Latina Agenda for Reproductive Justice

By Angela Hooton
Latinas are facing a reproductive health care crisis in the United States: over 41 percent of Latinas are uninsured and almost one-third lack a regular health care provider. In addition, immigrant Latinas are being systematically shut out of the public health system and, as a result, face even greater barriers to reproductive health care.
Limited access to basic reproductive health care services has forced many Latinas to forgo or delay essential preventative screenings. As a result, Latinas suffer from many preventable conditions. For example, their HIV/AIDS infection rate is six times higher than the rate among non-Hispanic Caucasian women, and Latinas have higher rates of syphilis, gonorrhea, and chlamydia than Caucasian women. As a result of inadequate screening, Mexican-American and Puerto Rican women’s cervical cancer rates are approximately twice that of Caucasian women. Although Latinas have lower rates of breast cancer than Caucasian and African American women, breast cancer is the leading cause of cancer-related deaths among Latinas. The five-year survival rate for non-Hispanic Caucasian women with breast cancer is 85 percent, compared to 76 percent for Latinas.
Many of the reproductive health disparities that plague Latinas can be attributed to low health insurance rates. Yet, other barriers, including language and poverty, also inhibit their ability to achieve positive reproductive health outcomes and to exercise their reproductive rights. For example, the poverty rate among Latinos was 22.5 percent in 2003, compared to 8.2 percent for Caucasians. According to recent Census reports, about 28 percent of Latinas speak English either poorly or not at all. It is not surprising, since interpretive services are not always available, that many Latinas report that they have difficulty communicating with their health care providers.
Latinas’ high poverty rates, coupled with restrictive reproductive health policies, affect their childbearing decisions and impede their ability to freely choose between parenting and abortion. Increased restrictions on access to abortion and the dearth of public funding for abortion force many low-income Latinas to make serious sacrifices in order to obtain abortions. In fact, Rosie Jimenez, a Latina college student who was unable to pay for a legal abortion, was the first woman documented to have died from an illegal, back-alley abortion after the 1977 Hyde Amendment restricted federal funding of the procedure.
At the same time, Latinas faced barriers -- including widespread and coercive sterilization practices -- that have restricted them from bearing children. Coercive and punitive policies are proliferating in the U.S. and disproportionately affect women of color, including Latinas. These policies include caps on the amount of welfare support a woman receives when she has additional children, court-mandated use of contraceptives such as Norplant, and cuts in Medicaid-funded services for pregnant immigrants. All of these policies have had a disproportionate impact on low-income women of color, including Latinas. While their tactics vary, these policies seek to remove control of reproductive health decisions from women, thereby violating the fundamental human right to self-determination and undermining Latinas’ health and well-being.
The National Latina Institute for Reproductive Health (NLIRH)’s mission is to address these issues and to safeguard the fundamental human right to reproductive health care for Latinas, their families, and their communities. NLIRH understands that the fight for reproductive health and rights is inextricably linked to the struggle for social justice. There can be no reproductive justice for Latinas without racial equality, without quality health care, without educational opportunities, without immigration reform, and without affordable child care options.
NLIRH has created a model national policy agenda to address the broad range of reproductive health challenges Latinas face today. The National Latina Agenda for Reproductive Justice has several priority areas: increasing access to affordable health care; ensuring the availability of culturally and linguistically competent health care services; expanding family planning options; promoting comprehensive sexuality education; protecting reproductive rights; and developing accurate and unbiased research on Latina health status. We hope that the Agenda will not only serve as a useful tool for improving Latina reproductive health, but also contribute to national efforts to broaden and diversify the reproductive rights movement.
NLIRH focuses on three specific policy campaigns. First, we work to expand Latinas’ access to and knowledge of Emergency Contraception (EC). NLIRH believes that EC can play an important role in reducing Latinas’ unwanted pregnancies and enabling them to exercise greater reproductive choice. Latinas who do not have access to a health care provider will benefit greatly if EC is available without prescription -- provided it is affordable and women know about the method. We are working with our activists to expand EC access at the state and national levels. We are also supporting state legislation that requires emergency rooms to provide EC to sexual assault survivors and allows pharmacists to dispense EC without an advance prescription. On the national level, we are advocating for the FDA to make EC available over-the-counter (OTC) and for state Medicaid programs to continue to cover EC if it becomes an OTC product.
Our second campaign is aimed at improving the reproductive health status of Latina immigrants. NLIRH recognizes that many Latina immigrants lack access to prenatal care and other basic reproductive health care services. Further, there is a growing trend to provide health care for pregnant immigrants by covering the fetus rather than the woman. We believe that Latinas have a right to health care regardless of their immigration status. For this reason, NLIRH advocates for state and federal policies to expand health care coverage (especially family planning and prenatal care services) for Latina immigrants.
Specifically, we are fighting to pass the “Immigrant Children’s Health Improvement Act”, which would allow states to use federal Medicaid and S-CHIP funding to provide health care to legal immigrant children and pregnant women. Under current law, these groups are barred from these programs unless they have lived in the United States for over five years. Although states can choose to cover immigrant women and children through state Medicaid funds, budget constraints and pressure from anti-immigrant legislators has resulted in many states electing not to cover this vulnerable population.
Third, NLIRH is dedicated to ensuring that all Latinas have access to reproductive health care services through viable public funding sources. Through public education and advocacy efforts, we advocate that Congress increase Title X’s family planning funds, protect Medicaid funds from threatened budgetary cuts, and eliminate the Hyde Amendment that restricts federal funding of abortions.
NLIRH does not work in a vacuum. We collaborate with Latina leaders across the country and provide a Leadership Training series to ensure that our national policy agenda and grass-roots campaigns remain relevant and reflect the reality of Latinas’ lives. If you are interested in joining NLIRH in our advocacy and community mobilization efforts, or want a copy of the National Latina Agenda for Reproductive Justice, please visit our website at www.latinainstitute.org.

The National Latina Institute for Reproductive Health is a non-profit organization dedicated to ensuring the fundamental human right to reproductive health care for Latinas, their families and their communities. Through advocacy, community mobilization, and public education, NLIRH is shaping public policy, cultivating new Latina leadership, and broadening the reproductive health and rights movement to reflect the unique needs of Latinas.
Angela Hooton is the Associate Director of Policy and Advocacy at NLIRH.