What does the future of reproductive health look like?

Alex Mell-Taylor, an editor from the writers' collective After the Storm Magazine, talks with the fabulous Adele Blow, who is part of Metro DC DSA's Reproductive Justice campaign and lead organizer for the chapter's Bodily Autonomy working group. Adele started in DSA about three years ago after Roe v. Wade was overturned. She was born in DC, grew up in Charlottesville, Virginia, and went to school at the University of Mary Washington in Fredericksburg. She currently works in the legal field and spends the rest of her time either volunteering for activism, taking care of her many, many houseplants, or enthusiastically embroiders and knits. 

This interview has been lightly edited for clarity and brevity.

THE PROBLEM

Alex MT: The first thing that we do in these interviews is we define the current problem. In terms of reproductive health in this country, what would you say are the defining problems?

Adele: First and foremost, our healthcare system is in tatters. There are so many issues we're having. I think a lot about Idaho since the abortion ban, for example, which has these huge swathes of land that are maternal health care deserts where women and pregnant people cannot get the health care that they need in a timely manner. Two million women in the US of childbearing age live in maternity care deserts. OB-GYNs are leaving Idaho in droves because they cannot become OB-GYNs without practicing abortion care.1 While you can become an OB-GYN without performing abortions, to be able to provide comprehensive care for your patients, you must be able to perform uterine evaluations (which can include abortion).2

On a wider scale, we need so much more. We need comprehensive sex education everywhere. We need free healthcare for all people. We need a living wage. We need high-quality, local childcare. Women, pregnant people, trans people, and queer people all need and deserve the basic human right of bodily autonomy, gender identity, and sexual pleasure.

We need to take a long, hard look at racism in healthcare and how it has a huge impact on black women. A well-known example people think about is Serena Williams’ birth story: She had a pulmonary embolism — a blood clot in the lung.3 She struggled with blood clots in the past, and when she felt short of breath, she knew exactly what was happening. The problem was nobody believed her. She begged her doctors to scan her for blood clots, and she almost died because she lacked the care she needed. Serena Williams is one of the most famous black women in the world — and even she had trouble getting proper healthcare. Black women are three times more likely to die from pregnancy or childbirth-related causes.4

What reproductive justice does is look at everything. It's an intersectional framework where we understand that people's identities overlap and interconnect. To achieve reproductive justice, we need to look at everything that's going on. Whether that be the healthcare system, childcare system, nutrition, living wage, etc. — all of these are important. For instance, I live in a food desert in DC. The closest grocery store is Yes! Organic Market — and it is not cheap. I got some ingredients for a meal and it cost $70. While there are a lot of problems, to reach a whole solution, we have to start looking at everything. That's really what reproductive justice is and aims to do.

Alex: Let's look at some examples. There are these gaps in the healthcare system that span from a racial disparity with access to care to, I imagine, also research where a lot of medicine is geared towards white cis men. How does your campaign work to address that? What are some ways that you try to mitigate those gaps?

Adele: A lot of it is awareness. People do not understand how bad the healthcare system is for women in general. Research on women's menstrual cycles and how it relates to all the medications that we take is lacking. There's no research into women's mental health. For instance, women are much less likely to get diagnosed with autism because the diagnostic criteria focus on men or boys. I have some friends who have certain disorders with their reproductive system, whether it be PCOS, endometriosis, or other issues that have little to no research or funding for them. Across the board, women are disregarded. The other day, I was reading about seatbelts. Seatbelts for cars are not tested on women's test dummies, and women are 17% more likely to die in a car crash and 73% more likely to sustain serious injuries.5 A lot of what we do is learning as much as we can about what the gaps are and telling people about them because the more people understand how bad it is and how much women are left out, the better things will get.

We're also doing a lot of mutual aid now. Not only are we doing awareness, but we are distributing plan B locally with an amazing organization called EC4DC. We're assembling reproductive care kits with plan B, condoms, literature, and pregnancy tests. It's amazing work, and we're giving them out for free all across DC. Check EC4DC’s website to see where they’re located. I'm actually hoping to expand these kits with the Opill, which is the first over-the-counter birth control pill, and it will be free. We’re also thinking about giving out Narcan, which you can get for free in DC.

Outside of mutual aid, we're also protesting. It's important to make your voice heard and to show up. Last summer, we went to work with the National Mobilization for Reproductive Justice. They're an incredible organization that works nationally to coordinate groups. And we went to the AFL-CIO to present a letter to their president demanding that they work to ensure abortion access, because that is crucial for workers who have the ability to get pregnant. We also worked with the Young Feminist Party, which is demanding the passage of the Equal Rights Amendment, as they protested outside the Supreme Court.6

THE FUTURE

Alex: Fantastic, that sounds really good. We've defined the problem regarding some of the gaps. I want to do an imagining exercise now. There are all of these barriers. I want us to imagine a world where you have been successful. The protesting has been successful. Your campaigns have been successful. You've overcome all the legislative barriers that you didn't even think were possible to overcome. And you wake up in this world. What does it look like?

Adele: The first thing that comes to me is the feeling of weight being lifted off your shoulders because it is a heavy burden to not have what you need from a healthcare standpoint. I feel like I'm already floating, if that makes any sense. In this world that we live in, I walk down the street and see a grocery store that's affordable. I see a child care center that's affordable, local, and high quality. I see affordable housing everywhere and houses for sale that people can actually buy. I see people walking to work and going to jobs that fulfill them emotionally. They're being paid a living wage. They are able to make the decision to have children or to not have children. They are able to live comfortably. Everyone I see has free, affordable healthcare, and there are hospitals everywhere because in my dream world, medical school is free, and anyone who wants to become a doctor absolutely can without the burden of debt. I think about seeing the bus, and it's free, and it runs every 15 minutes like it's supposed to. And there are no cars in my dream world. Everyone's just on bikes, and there are bike lanes. I think about being able to go out in public with my partner and kiss her goodbye on the metro and not suddenly worry that someone's going to attack me. I think about being a femme-presenting person in public and knowing that someone is not just going to come up to attack me. I think about therapy. I think about sex education. I wake up in this world, and I know if I have children, that they are being taught safe sex education and that people talk about queer people and learn about them. 

Alex: Let's dive into that. What do you imagine that education is like? Because right now we exist in the opposite context. We exist in a period where that sort of reproductive education is being constricted. What is the antithesis to that? What's happening in your dream world instead?

Adele: In a world where the opposite happens? When you talk about sex, you give out free condoms, and you make sure children have access to contraceptives before they become sexually active if they need them. In this world where people talk about how it's okay to be gay and talk about queer history and queer sex… Where we talk about being trans and the healthcare that trans people need and how it's so important…. In a world where we have kids who are taught and understand that it is okay to be who you are, it is okay to be queer or trans or gender nonconforming. It would be beautiful. There would be so much less hatred in the world. There would be so much more joy and understanding. 

It would also help men a lot, because I think men need this message more than anyone. I'm waiting on the men's rights movement.

Alex: What do you mean by that? 

Adele: We need to see more men sticking up for other men. There's a lot to be done for straight men to… have more flexibility and femininity in the masculine world. I'm hoping there's this movement against the incel culture where men instead talk about vulnerability and their feelings. Where men go to therapy. Men need to talk about this hateful interior culture in the US and do something to stop it.

A long time ago, I first learned about the stark differences in the ways that men are treated and stigmatized for sexual assault. Just to mention how relevant this still is, a couple of years ago, a friend was telling me about Riverdale, a really popular Netflix show — which opens with a teacher sexually assaulting a child. I believe at the end of the episode or season (I admit I immediately turned off the show and haven’t watched past the first five minutes), the teacher goes to another school, presumably to sexually assault more children. All of this was totally shown as unproblematic in the first five minutes of the show, and lots of my friends totally glossed over it because the teacher was a woman and the child was a boy. 

As a femme-presenting person, I have some understanding of men’s rights and the stigma around men being victims of sexual assault, but not a lot. I'm really hoping and waiting for a men's movement to join feminism because I think that's the way we will win. Only when all of us get together and understand that the gender binary does not serve us anymore. And that everyone, regardless of their gender identity or sexuality, can have both femininity and masculinity, because they're made-up concepts. We all have the ability to be feminine and emotional, and we all have the ability to be masculine and strong… Feel free to challenge me. 

Alex: No. I agree. Wasn't it bell hooks who said that the first person men have to harm is themselves to maintain patriarchy? We touched a little bit about sexual assault (SA). This sounds like a more inclusive world you're imagining. One that honors people's differences and their emotional needs. But I do wonder, right now, we have a very carceral-mindset when it comes to SA. It's one that hurts everyone because even victims often have to relitigate their assaults in court. It's very difficult to get justice. What would you imagine happens in this world when people do hurt each other? What does care look like when it comes to seeing someone who has experienced SA, for example? What does it look like in this world where we are not as carceral-oriented? 

Adele: A huge part of reproductive justice is prison and police abolition. Increasing safety for people starts at the beginning of their lives. Making sure people have quality education, a living wage, and healthcare — all of that makes us safer. I really recommend reading Are Prisons Obsolete by Angela Davis or a more in-depth book called The New Jim Crow by Michelle Alexander.

I was talking about pedophiles recently as, more often than not, most people who go through school encounter one — but it is a really hard topic to discuss with people, one that is often used to argue against prison abolition. I would first say that pedophiles are people and deserve help: rehabilitation. The studies show that the earlier you catch a pedophile before they commit any type of SA, the chances are they will never commit any sort of act.6 Not only is the prison abolition movement arguing against prisons — a racist, colonialist construct — but prison abolition will also make us safer in the long run by putting more money towards preventative measures, which will catch these crimes before they happen.

We need to take a long, hard look at our prison system at our policing system because even for pedophiles, I don't believe prisons stop anything. What does prison do? Jails criminals after the fact.

What about before the fact? Even for people who commit violent crimes, we need to take a look at why they committed violent crimes. Was it a problem in their home? Was it because they didn't have access to education? Was it because their mom couldn't get an abortion and couldn’t afford to raise a child? There's a lot that goes into it that I'm not doing justice. 

In this world that I believe can exist, we don't have prisons. We don't have police. But we have all of these other things: free healthcare, free education, free childcare, and living wages for people. And these things stop crime and actually help. So that is the end of my extremely piping hot take. 

Alex: Yes. And thank you for being honest with me. I know this is a topic that’s very charged in our current society. So I appreciate your candor here. 

NEXT STEPS, RECOMMENDATIONS, & PLUGS

Alex: I want to transition. We talked about what this world could look like. What are some steps people can take right now to help achieve this more inclusive world?

Adele: My first suggestion is to organize locally. It's so important to do something, whether it's joining Metro DC Democratic Socialists Of America (DSA) or going to a local book club, heading to your ward's mutual aid group, or just looking around and seeing what your community needs. There are many studies that show that organizing locally can have an impact nationally. One of the examples I was thinking about was how, in San Francisco, the first same-sex marriage was in 2004, and that was because of Gavin Newsom. And that was on the city level, which is why our bodily autonomy working group is organizing for trans sanctuary cities in Virginia. Our comrade Lyra was actually able to get the Alexandria City Council to pass this trans sanctuary resolution — the first in Virginia — and it has had this huge snowballing effect. So talk to your city council members, make sure they know what's up. 

And then I would say next, in organizing, is building community: Saying hi to your neighbors, getting to know them, walking around, introducing yourself to people, being friendly. That is so important, especially with all these climate change catastrophes and not to mention the current Trump administration. It is more important than ever to know your community, to know who's around you. Not only for safety, but also so you can know who you can depend on and ask how you can help other people. 

I have a little list to join DC Dyke March, Harriet's Wildest Dreams, etc.. Every ward in DC also has its own mutual aid group… Donate to the DC Abortion Fund, Feed the People, Food Not Bombs DC. Join your local Palestinian organizing group like Arlington for Palestine, DC for Palestine. Go thrifting. Gaza thrift is a huge thing in DC. Shut Down DC is a protest group I love, and the DC Safety Squad as well.

There are so many ways you can get involved on a small scale that will make such an incredible difference in your community. I want to stress that to people. A lot of people are like, “If I'm not doing stuff nationally or on the state level, what does it matter?” No. Get involved locally. Do something small, and I promise it will make a huge difference.

Alex: That is fantastic advice. Something that we like to do closing out is to ask what is a favorite piece of futurist media that you like? It can be solarpunk. It can be Afrofuturism. It can be a book, music, TV show, or commercial. The sky’s the limit. We just ask that if you do Star Trek, you must tell us your favorite trek. 

Adele: The first thing I thought of was Dune because of Timothee Chalamet, but this one studio did these Solarpunk commercials where it's really beautiful. Gosh, what are they called? 

Alex: The Chobani commercial?

Adele: Yes, it was Chobani. It had these beautiful man made machines working together in harmony with nature. Look into regenerative agriculture, because a lot of people come up to me, and they're like, “What are we going to do about climate change? It's over.” But search regenerative agriculture. It's a farming practice that sequesters carbon, and I think that's one of the ways we're going to be able to reverse climate change, hopefully, and work with the Earth rather than against it. That Chobani commercial has giant man-made air balloons, but they're harvesting wind power and not polluting, giving that back to the Earth. 

Alex: It's wild to me sometimes that the solar punk genre was sort of started by a commercial. Final question: do you specifically have any plugs? 

Adele: Yeah. I will say I did like a whole repro justice 101 that I'm going to put up on our linktree. We're doing a lot of amazing stuff there. I would also say World Pride is this year so come out to DC Dyke March if you're a dyke. It's a wonderful collective event. Please follow all of the other groups I mentioned. There's a ton of people doing incredible, amazing work. We also work with the Gender Liberation Movement and have f partnered with them for a DC March, and they're really amazing. But follow the Bodily Autonomy working group on Instagram!

Alex: Fantastic. If you're reading this, you're probably familiar with afterthestormmagazine.com, but you might not know that we have several books out. Our latest is a novella called Bone Rush, which is about a PhD student in space trying to find another planet to prove their thesis correct. You can buy that where all books are sold.


ENDNOTES

1 - See March of Dimes' collated research on Maternity Care Access in Idaho.

2 - See Sara Hutchinson's report "Abortion bans complicate medical training, risk worsening OB/GYN shortages" published in The Washington Post. October 13, 2023.

3 - See Emily Dwass' article "Serena Williams Saved Her Own Life" published in Medpage Today. August 12, 2022.

4 - See Serena Williams' op-ed "What my life-threatening experience taught me about giving birth" published on CNN. February 20, 2018.

5 - See Eva Epker's report "Fasten Your Seatbelts" published in Forbes. Sep 12, 2023.

6 - See Jane F. Silovsky's research "Impact of early intervention for youth with problematic sexual behaviors and their caregivers" published in the Journal of Sexual Aggression, Vol 25, 2019.

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