 Good afternoon and thank you for joining us and thank you for coming a little closer in this conversation. It's great to have this group here. I am Celeste Watkins Hayes, the Joan and Sanford Wildein of the Gerald R. Ford School of Public Policy here at the University of Michigan. I'm also founding director of the Center for Racial Justice and I am delighted to welcome all of you this afternoon to our policy talks at the Ford School event. Today's event is supported through Gilbert S. Oman and Martha A. Darling Health Policy Fund. Established in 2001 by their generosity, the fund provides funding for health policy faculty and health policy outreach activities which allows the Ford School to address a spectrum of health policy issues. I sincerely thank Gil and Martha for their support. Thank you so much and thank you for being with us today. This 2023 Oman Darling Health Policy lecture features Lordess Rivera, president of Pregnancy Justice. Her organization fights the ways that people's rights are threatened because of pregnancy or any pregnancy outcome including pregnancy loss, abortion, or birth. Through legal defense, public education, advocacy, and research and documentation, it seeks to challenge harm caused by unfair state criminalization. Among many other achievements, her career has included leading legal and policy programs at the Center for Reproductive Rights and implementing the Ford Foundation's US and global grant making strategy in sexual and reproductive health rights. Lordess received her law degree from Yale University and also has been an adjunct professor at the Columbia University Mailman School of Public Health. Reproductive Justice has been at the forefront of political and policy debates for more than 50 years and gained increased intensity after the Supreme Court's decision to overturn Roe v. Wade. The issues continue to animate public discourse and elections. We look forward to this important healthcare conversation. Today's discussion is moderated by the Ford School's James B. Houdak Professor of Health Policy Paula Lance, a nationally renowned social demographer and social epidemiologist who studies the role of public policy in informing public health and reducing social disparities in health. Professor Lance was recently named a university diversity and social transformation professor for her exceptional contributions to diversity, equity, and inclusion through research, teaching, and service. There will be time for questions at the end. For those of us here in the room, please use the QR code that you have on the program that we've distributed. For those who are watching, please follow the link on the event page, which can also be seen in our social media posts about the event. We have two Ford School students here who will help us with facilitating the Q&A. 2023, Rebecca A. Copeland Fellows, Jeanne Shearer, and Olivia Morris. Wonderful to have you with us. With that, please join me in welcoming Lourdes Rivera and Paula Lance. Good afternoon, everyone. Thanks so much for coming to this conversation today. I'm really honored to have the chance to have a conversation with Lourdes. We chatted a little earlier today and then decided we're really going to save the conversation for, to share, you know, share with all of you. Lourdes, thank you so much for taking time out of your incredibly busy schedule to come to Ann Arbor on one of our typical November gray days, right? But thanks for coming and sharing your insights and expertise with our community today. I have some questions I'm going to ask her. We'll go back and forth a little bit and then later we'll turn it over to all of you and get your questions and have more of a group conversation. Lourdes, we always, because we're an educational institution and our students are at the forefront, I do want to start with asking you to share with us a bit about your own career journey and what brought you to this relatively new position for you as a president of pregnancy justice. When you were in law school, what were you envisioning your career would be? Did it pivot and change? It always does, right? And what were your personal entry points into reproductive rights and justice? Well, first of all, thank you for having me here. I'm so honored and delighted to be here with you all. It is such a great opportunity. I met earlier with a group of students and they were just phenomenal. So thank you so much. I like to start answering this type of question with my personal journey because that really was the driver for me wanting to do this work. So my grandmother, my abuela Carmen, she was born in the southern coast of Puerto Rico to a family that basically, you know, they were slave plantation workers on a sugarcane plantation. She was born about 20 years after slavery was abolished in Puerto Rico. But yet she did not have a lot of agency. She had 14 pregnancies, 10 live births and nine children that lived into adulthood, right? So I'm sure her life could have been extremely different. And I have to tell you abuela Carmen was it was was a tough cookie. She outlived my grandfather like 50 years. And you know, but but you know, still, I mean, that that was, you know, quite an experience for her. And Puerto Rican women on the island and in the US also have a history of reproductive oppression. One third of my mother's generation were sterilized without informed consent. Puerto Rican women's bodies were used to develop the pill with experimentation again without informed consent. And this was a history that I later learned in college that it was a shared experience with other women of color with poor women, women with disabilities. Fannie Lou Hamer civil rights activist called sterilization abuse the the Mississippi appendectomy, because it was that it was so common, you know, you know, for black women's bodies as well. And you know, Chicana women on the West Coast indigenous women really had similar experiences. So so this was, you know, this was one entry point. And for this role in particular, I feel like all row roads have led here. I also grew up in Bedford Stuyvesant, Brooklyn, you know, which if you're there, you know, if people know about it now, it's, you know, it's more gentrified. But, you know, in the in the 70s and 80s, it was a place where the war on drugs was really wielded against our community. Rather than investing in harm reduction and treatment, and investment in schools, desegregation, housing, it really was an approach about surveillance and policing and incarceration so much so that able body like swaths of able body people were removed from my community. Right. So so all of these things really informed my career trajectory, my interests and passion for social justice, and later reproductive justice in particular that gave me a framework to put these things together. And in terms of law school, I actually was going to go to medical school. And I'm funny story. I couldn't get over the side of blood. So I needed a plan B. And that plan B was law school. And no blood in law school, no blood in law school, at least, you know, not on a daily basis. And I ended up being a health lawyer, a low income health lawyer, working on Medicaid issues. And you know, and I brought in the reproductive health piece into the work that I was doing just because it's always been part of the fabric of my experience. So I will pause there. But that's really my formation. Oh, the one last thing I would say is my first rebro job in the movement was at the ACLU reproductive freedom project as a law student intern and Lynn Paltrow, who's the founder of pregnancy justice was my supervisor. So all, all, you know, all roads have led here. So you were an intern in the organization, you are now leading. No, no, no, this was before she founded the organization. But that's when I first made that individual contact with her. So my internships are important. Yes, they are. Relationships are important relationships. Great. Well, please tell us more about your organization pregnancy justice. What's what is your mission? What are your key advocacy issues? Sure. Well, we heard a little bit about an introduction. We pregnancy justice advocates for and defends the rights of people who are pregnant, pregnant women, you know, who come who are criminalized or penalized because of their pregnancy status and across pregnancy outcomes, whether it's abortion, stillbirth, miscarriage, or live birth. And this usually comes up in the context of a pregnant person or a pregnant woman who is using substances and, you know, for some reason that is detected and reported to family, the family policing system, child welfare system, or directly to law enforcement. So that, but there are other fact patterns here as well, any type of action or behavior that government officials or local, you know, law enforcement deemed to be harmful to one's own pregnancy or or to the fetus can really subject someone to surveillance and criminalization or potentially the loss of one's newborn or children. So it really while the typical pattern now is in the context of substance use, it's certainly not the only and it's expanding to other types of actions. So what kind of work does your organization do? So we provide we provide criminal legal defense. We work with local counsel, public defenders. We also do policy advocacy reform. We challenge junk science because a lot of the criminalization and surveillance is really based on stereotypes and stigma and not evidence. So we also do legal and social science research with partners. And I understand that that is something that you all do and is really important to really generate that evidence, not just for legal procedures in the court system, but also, you know, to help really inform narratives, the narratives that were the stories that we're telling publicly to really debunk the junk science to really debunk the stigma and the stereotypes. We were talking a little bit earlier today about a case that you have regarding a woman in Alabama. We want to share that. Yes. Well, maybe maybe I should first share some of the findings from the study because I think it puts a lot of context for that particular case. So we just released a report in September called the rise of pregnancy criminalization. I should preface that by saying that pregnancy criminalization has been happening since 1973, and you know, perhaps before then, we did a prior research project that found around, you know, 413 cases of pregnancy criminalization or forced medical intervention between the years of 1973 and 2005. So there were about 413 cases. The report that we just released found almost 1400 cases in about half the time. So there's a trend of acceleration of pregnancy criminalization. And what's driving this, you know, what's driving this acceleration are two things. One is the ideology of fetal personhood is gaining traction and being embedded in our state laws and also providing a justification for aggressive prosecutors to even apply existing laws that were not meant to apply to pregnancy, you know, beyond what the law was meant for. And then the second driver is the opioids and methamphetamine crisis. I mean, I think that we've had, we've made progress as a society in understanding drug use as a health mental health and a public health issue, but except, except for people who are pregnant. And this is where the war on drugs comes back. Those those punitive approaches that were used against black and brown communities in the 70s and 80s are being applied to people who are pregnant. And the interesting thing we found with this research is that, you know, we had the hypothesis and the second research that we were going to continue to find black women to be the highest number of the highest prevalence of people being criminalized. And indeed, they, they are overrepresented. But but the highest number of people and proportion are actually poor white women. So, so the war on drugs is actually, you know, coming home to roost on poor white people as well. Right. So, so, so it's a story about the criminalization of poverty and the criminalization of race. In addition, the criminalization of pregnancy. So the case we filed in Alabama and Alabama is responsible for about half of these cases. So Alabama has a judicial opinion. You know, a fetal person had judicial opinion and statutory law. And there's one particular county in Alabama, Edowa County, where it's very aggressive. So there are people in prison who are pregnant for harming their fetuses. And so our client has been in jail and is in is in jail. You know, she was she was in jail, waiting for pretrial. So it was pretrial. And while she was there, she was refused prenatal care. She was refused access to her prescribed mental health medication. She went into labor and delivery. And no one assisted her. She delivered herself after 12 hours of laboring and delivering. She caught her baby. She delivered in a prison shower. And then she passed out in her own pool of blood. And, you know, right, right after she handed her baby to prison officials. And when she woke up, they were taking pictures with her baby, while the baby was still connected to her umbilical cord. So we filed a a federal district court case, asking for damages on behalf of of our client. Because this is this is just cruel, degrading in human treatment. It's it's akin to torture. If you hold it up against international human rights standards, this this would be recognized as torture. It's shocking and shameful. Yeah. Yeah. Um, I think a lot of people might think that sterile forced sterilization is a thing of the past. Do you want to tell us a bit about how you see the problem and well into the 21st century here? Yes, sadly, um, you know, this is an issue that still crops up every now and then. Not too far distant past. Women in California prisons were being sterilized. I think we've all heard more recently the Georgia detention center where you know, women were being subjected to, um, uh, gynecological procedures that they didn't need it, you know, without informed consent. So every now and then it pops up. You know, during during the war on drugs, um, uh, you know, black women and brown women in particular who were struggling with substance use, um, were being pressured, um, you know, to be become sterilized, right? And instead of being offered, um, substance use treatment, um, and support and the social supports that people need to address substance use. Um, you know, the answer was, well, just be sterilized and then you can go off and continue using drugs and, you know, we don't care about you anymore, right? So, um, so it keeps coming up as an issue. And the other thing about the war on drugs is that, you know, it was really maligning black and brown women, black and brown communities. Um, you know, it was the myth of the crack baby that we were going to have thousands and thousands of crack babies. Well, that never materialized, right? Because that was based on junk science. Um, and, um, and so, you know, we see these patterns replay in different ways throughout history, but, you know, we have these opportunities to just, you know, to break these cycles. Yeah, in these interconnections between assaults on reproductive rights and wars on drugs, um, and really focusing on marginalized populations, can you talk a little bit about how you see, um, the pipeline for these things happening that sometimes involves clinic clinicians and other health care workers and people who work for departments of children's services and child protection services? Yeah, absolutely. So in our experience and in our data set, um, we found that, um, around 40% of these cases that end up in law, that, you know, end up in arrests, um, are initiated by health care professionals. Um, so what happens is people share, um, their drug use history in either in the context of a prenatal care visit because they want help. They're trying to get appropriate health care for good health outcomes or during labor and delivery, people are tested, they or their babies are tested without their informed consent. And then, um, you know, next thing they know, there's a law enforcement officer at their bedside, right? So, or, or there's a child protective services person at their bedside, um, taking the infant away and investigating their home and taking the rest of their children away. So these are things, um, these are patterns that we're seeing. And I think, um, you know, I think it's a combination of things like people believe they're doing the right thing. And again, um, you know, it's not necessarily based on evidence. Major medical, all the major medical associations say either that, um, you should not be testing people just indiscriminately that, you know, there has to be a particular medical need to do it, right? What is the particular medical need? And then secondly, um, they oppose criminalization of, of, um, of pregnancy because it really is counterproductive to good health outcomes, maternal health outcomes and infant health outcomes. Just think about it. If you know that you're going to get locked up because you went to the doctor, are you going to go to the doctor? No, right? And so, um, and it's really important for, for, um, people who are pregnant to receive prenatal care for good maternal health and infant health outcomes. It's really important for people with substance use issues to be able to receive appropriate substance use treatment and supports if they're ready for that, right? So, um, so, so it's a really counterproductive thing. So I think, you know, people really have to kind of examine the health, health professionals really need to examine, you know, is this based on evidence? Is this best practice? So, so that's one thing. The other driver of this, I think, is, um, is an over, um, interpretation of mandatory reporting laws. Um, you know, there's, there are people who are mandatory reporters for, for child abuse and neglect. Um, but, um, you know, one positive talk screen does not mean that there's child abuse and neglect happening, right? There should be other evidence. And just based on that one talk screen, people are getting reported and, and they, and then they just like spiral, their lives just spiral, um, out of control because now they're involved with, with law enforcement and with child protective services, right? Unnecessarily. So, and, and that's a really big pattern that we've seen. On that issue, what do you, what do you recommend? Are there clinical guidelines that need to be changed, different kinds of training? I mean, I think probably good, well-intentioned people are airing on the side of caution, right? Absolutely, absolutely. And so, and I'm not obscura-subscribing ill intent on this. I just think that, you know, people just really need to, um, I think it is a matter of training. I think it's a matter of hospital policies, really. I mean, health facilities should operate on evidence, right? So, um, so on our website we actually have, um, guidance for health professionals, for lawyers, um, you know, for public defenders, for social workers and, and, and child protective services. So, you know, we have materials on our website, um, with, with guidelines, recommended guidelines. Um, I, I, you know, we are advocating for stronger protections within, within HIPAA, which is the, you know, the federal statute that protects medical information to, um, to make it harder to transmit medical, private medical information to law enforcement. Um, and, um, you know, and, and we're advocating to either reform or clarify federal law, which is a, um, it, this federal statute is called CAPTA, which is, um, the federal statute that came about under the Nixon administration, um, that, um, states misinterpret as federal law requiring that individual people have to be reported to, you know, to child protective services. And in fact, that's not the case, right? Um, the reporting is a data collection or, or so that individuals can receive, um, a safe plan of care. Um, and that could be done with, through discharge planning, right, with referrals, but yet it's being interpreted as you have to report that person. Um, so I think there's a lot of education, um, that can be done and also, um, some clarification of, of policy. Great. Thank you. Well, let's, let's talk about, uh, a Supreme Court decision that came down last summer, uh, in DOBS, uh, and what the legal landscape for abortion policy is in the U.S. right now. Um, of course everyone here knows, uh, what happened in Ohio yesterday, so let's maybe first get your reaction to that. Yes, we can clap, we can clap. We're happy about that. Yeah. So, um, well, you know, the, the DOBS, well, let me start by saying that, um, you know, Rowe v. Wade and Planned Parenthood v. Casey, it had established a national floor of legality. It did not guarantee access. I mean, everybody understood, you know, understands that Rowe and Casey did not guarantee access, because there was a lot of wiggle room. I used to call it, you know, when we were still in that space, I used to, um, use the analogy of the, um, uh, you know, the, the, uh, carnival game, whack-a-mole, where the states kept, you know, passing restrictions, and then you would try to go out, you know, hammer it with the lawsuit, and so that was the landscape then. Um, what the DOBS decision basically did was kick the question of legality back to the states. So now we have just utter chaos, um, where, um, you know, we have, um, um, like 14 states where abortion is completely banned. Um, you know, there's, there's a handful of other states where there are bans that are so, so far blocked by, by courts. Um, and, um, yeah, and for those people in those states, um, it is really difficult for them to access needed abortion care, and many of them can't. And, you know, we're seeing people in obstetric emergencies not being able to access the care that they need. Um, there, there are these so-called exceptions to save the life of the mother. That's how it's framed, but that doesn't, I mean, I, there, there are physicians in the room who can say better than, than me that, that is a useless, you know, um, framing of, in the law because like how close to dead do you have to be in order for a doctor to safely for themselves be able to intervene without, you know, it be a felony, right? So it's, it's very difficult for doctors to, um, uh, to provide medicine, to practice medicine in those, in that landscape. And the result is that doctors are leaving those states creating obstetric deserts, or expanding the deserts that were already there. Um, you know, because in many of these states, those restrictive environments, short of a ban, was really difficult to practice in. So, um, so those are those states and, you know, maternal, um, mortality, um, before doves was already on an upward uptick, um, for everyone, but especially for Black and Indigenous women. Um, this, this just, um, you know, this, this just exacerbates, um, that situation. Right. Um, and now we're starting to see, um, an increase in infant mortality, um, which is a reverse trend, um, from what was happening before. Um, the U.S. compared to every other high income, even middle income countries, is terrible on those metrics. Absolutely. And they're going in the wrong direction. Absolutely. So, um, yeah, I mean, and, you know, we spend so much money on health care in this country compared to other countries, and yet our indicators are just atrocious. So, um, and, you know, and, and I also think, so it's like a combination of punishing people when they're trying to access health care, and then, um, you know, the abortion bands, like creating these abortion deserts and fear among doctors of, to be able to provide the health care that they were trained to provide. Um, so all of these factors are, are really, you know, contributing to those health indicators. And, and, and then, of course, like there's like racism, um, that, you know, black and brown women experience, um, uh, you know, that also impacts their, their health outcomes and their maternal health outcomes. So, but this is just a terrible overlay. So that's, that's the bad news. Um, the good news is, are things like Ohio, right, are, um, there are, um, there are 25 states where abortion is legal, including 20 states in the District of Columbia, um, where there are new protections, like Ohio, like Michigan, like, um, statutory laws that have been passed to strengthen abortion access, right? The one thing I will say is those, those laws and ballot initiatives are super great for abortion access, for contraception access. Um, you know, the language in Michigan and Ohio is very expansive. We need to puzzle through a little bit more about what this means for pregnancy criminalization, right? It doesn't necessarily, um, fully protect people against pregnancy criminalization, against prosecutors who, for example, are equating the womb to a meth lab and a, right? Because that's how, that's how this comes up, interpreting, um, statutes that were meant, for example, to protect children who were being, um, taken to meth labs, which it's, that's a really bad idea and that should not happen. Um, but, you know, a womb is not a meth lab, but that's how the laws are being interpreted, right? So we were, we were talking about this earlier how, yeah, it's great that in both Michigan and Ohio, there were citizen initiated ballot initiatives to change the state constitution. So that's great. However, there are only 18 states where citizens have that right power. And right before we came down here, I looked up, here's some of the other states that have the power to do it, but they have, um, very restrictive abortion policies in place or maybe enjoying by the courts, but it doesn't look so good. So we have Arkansas, Mississippi, Missouri, both of the Dakotas and Oklahoma. Arizona, Florida, did you get those? They don't have the citizens don't have the power to do a constitutional amendment in those states. Well, Florida's weird because they, they can do it every like two decades or something, so. And you need, it's a 60% threshold, but the advocates are working on something there, but it's hard. It's going to be a high bar because you need 60% of the vote. Yeah, so while that, the strategy that worked in Ohio and Michigan is great, again, there aren't a lot of states that that have that. So what do you, what are you seeing as other kinds of strategies where it's going to be a hard, um, hall, either through the legislature or the changing the constitution, right? It's going to be a longer hall, right? But I think I'm actually optimistic. Remember prohibition? Prohibition was like an actual constitutional amendment, but it did, it was so unpopular that it didn't last, right? I, I'm optimistic and, and you know, I don't know if this is going to come to pass, but I just don't think that this is going to, the Dobs decision is going to crush under its own weight. Just because it is so unpopular. Um, Ohio voters are not the most progressive bunch, right? And yet they are supporting abortion rights. Um, same for Kansas voters, right? So, so I think, um, I, I, I really am optimistic that, um, it's, it's, it's just, it long term, this is just not going to stick. So we all need a long, a long term perspective. That's great. Um, so back to thinking about your organization and your work in general, you really approach your reproductive justice work from a human rights perspective and love it if you could unpack that a little more and talk about that for our audience. I, I'm afraid I'm going to get into my, um, adjunct professor mode here. So, but I, I, just a really big, um, picture, um, human rights, um, detour. So human rights come from international human rights treaties, from political documents, um, that I get voted on, um, you know, at the UN in, in these regional human rights mechanisms. And, um, there are a number of, um, of these political documents and human rights treaties that, that, um, have been interpreted by the treaty monitoring bodies as undergirding reproductive rights. And this includes the rights include, they're like 18 of them, but I'm going to just mention a couple of them. The right to life, the right to health, right, the right to be free from cruel degrading and inhuman treatment. You know, the right to be free from race discrimination, right. So, um, and these rights have been interpreted to require, um, member states, which are countries, um, to, to, um, uh, ensure access to safe abortion. So it's, and I love talking about that because, especially with the right to life because of the rhetoric that we hear, um, here in the U.S., um, but we know, um, we, all we have to do is look at what's happening with these obstetric emergency services. When you ban abortion, it endangers the life of the people who are carrying the pregnancy and, and human rights apply to people who are born. You know, that's just the structure of, of the framework. Um, so that's, that's one piece. Um, so even though the U.S. has not ratified all these treaties, you know, they've ratified some, um, and the courts don't care, but yet it's, it's an important framework for us to use and, and, and, um, in our advocacy, is an advocacy framework. These are human rights. So that's one thing. I also like to, um, um, you know, talk about the origins of reproductive justice, um, because reproductive justice is a U.S. expression of human rights. Um, and it came about because Black women and other women of color went to these international human rights conferences in Cairo and Beijing in 1994 and 1995. They were, they were these international conferences on development and women's rights, um, where the women from the global south pushed the global community, the global development community away from population control, right? Like the stuff that was justifying sterilization abuse and you, you know, using women's bodies as guinea pigs and all that other stuff to human rights and reproductive rights, to women's rights. Um, um, and, and so, you know, using really forced the global community to embrace a, a, a re, a reproductive rights and a human rights framework. So Black women, women of color were in these spaces encountering the women from the global south and they recognized the, you know, gave them the language of the experience that they were having here in the U.S., but they didn't have the language, right? So, um, upon going back to the U.S., right, um, they, Black women coined the phrase reproductive justice as this U.S. expression of human rights. And it was an answer to the sole focus of abortion rights and contraception by the mainstream feminist movement, and then, but also, um, a response to the civil rights movement that ignored gender, right? It, it, it, because it recognized the intersectional experience of Black women and women of color. So that was, that was reproductive justice. And reproductive justice is defined by sister song. Um, sister song women of color collective is the right to bottle, the human right to bodily autonomy, the human right to not just not have a child, but the right to have a child and to be able to raise our children in safe and sustainable communities, right? And, and that is the framework that to me very early on, um, you know, one of the things I don't know if it's in, in my, um, uh, resume, but, um, you know, I was early, um, not a super, kind of second generation board member of sister song, and then also a co-founder of California Latinas for reproductive justice, precisely because in the spaces that we were working in, in, in the reproductive rights, the mainstream reproductive rights movement, and I did a lot of work, like within the Latino health, um, folks, no, no, you know, like we can't talk about gender, you know, and we can't, you know, and then we can't talk about race here. And so, you know, that reproductive justice space was really critical for me, throughout my career, but then also it's, it's, it's really, um, integral to the work that we do at Pregnancy Justice. That's great. And thinking about the work that you're doing at Pregnancy Justice and also other work you've done, it's hard work. It is. And I want to talk a little bit about leadership. So here at the Ford School, we have invested a lot in being active in terms of developing leadership among our students, but also faculty and staff. And leadership is defined not as like running an organization, but basically just having a positive impact on communities and organizations and on the world about things you care about. So, um, what do you see as the most important leadership traits for someone who's working on really politically volatile issues that, you know, get just to, you know, the heart of human rights issues, um, day after day after day. How do you, how do you keep doing this work? And again, what kind of advice do you have for others who want to have that impact? So I, I define leadership more of like how you show up every day, right? It's, it's not the fancy title, but it's really how you show up in the space every day with humility, with a lot of humility. I've learned, you know, humility along, along the way and always regret it when I didn't show up with humility. So humility is a really important trait. Having to deeply listen, because even though I come from a particular community, I don't, like even today I don't have the same challenges in my personal life, you know, as, um, you know, people who still live in communities like the ones I grew up in so deep listening. And, um, the willingness to engage and talk to each other, right? I'm, I, I get really dismayed by the, um, arguments that happen in, in social media rather than people face to face being in, um, you know, in, in principled struggle with each other. That's, you know, if that is so important and so key, people can disagree, right? But we have to be in principled struggle with each other for the health of our movement. You know, the willingness to develop relationships with people, like I was talking about before. That's really critical. But then also, um, and I can't take credit for this. This comes from the management center. And I recently, they published this really great management, um, book I recommended to everybody. But they really articulated a framework for organizational culture that really resonates with me. It has three components. One is collective purpose. Why are we here? What are we, what is it that we're here to do together to achieve? What is the mission? What is the, what are the priorities? What are the objectives? Not my personal agenda, but why are we here together? Right? The second one is caring for people, right? Which is fair policies and practices that are transparent. Like, you know, paying people living, you know, good, you know, salaries, you know, the good benefits that people need. But treating each other with dignity and respect, right? Not address, not like expecting employers to address your every single individual need because nobody can do that. It's really fair policies and practices. And then the third one is commitment to excellence, right? I'm not talking about perfection. Perfection is poison. I am talking about doing your best with rigor, with diligence, with owning, mitigating, and learning from mistakes. And understanding that we're going to make mistakes and being okay with that as long as we own, mitigate, and learn, right? So really, you know, and then like that gets embedded on values, like integrity, you know, showing up with integrity is a really important leadership quality, I think. Because we have to be able to trust each other. Right? It doesn't mean we don't make mistakes, we don't argue, and we don't like have conflict, but we have to be in conflict with each other with integrity. Right? So those are the kinds of things that I think about in leadership. That's great. Thank you so much for that. I think now's a good time to turn to all of you. And I'm sure a lot of questions have been coming in, right? So we're going to have again our two current Rebecca Copeland Scholarship awardees, Jenny Shearer and Olivia Morris moderate this next phase of the program. Could you both please quickly introduce yourselves, and then we'll get into the questions. Sure. Thank you for that great conversation. I'm Olivia Morris, and I'm a dual master's student with the School of Social Work in the Ford School. Jenny? Yes. Thank you so much for being here. I really appreciate this conversation. I'm Jenny Shearer. I'm a dual degree master's student here at the Ford School and at the School of Public Health. And I'm very interested in studying reproductive health policy. So, and people can keep sending in questions and we'll be monitoring them. So I'm just looking over that. But just to start this Q and A off a little bit, my interests are really in opioid reform and government payer insurance. And so I was curious your thoughts on what role should government play in supporting pregnant and postpartum people in going against pregnancy criminalization. We also received a question online that has to do with this. How can social services and legal entities balance the protection of pregnant people, perhaps who do have opioid use disorder, and the needs of the children, perhaps already in the mother's family, or yeah. Well, I think you know, first of all is being driven by best practices and evidence, right. So again, the patterns that we see is that people are being sucked into child protective services, investigations and criminal, you know, just outright criminalization based on one tox, one positive tox screen, right. There is no evidence that that one tox screen equals being a bad parent. You can be a bad parent and not use any substances, right. So yeah, you know, so I think that we have to really examine what the stereotypes are and really look at the medical evidence. And we do have a fact sheet on our website that, you know, lays this out. I recommend folks to take a look at that. But, and we do have some guidance, you know, for people within child protective services and child welfare and social workers about, you know, what are the steps that they can take to try to disrupt, right. Unless there's additional actual evidence that there is child abuse, people shouldn't be investigated. You know, people should not be reported because just that step ruins people's lives and leads to family separation, right. There is known harm to children and foster care. There is known harm and it's intergenerational harm that happens to parents and children, right. The children and foster care then become the next generation of people who are policed and tested and then have their children taken away. There was just a hearing at the New York Assembly precisely on this and hearing the voices of like 15 they happen to be women, 15 women who testified about their personal experience precisely around this and being in that intergenerational harm space because of the interventions of the state it was just, you can't tell me that you're protecting children if that's the outcome, right. So really, you know, what is the evidence and so that's, that is what I would say. Thank you. So in the role, role of government, I mean there is a role of government to provide you know, resources, you know, funding, evidence-based guidance, fund research, I mean there's all, you know, there's a lot that that can and should be done by government. There, there aren't enough drug treatment programs for people who are pregnant and people who are primary caretakers of children. That's been true since the 1990s when I first, you know, dipped my toe in this, in this area and it's still the case. So why is that? So, thank you for addressing both parts of that question. Yeah, thank you. Just like a quick follow-up to that question. What are your thoughts on programs like nursing and visiting programs or things like that where they're run by the state but reach pregnant people and postpartum people like in their homes? Um, I, I think it really depends on what their mandates are, right? And because there is a danger that people, like the more you test and investigate, the more you find stuff and it doesn't mean that it's not happening in other people's houses and those kids turn out fine, right? You know, it's, it's, so there's a danger of that. So, and those programs could potentially provide really important support. So, they have to be carefully tailored and, you know, the confidentiality, you know, like, like, what is their mandate? I think it's a big question for me. I would need to kind of take a look at this a little bit more, but, I would be cautious and understanding that they potentially can provide important support. Thank you. So, another question from the audience. What advice would you give to students who are interested in doing this work? What resources do you know of that might be available on campus and how do students get started and work about reproductive justice? Well, I don't know what resources are here on this campus, but usually on, you know, they're, they're very various resources. You know, there are organizations, advocates for youth and urge that work with young people and college students. I would really recommend reaching out to them. They're phenomenal. They're usually some campus chapters. You know, in different states, you know, they have different priority states, but I'm sure if you're really interested in want to build a chapter, you know, they might be very interested in talking to you. So I think those two groups would be the starting place, but there might be existing organizations and resources, right? So if, for example, if you're in law school, you know, there's the if, when, how lowering, lawyering for reproductive justice chapters. So there are some existing things like that. What was the other part of the question? How do students get started in the work of reproductive justice? I feel like you... I think, yeah, so reaching out, I think to some of those, some of those groups. I want to jump in because a question I get from students a lot is, do I have to go to law school? No, you don't. Right? And some of you are thinking about that. Do I have to go to law school if I want to be involved with work that intersects with civil rights and human rights and justice issues? Reproductive justice and others. You don't have to go to law school. Look, you know, being a lawyer can be very useful in many ways, but it's not for everybody and it's not necessary for, you know, to do this work in very meaningful ways. There are many different roles. Like again, I'm harping on this because I know who's in the audience. Go do research, right? Produce the evidence that we need to bring to the court, to bring to the court of public opinion, you know, to, you know, to bring to policymakers, especially when we operate in this fact-free world that we're operating in, that evidence, you know, continues to be really, really critical. Help communities do their own research to, you know, tell their own stories, you know, to define the problems from their perspective, right? So, there's a lot, there's a lot that can be done. Learn how to raise money, you know, for organizations. You know, the development is a career and you know, it's really important to be able to raise resources you know, for this work, especially the groups on the ground, you know, for the grassroots organizations doing that hard work, which they don't often have that capacity, right? So, so there are so many different ways. Do communications work, strategic communications work is really critical. So there's so many different roles that, you know, so we have somebody on staff who's a social worker because that's a skill set that's really, that kind of skill set helps us bridge those relationships with our state partners, with our RJ partners, right? So you know, with our clients even. So there's so many things that you can do that's not going to law school. We just received a question that really connects to your emphasis on research and evidence. How do you work with opposing policymakers or advocates when they do not listen to evidence-based policy? How can you frame protection against criminalization of pregnancy? So what is understood within the opposition, within the opposition's value or morality-based arguments? You know, that's, I mean, throughout my career, I have worked with people from different political spectrums in a very nonpartisan way. I think it's harder to do in the current landscape, right? But it's not impossible and it's, it's, and it continues to be important to try. It's, it continues to be important to try to break through these ideological camps. And I, I can't believe, for example, like the vote we saw in Ohio, those were not just Democrats, right? It was people across the political spectrum. And we have to, and I should say, we're a nonpartisan C3, so that's just the public service announcement. But, you know, but it's, it's really important to have the conversations and not just talk to ourselves in the ways that we are used to talking to ourselves. My, I have like a little focus group. Like, I have a big extended family. If they don't understand what I'm talking about, I failed, right? I have a beloved family member that, if things weren't so ideological in the way they are, that person would be voting Republican. So that family member who is my beloved family member, you know, is like my little focus group, right? So, so we have, like these are, you know, the people who don't agree with us are people in our communities and our own families. We have to be able to have these conversations. Right? Thank you. So, yeah, and kind of going off of that, how can anti-abortion supporters understand pregnancy justice and maintain their moral obligations while still understanding the needs to protect human rights? Say that part again about the moral obligations. So, how can anti-abortion supporters understand pregnancy justice and maintain their moral obligations while still understanding the need to protect human rights? Sure, sure. Well, you know, I would say that perhaps kind of looking at the definition of reproductive justice, right, and see if there's a space in there that would feel comfortable to work in. Because again, reproductive justice is not just the right to not have a child, it's the right to have a child and to be able to raise our children in safe and sustainable environments. Right? So, and you know, people make decisions about their own lives that I myself would not necessarily make myself or agree with. But, you know, the question that I would pose back is you know, can you live with people making their own decisions even if it makes you uncomfortable, even if it, you know, but still find some places where we can work together, right, to ensure safe and sustainable communities. You know, this makes me remember, I did a podcast you know, with a young person who, I forgot how the question was posed, but basically my response to them was like, wait a minute, if people actually had different choices, like had social supports, had access to healthcare, had support to continue with their education, they actually might decide to keep their children because people actually want, some people want to have children, right, you know, or I don't think it's random that it's not 60% of women or people who have abortions are living in poverty or also parents or yeah, and already have kids, right, they're also parents, right. So, you know, advocate for policies, perhaps spend your energy advocating for policies that help communities thrive because then people make different decisions in that context, right, you know, rather than just focusing on preventing people from making decisions. Thank you. Yeah, this question connects perhaps to some of the expansion of welfare policies that you just discussed. How are immigration laws potentially intertwined with the concept of pregnancy criminalization and how does this concept marginalize those individuals even further? So, part of me is thinking about barriers to accessing certain welfare programs if depending on your status, but Right, right, right, love to elaborate on that one. Yeah, I mean, I do think there are current policies now that prevent people from accessing healthcare. You know, there's like a five-year ban on legal immigrants from, you know, accessing, you know, programs, for example, that impacts health status and healthcare of, you know, not just they themselves, but, you know, of their children who are, you know, born here or being raised here. And again, you know, people are not coming here so they can sign up for Medicaid. Let's just, you know, let's just be real. People are not coming from Venezuela, risking their lives to, and I have to say, this is not, you know, I don't work on immigration policy, but, you know, I just read the newspaper and like, no people, right? So, people are not risking their lives coming through mountains and deserts and hopping on trains and crossing rivers and going through barbed wire so they can like sign up for Medicaid. Right, it's absurd. It's absurd, right? People are coming here because their countries are in crisis and they are in danger. That's why they're here, right? So, so perhaps we should have a more humanitarian approach and a human rights approach and then, you know, help to try to understand why people are coming and help maybe partner, you know, with the global community try to help address that issue that's like the push, right? So, so that's, that's what I would say. So this person is saying that they appreciate your mention of generational trauma at the hands of the state due to racial stigma and the segmentation of opioid misuse. Could you speak a little bit more about the role that education can and should play in enhancing access to comprehensive reproductive services? Yeah, I mean, we are, I mean, we have a whole other problem in this country where the answer to young people's sexuality is to deny them comprehensive sexuality, sexuality education, right? And we see examples in other countries where young people who actually get comprehensive sexuality education, again, that's human rights-based that talks about, you know, relationships and power dynamics and relationships and, and, you know, understands that there's many different genders and embraces, embraces the fact that there's gender diversity and all of these things, right? That there are better health outcomes. They're just, it's just, again, the evidence is there. So are we going to continue to ignore the evidence and hurt young people versus embrace the evidence and provide what they actually need, which is education and services so that they can make the best healthcare decisions for themselves and have better health outcomes? I mean, it's not rocket science. But here we are. So. For this next question, I'm going to shift a little bit to talk more about the role of courts. So, before you spoke about the changing landscape, post-row, and now more of an emphasis on state law and state policy. How has this impacted or shifted pregnancy justices litigation strategy? Are you choosing the types of cases you take and how much of that is impacted by this landscape shift? Yeah, that's a great question. It's a little bit of a yes and no. So we actually have an intake system where people just reach out and tell us what's happening and we assess is this the kind of case that is within our expertise and we do also think about is there a way of not just providing individual legal assistance but can we leverage this to make bigger policy change and impact, right? Either by setting a precedent that impacts more people or brings such attention to what's going on that it's just indefensible. I'm just giving you a couple of different examples and we also work a lot with public defenders and local counsel who reach out to us. We do a lot of training of legal networks. We work with pro bono folks. We have 15 lawyers from Sullivan and Cromwell and also the Southern Poverty Law Center on this Alabama case with us. So there are a lot of folks that are very interested in working and a lot of things that we don't do that we share or we refer out or we connect with those resources that's a way of expanding our capacity, right? The Alabama case we did decide to file in federal court because we could ask for damages and we made the assessment that in Alabama the federal court was actually a less hostile environment than in the state court. So these are the kind of strategic decisions you make and choosing your venue. Like where can you make more progress, right? And I have to say that and this was something that we talked a lot about at the center when I was at the Center for Reproductive Rights you can't make an assumption that just because this judge or that judge was appointed by a Republican or not that they're going to rule against you. We won cases before judges that were appointed by different administrations, right? We lost cases that were appointed by different administrations, right? So and the other thing I would say just globally about the courts because I know there was a lot of feeling that after losing row that we should just kind of pull away from a court strategy and yes, I think that it's a more surgical strategy but we cannot see the space of the courts. The courts are an important pillar of democracy, right? That's like the bigger framework here is democracy and the courts being an important institution as part of our democratic system and we have to keep advocating for rights, right? You know, for civil rights for constitutional rights for statutory rights and statutory interpretation and there might be periods where we're going to be losing but it's still important to do. We have to be selective and not just kind of really nilly and naive about it but we can't just abandon the courts and yes, there are many other strategies that as a movement we also need to employ and invest in and perhaps like, you know, step on the gas a little bit more in other strategies as well, right, or more so sometimes. It just depends. Yeah. Thank you. So, saying on the topic of pregnancy justice work, someone from the audience is wondering why do you focus on pregnancy justice rather than reproductive rights and reproductive justice more broadly? This is an awesome question. So, pregnancy justice which used to be called National Advocates for Pregnant Women was founded by Lynn Paltrow, my predecessor while, you know, because when she was working in some of the reproductive rights organizations nobody else was doing these types of cases but she was getting these phone calls of people being people being criminalized because of their pregnancy status but it was outside the context of abortion and don't get me wrong we're supporters of abortion and you know, we write amicus briefs and you know, sometimes we represent people who are being criminalized because of pregnancy, you know, perceived abortions or pregnancy loss but nobody was looking at people being criminalized because of their pregnancy status and then the growing and kind of like the infiltrating of the fetal personhood ideology that by the way helped to undermine and overturn the right to abortion right? So somebody had, you know, so NAPW now pregnancy justice was minding the store over here right? And now we're front and center with criminalization because it's the same continuum so it is reproductive justice probably have time for one more question Yeah. Maybe two. Okay. Yeah, now the pressure is on. Just do two. I'll consolidate a few of these. There's a lot of questions. Yeah. Just because we've talked a lot about both the human rights perspective, building relationships with your community to share information and also the importance of research in your work experience what are the hallmarks of good relationships between researchers and community-based organizations or communities for research projects? Oh my goodness. I don't know if I can fully answer that but I'll give it a shot and I'll just do this for my personal experience in the very different roles and I'll answer it this way so here's a very early lesson that I learned as a young lawyer and I think it would apply to researchers too right? So as a young lawyer we were looking to bring a case around lead poisoning prevention you know this was in LA you know and in the context of like Medicaid so I was like sent go find plaintiffs the community groups that I took I talked to how can I say they kind of handed me my rear end because their perspective was like you lawyers come to our communities you file your lawsuits you do your press releases you go away and nothing changes so I you know it's like oh yeah right because I used to be you know on that side of the table and I was like that was a good reminder so that kind of that started a whole long period of me sitting down with the community over spaghetti dinners for months and months and months to understand what their agenda was right and to create a strategy that they were leading and that I was supporting and we actually you know there was the specter of litigation which was helpful to them as we were engaging with the state agencies but the strategy that they were leading and that I was supporting actually resulted in more than had we just filed a lawsuit right sometimes lawsuits can be very useful but you know sometimes you need to take the back seat right and so what I would say to researchers in terms of building those relationships you need time you need humility right and sometimes you know like people have skills in communities and you need to honor those skills right and like institutions like this actually need to educate people from those communities so that they can go back and do that research the affirmative action case is a whole other thing that we can talk about some other time but you know but having that humility and deep listening like I was talking about before how you show up that's really critical rather than going in with like this is my research agenda and can I just interview like 10 people and it's really spending the time to figure out what is your agenda how can I be helpful to you okay so I guess as like a closing question what do you wish that someone told you when you were earlier in your career or even as a younger person about how to navigate a society that not only limits female reproductive rights and all reproductive rights for people with uteruses and is also disempowering towards these people in general oh my goodness I don't I don't know if I can remember back that far now I think the one thing I would say is you need to have the long view right I am very conscious of the fact the work that I'm doing today I may not see results until after I retire right but it's important to have the long I mean it's well two things it's important to have the long view and it's important to understand that you also need to on that path create moments of wins that are meaningful to the communities that are most impacted right so I had to kind of learn that along the way of thinking like that like what is it what is the outcome that we're trying to achieve and that the strategy that like the specific activities that's less important because it could be those things pivot depending on what the landscape is it's like what is it that you're trying to change like what is the change you're trying to make right and really keeping an eye on that and sometimes it's mid view sometimes it's long view right but we need also as movements we need longer view strategies and you know the other thing is social justice work is not linear you have forward movement you go sideways you step backwards but you know overall it goes forward and I know it feels like we're in this moment that it's backwards but then you get Ohio right so that's the other thing do not get discouraged you have to have optimism because if you despair we've already lost right so and even in losses you have to think about how can we turn this around into a win right and in what sphere because we lost in a court but we're winning in the court of public opinion right so you know you have to be nimble is the other thing thank you so much it's very inspiring thank you and apologies for what I'm sure are a number of great questions we didn't get to a really at the last few months of time here is there anything that you wished you would have had the opportunity to say I just want to share I want to share a quote from the Mexico Supreme Court when they ruled this past year that abortion criminalization was unconstitutional under the Mexico Constitution and it said the criminalization of abortion constitutes an act of violence and discrimination based on gender as it perpetuates that women and pregnant individuals can only exercise their sexuality for procreation and reinforces the gender role that imposes motherhood as a compulsory destiny and I think that's true also around pregnancy criminalization because it's punishing people who are not guaranteeing like the perfect conditions for a pregnancy because they're not they're not living out their gender role of motherhood above all else so the Mexico Supreme Court got it we should be able to get it too very very Catholic country yes very very Catholic country the last thing I will say which I should have said on top pregnancy justice we just a note on language we use pregnant people pregnant women pregnant person for three reasons one is you know sexism and the gender binary is very real right and we and we have to acknowledge that it's a through line in our work it's that imposition of trying to impose that gender binary secondly because of all the issues that we were talking about it's really important to assert the personhood of the person who's carrying the pregnancy right you know in a context where the personhood of fetuses are supposed to override the personhood of the person carrying the pregnancy and then the final reason is like we understand that you know and we know that not everybody who is pregnant becomes pregnant identifies as a woman and it's important to be inclusive so for all of those reasons we use those terms depending on the appropriate context so thank you all I'm so sorry we don't have any more time but thank you all for coming and thank you so much thank you for joining us today if you want to ask you is is Abuela Carmen still with us no my Abuela Carmen lived to 106 years old oh my goodness and my mom lived to 95 well I know they're all very very proud of you and appreciate as we all do the amazing work you're doing thank you so much thank you