law violates the Georgia State Constitution. We will follow with updates as this continues, hopefully with safer and healthier outcomes. 

To be clear, this ruling does not change the current law, it just allows it to stay in effect. A person seeking abortion care within the state can do so prior to six weeks, but that is often well before a person even knows they are pregnant. It is illegal to access abortion care at around six weeks OR when electrical activity is detected by ultrasound in the uterus. This forces many Georgians to seek care outside of the state, a trying and sometimes impossible task. 

SPARK remains dedicated to expanded abortion access and abortion justice for all Georgians and will continue to fight. 

We know that this abortion ban and all other barriers to abortion services are the most harmful for our marginalized kin, especially those of us who are Black, brown, Indigenous, im/migrants, disabled, low-income, queer, and trans/gender-diverse.

If you have questions about your legal rights surrounding abortion, check out the If/When/How Repro Legal Helpline

When the government fails to protect us, we protect each other. 

In solidarity,

SPARK Reproductive Justice NOW!

Summary of opinion

Letter to Our Communities: Georgia SB 140

Reproductive Justice Is For Everyone—Including Trans Youth In Georgia

We are sad and angry that Georgia’s governor has signed Senate Bill 140, a deadly bill to ban hormone replacement therapy and gender-affirming surgeries for trans youth under the age of 18. Despite Georgians’ overwhelming opposition to SB 140, on March 21 the state legislature passed this bill, and today, March 23, Governor Kemp signed it into law. In addition to denying care to trans minors that can be life-saving, it allows their doctors to be held criminally or civilly liable for practicing according to the standard of care. While this law denies gender-affirming medical care for trans youth, it will in contrast protect medical providers who harm intersex children by performing unnecessary surgeries. This is an attack on multiple communities.

To our trans community members, we want to make two things very clear:

  • This law takes effect on July 1, 2023, but any minor under 18 who started HRT before July 1 can continue that care. The Atlanta Trans Resource Guide can help you find transition-related medical providers in the Metro Atlanta area.
  • Wherever you are in your healthcare journey and no matter what the law says— you are loved; you deserve safety and care; and you can count on us. Please visit the Trans Lifeline if you are in need.

This law is harmful. It panders to extremist partisan lobbyists and the minority of people who want to further marginalize an already singled-out and oppressed group: trans and gender-expansive minors. As Georgia organizations fighting for reproductive health, rights, and justice, we have strongly opposed SB 140 since its inception. Grounded in our commitment to bodily autonomy, we believe the decision to pursue gender-affirming care is best made between trans youth, their caregivers and healthcare professionals—without meddling lawmakers. To this end, healthcare providers serving trans youth should not be criminalized simply for following the rigorous standards of care established by the World Professional Association for Transgender Health (WPATH) and the lived experiences of trans people.

Just like their cisgender counterparts, trans minors deserve to experience their youth in embodied and affirming ways. Gender-affirming care sets trans youth up to exist in their fullness—in sports, education, relationships, employment and ultimately public life. We imagine a world where trans children get to live their full authentic lives on their own terms. Trans youth deserve the support and care that is necessary for them to not only survive, but to thrive.

We are asking for sustained, public solidarity with trans youth from all our organizations’ supporters and all people allied with trans minors. At this time, trans youth need assurance that there is a strong coalition of people working to protect and honor their existence. SB 140 may have been signed into law, but we will never stop fighting.

In the face of continuous attacks on trans people, particularly trans youth, it is important to remember that transness is not solely a site of discrimination and sorrow, but can also be a source of connection and joy. Take action with us next week in honor of Trans Day of Visibility (TDOV). Although “visibility” alone will not lead us to trans liberation, TDOV is a time to come together as a community and celebrate transness and raise awareness. In a time when our identities are being legislated out of existence, the celebration of trans life is a powerful act of resistance. Some upcoming Georgia TDOV events include:

  • March 26-31, SPARK Reproductive Justice NOW’s TDOV programming to celebrate our Black trans communities and trans communities of color.
  • March 28, Trans Liberation Day at the Capitol, organized by local organizers, activists, and community leaders across movements for trans, environmental, immigrant, and racial justice.
  • March 30, local drag collectives Chapel Beauty and Amen are hosting an all-Black trans drag show at Noni’s Deli to raise funds for local trans organizations and mutual aid; and trans-led AAPI drag show (Persuasians) at Mary’s in East Atlanta Village.
  • March 31, rallies with Queer Youth Assemble in Atlanta (Georgia Capitol) and Gainesville.

For trans folks and the caretakers of trans youth, we are living in a difficult time. It can be scary to be trans right now, especially as lawmakers continue pushing legislation targeting trans people. But through sustained action, we can win. We will continue to fight for and stand in solidarity with trans people across our state. The liberation of trans people is necessary for the liberation of us all.

In solidarity,

SPARK Reproductive Justice NOW!

URGE: Unite for Reproductive & Gender Equity

Access Reproductive Care – Southeast

Amplify Georgia Collaborative

Feminist Women’s Health Center

Planned Parenthood Southeast Advocates

NARAL Pro-Choice Georgia

Women Engaged

A Message from SPARK Reproductive Justice NOW! — In Support of Trans Youth

Just this month, three pieces of anti-trans legislation have been introduced in the Georgia legislature: SB 88, SB 140, and SB 141. These are the first pieces of anti-trans legislation that we have seen this session, and SPARK will immediately begin organizing against these dangerous bills in the interest of supporting our trans kin, and specifically trans youth.

SB88 was introduced on February 2. Effectively serving as Georgia’s own  “Don’t Say Gay” bill,it would ban any adult at a child’s school (public or private), library, social services agency, camp, or similar program from talking with a child about the child’s sexual orientation or non-cis gender identity, even if the child initiated the conversation. The law would also require signed parent permission and an amended birth certificate to change a child’s gender or name in their school records. The statute may also be used to ban any drag queen story hour events through a provision banning the instruction of a child by any adult who is “dressed in a sexually provocative manner” according to “current community standards.” We know that this phrase is a euphemism for drag, and could also potentially be applied to any person who is visibly trans or gender non-conforming. 

SB 140 was introduced on February 9. This bill would ban all gender affirming surgeries for minors in the state of Georgia, regardless of the opinions of the minor, their parents, or their doctor. The ban includes a carve-out to continue medically unnecessary and unwanted surgeries on intersex youth. 

SB 141 was also introduced on February 9. This bill would ban all gender affirming care for minors, including hormones, puberty blockers, and any surgical procedures. The ban would also require teachers, school nurses, and other school staff to out trans youth to their parents. A carve-out to continue surgeries on intersex youth is included in the bill. 

SPARK loudly and unapologetically opposes these pieces of transphobic legislation. We know that we are in the midst of a national political and social push to further marginalize trans people. Anti-trans legislation, even legislation that does not pass, is dangerous – the political and social normalization of transphobia creates a society where it is unsafe to be trans. Trans youth deserve to live in a world where they are loved and protected, not one where their existence is constantly debated and denied. 

Queer, Trans, and questioning students have the right to speak privately with adults they trust about their gender identities and sexual orientation. Trans youth have the right to seek gender affirming care without government interference. The doctors and parents of trans youth have the right to affirm and care for trans youth without criminalization. These are true statements that SPARK will continue to repeat and organize around until trans folks have been liberated from political and social violence and oppression. Trans liberation is reproductive justice. 

If you want to help fight against transphobia and anti-trans legislation here in Georgia, contact your representative and let them know that trans youth deserve protection in our state. You can also register to join SPARK’s advocacy day, Legislate This!, to gain advocacy skills and have opportunities to speak directly to your legislators. 

In Solidarity,

SPARK

Emergency Announcement – Georgia’s Six-Week Abortion Ban is Back in Effect

On Wednesday, November 23, the Georgia Supreme Court stayed the Superior Court of Fulton County’s previous ruling in Sistersong v. Georgia and reinstated the state’s ban on abortions after six weeks of pregnancy. 

The Georgia Supreme Court put the lower court’s ruling on hold while it considers the appeal filed by the state attorney general’s office. However, this is not the court’s final ruling. This means that, while the stay is in effect, abortions procedures are once again limited to those occuring in the first six weeks of pregnancy. 

While this is not the final ruling from the Georgia Supreme Court, SPARK is frustrated and devastated that our state’s judicial system is willing to, at least temporarily, reinstate cruel and unfair bans on abortion and limit Georgian’s bodily autonomy once again. 

SPARK will continue to fight for abortion justice within our state. We know that this abortion ban and all other barriers to abortion services are the most harmful for our marginalized kin, especially those of us who are Black, brown, Indigenous, im/migrants, disabled, low-income, queer, and trans/gender-diverse. SPARK will also continue to provide any relevant updates on this case as it relates to abortion access within Georgia. 

We urge you to directly support your community by donating to local abortion funds. Some abortion funds serving folks in Georgia include:  

  • ARC-Southeast, providing abortion assistance to folks across Alabama, Florida, Georgia, Mississippi, South Carolina, and Tennessee.   
  • The Brigid Alliance, a referral-based service that provides people seeking abortions with travel, food, lodging, child care, and other logistical support. 
  • Indigenous Women Rising, providing abortion assistance to all Indigenous people in the United States and Canada who are pregnant and seeking an abortion in the United States. 

If you have questions about your legal rights surrounding abortion, check out the If/When/How Repro Legal Helpline

When the government fails to protect us, we protect each other. 

In solidarity,

SPARK Reproductive Justice NOW!

SisterSong v. Georgia and the Blocking of Georgia’s 6-week Abortion Ban

11/18/2022 

Monday, November 15, the Fulton County Superior Court struck down Georgia’s six-week abortion ban in the case SisterSong v. Georgia. This ruling means that, effective immediately, there is no longer a six-week abortion ban in Georgia. Pregnant folks in Georgia can now seek legal abortions up to 22 weeks following their last menstrual period.  

In 2019, Georgia lawmakers and Gov. Brian Kemp signed HB 481 into law, banning most abortions after a fetal heartbeat is detected – as early as six weeks following a pregnant person’s last menstrual cycle. This created extreme barriers to abortion, as many people aren’t even aware that they’re pregnant until after six weeks. Although the ban was passed in 2019, it only went into effect this summer after Roe v. Wade was overturned. 

In the SisterSong v. Georgia ruling, Judge Robert McBurney declared that the six-week abortion ban was void ab initio, or void from the start. Under the Georgia State Constitution, any legislation that violates the United States Constitution when it is passed is automatically void. The ruling states that because Roe v. Wade was in effect and pre-viability abortion was protected under the Constitution when HB 481 was enacted, Georgia’s six-week abortion ban violated the United States Constitution at the time of the ban’s passage. This makes the six-week abortion ban automatically void. Effective immediately, abortion providers in Georgia can begin providing full services to pregnant folks across the state. 

The court did not rule on the question of whether the abortion ban violates the Georgia Constitution’s rights to privacy, liberty, and equal protection by forcing pregnant folks to carry to term. Judge McBurney also clarified that the ruling does not bar Georgia from passing a new six-week abortion ban if it is re-enacted by the state Legislature. Because of this, we should prepare for the potential re-introduction of another abortion ban this upcoming legislative session. The state is also appealing the decision to the Supreme Court of Georgia.  

SPARK celebrates this historic moment for Georgians in the fight for reproductive justice and bodily autonomy. We also recognize that the fight is not over in Georgia, and will continue to support abortion justice in our state. 

To help in the fight for reproductive justice, we encourage everyone to post on social media and talk with folks in your community to help spread the word that abortion after six weeks is once again legal in Georgia! 

The Indian Child Welfare Act as Reproductive Justice and Why RJ Folks Should Keep Haaland v. Brackeen on their Radar

Elias Fox Bova Schmidt, If/When/How RJ Fellow

On November 9, 2022, the Supreme Court is set to hear oral arguments for Haaland v. Brackeen, a challenge to the constitutionality of the Indian Child Welfare Act (ICWA). This is an important case for RJ folks to have on their radar – the outcome of Haaland v. Brackeen could have detrimental consequences for the state of Indian law, tribal sovereignty, American Indian and Alaska Native children, and reproductive justice for Indigenous communities across the United States. 

History of ICWA 

ICWA was passed in 1978 to combat the forced removals of Native children from their homes and placement into White families by Federal, State, and private agencies. In the context of ICWA, “Indian” is an appropriate term as it specifically denotes a political identity relating to enrollment in a Federally recognized Native tribe. An enrolled member of a Federally recognized tribe is a citizen of a sovereign Native nation. All Federally recognized tribes have unique enrollment requirements, as would be the case for citizenship of any other nation. ICWA applies only to children that meet the requirements for citizenship of a Federally recognized Native nation. Thus, in the context of ICWA, “Native” or “Native American” and “Indian” are not interchangeable. Additionally, “Indian” is generally not appropriate to refer to a Native or Indigenous person outside the context of that specific political identity. 

ICWA sets minimum federal requirements for the removal and out-of-home placement of American Indian/Alaska Native (AI/AN) children. The minimum standards of ICWA seek to keep AI/AN children within their families, their communities, or with other AI/AN families. Only once these options are exhausted are AI/AN children placed with non-AI/AN families. For decades, ICWA has been described as the gold standard for child welfare laws, and praised by child welfare experts for its goal of keeping children with their families and communities. 

The United States has a long history of forced removal of Native children as a means of eliminating Indigeneity and tribal sovereignty. Although the first boarding schools may have been opened earlier, the Federal Indian Boarding School Initiative has identified 401 Indian Boarding Schools that operated with Federal support for 150 years between 1819 and 1967, including 21 schools in Alaska and seven schools in Hawai’i. Through these schools, Native children were ripped away from their families and forced to endure genocidal and assimilationist abuse at the hands of school administrators under one principle: “kill the Indian in him, and save the man.” By 1926, it was estimated that 26% of all school-aged Native children were placed in Indian boarding schools. Similar genocidal projects were implemented by colonial governments across the globe, such as Canada’s residential schools and Indian Day Schools (1870’s-1990’s), New Zealand’s Native School System (1867-1969), and Australia’s removal policies of the Stolen Generations (1910-1970). 

The U.S. Federally funded boarding school system began winding down by the middle of the 20th century and ended by the 1970’s. However, by the 1950’s, a new system of forced removal was created. As Native families and traditional childrearing practices were deemed unfit to raise Native children, child welfare institutions and government agencies felt that Native children needed to be placed in “better” homes. Thus, Federal, State, and private agencies began to create and fund formal and informal adoption projects. A 1966 Bureau of Indian Affairs press release reads: “One little, two little, three little Indians–and 206 more–are brightening the homes and lives of 172 American families, mostly non-Indians, who have taken the Indian waifs as their own.”  

From 1958 to 1967, The Bureau of Indian Affairs, supported by the Child Welfare League of America, ran the Federal Indian Adoption Project as a program that promoted the removal of Native children from their homes and adoption into the homes of White families. The Mormon church ran a similar Indian Placement Program from 1947 to 2000, removing Native (mostly Navajo) children from their homes and placing them into Mormon homes and onto Mormon farms for forced labor. Other Native children were removed from their homes by informal policies as well. 

These programs and policies had devastating effects on Native children, communities, and families. A 1976 survey conducted by the Association on American Indian Affairs found that 25-35% of all AI/AN children were being removed from their homes and 85% of those children were placed with non-AI/AN families. In Alaska, AI/AN children were 4.6 times more likely to be placed in adoptive homes than non-AI/AN children. In Arizona, the state with the largest number of American Indian children at the time of the survey, AI/AN children were 4.2 times more likely than non-AI/AN children to be placed in adoptive homes. Before ICWA, at least 80% of families living on reservations lost at least one child to the foster care system. 

ICWA was passed, thanks to Native and allied advocates, in an effort to protect AI/AN children from these genocidal practices of forced removal. With the minimum standards set by ICWA, a greater effort is made to keep AI/AN children with their families and communities. ICWA additionally also allows tribes control over the placement and welfare of enrolled children, allowing tribes to exert sovereignty over their own citizens. Thus, ICWA is a tool that can be used to strengthen tribal sovereignty and to protect the welfare of the children of sovereign Native nations. 

ICWA is not perfect, as AI/AN children still face disparities within the child welfare system. AI/AN children are still four times more likely to be removed from their homes than non-Native children and 56% of all adopted AI/AN children are adopted outside of their families and communities. There are additional, more nuanced considerations as well. Because ICWA only applies to Federally recognized tribes, ICWA does not apply to Kanaka Maoli children, as the colonial United States government refuses to recognize Native Hawaiian sovereignty. However, despite any weaknesses, ICWA continues to be much needed for the sovereignty of Native nations and the protection of AI/AN children. 

Haaland v. Brackeen  

Haaland v. Brackeen is a lawsuit brought by Texas (and formerly Louisiana and Indiana) and several individual Plaintiffs who argue that ICWA violates the U.S. Constitution. The case includes three additional cases that have been consolidated for the Supreme Court to hear at the same time. Mainly, Texas and the individual petitioners in the case argue that ICWA’s placement priority requirements violate the Consitution’s guarantee of equal protection by discriminating against non-AI/AN prospective adoptive parents on the basis of race. It should additionally be noted that the individual petitioners in this case include several White couples that were unable to adopt AI/AN children due to ICWA’s placement requirements. 

The argument made by Texas and the individual petitioners fundamentally misrepresents what “Indian” means within the context of ICWA. As stressed above, Native nations are political bodies that pre-date the United States and are recognized by the US Constitution as sovereign nations with the right to self-government. Thus, the identity of “Indian” is a political identity, not a racial identity, similar to how being a citizen of a foreign nation would function. 

However, we know that tribal sovereignty, pre-determined judicial precedent, and the text of the Constitution has little meaning when it comes to the rulings of the Supreme Court. Although ICWA withstands constitutional muster based on a good faith reading of the law itself and the understanding that “Indian” in the context of ICWA is not a racial categorization, there is a very real threat to the abolishment of ICWA this term. If ICWA is abolished and tribes lose the ability to control the placement of AI/AN children, this will be the beginning of the end of tribal sovereignty within the United States. With Haaland v. Brackeen, the future of Indian law, tribal sovereignty, and the protection of AI/AN children are in the hands of the Supreme Court. And with the current bench, things aren’t looking good. 

ICWA as RJ – What We Can Do to Help

SisterSong defines Reproductive Justice as “the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.” ICWA is situated in the very center of major RJ implications – without ICWA, AI/AN families will lose the right to raise and nurture children within their families and communities. When Native children are removed from their families, communities, and cultures, the practices and traditions of their Native identities are often lost. This has devastating consequences for Native children and their Nations. 

On November 9, 2022, the Supreme Court will begin to hear oral arguments for Haaland v. Brackeen. Oral arguments of Supreme Court cases can be heard online. The oral arguments period of Haaland v. Brackeen presents a crucial time for reproductive justice advocates and organizers to learn about and voice support for ICWA. 

RJ speaks to the right and power of all people to raise their children at home with their families and in traditional practices and culture. In RJ spaces, ICWA should be understood as a tool of Reproductive Justice; ICWA protects AI/AN children from removal from their homes, from their families, and from their communities simply because they are raised in traditional Indigenous ways or because they are raised in conditions of systemic poverty. ICWA also allows for federally recognized Native nations to control the custody and placement of their children, further protecting tribal sovereignty and the preservation of cultural practices and tradition through the safety and love of Native children. Unfortunately, with the current judicial climate, RJ advocates and organizers should also begin to plan for what happens if ICWA is ruled to be unconstitutional. 

ICWA provides protection for AI/AN children by prioritizing placement within a child’s family, community, and culture. Although ICWA is not perfect, it allows an opportunity for AI/AN children to thrive within their own families and communities, even when they are removed from the care of their biological parents. ICWA also has the ability to preserve cultural practices and traditions passed through generations via Native children. 

Overturning ICWA would be a continuation of 500 years of colonialism and genocide at the hands of settler governments across Turtle Island. It would also be a part of the calculated attack by those in power on the bodily autonomy of the most marginalized people within the United States. The threat to ICWA posed in Halaand v. Brackeen is real. It is a Reproductive Justice issue, an issue of tribal sovereignty, and an issue regarding the protection of Indigenous communities against further attempts of genocide. 

If you consider yourself to be an RJ organizer, advocate, or ally, Halaand v. Brackeen and the current threat to ICWA should be on your radar in the coming months. Check out the Protect ICWA Campaign for opportunities to show your support for ICWA and Indigenous communities. If you are interested in providing additional support to Indigenous RJ organizations, consider donating to Indigenous Women Rising. RJ folks must begin to prepare for how we will protect all communities and kin as SCOTUS continues to strip us of any semblance of protection that previous judicial precedent had afforded us.