The history of African American women and their participation in the birth control movement reflects a very conflicted set of ideals regarding African American women, the use of contraceptive practices and abortion. Prominent historical figures debated whether African American communities would benefit from birth control or if birth control was another methodical scheme put in place to suppress the African American community.
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Early uses of birth control during slavery
During slavery times in the United States, black slave women were viewed as "breeding slaves" and "child bearing women"--simply vessels to meet the demands for labor in Southern agricultural areas. Through arranged marriages and forced mating with other slaves along with direct rape from slave owners, slave women were subject to frequent sexual exploitation. The women were even blamed for these phenomena as white male masters developed the "Jezebel" stereotype of black women as passionate, hypersexual beings who wanted to engage in sexual acts with anyone and everyone.
In resistance to slavery and specifically sexual oppression, black slave women often resorted to their own forms of abortion and contraception. Southern physician E. M. Pendleton reported that plantation owners frequently complained about "the unnatural tendency in the African female population to destroy her offspring. Whole families of women ... fail to have any children." The women drew upon African folk remedies to concoct medicines that would be shared and spread throughout the slave women community.
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The beginnings of organization
After the slavery era, black women mobilized in a variety of African American women's clubs across the nation to exercise their beliefs within a political platform. Prominent African American women leaders such as Harriet Tubman, Frances E.W. Harper, Ida Bell Wells-Barnett, and Mary Church Terrell led the founding of the National Association of Colored Women's Clubs. As issues of racism, segregation and discrimination perpetrated life for African Americans in post-slavery America, the NACWC and its 1,500 affiliate clubs worked to promote "racial uplift with the motto of "Lifting as We Climb," aspiring to show "an ignorant and suspicious world that our aims and interests are identical with those of all good aspiring women." Along with fundraising to establish schools and community services, the NACWC endorsed the movement for birth control as part of its agenda to empower black women and help them achieve better lives.
The black community of Harlem was particularly interested in birth control for women, and in 1918, the Women's Political Association of Harlem was the first African American women's club to schedule lectures on birth control. Their efforts continued with the Harlem Community Forum inviting Margaret Sanger to speak in March 1923 and the Urban League asking the American Birth Control League to establish a birth control clinic in the city. In 1925, Sanger attempted to open a nearby clinic in the largely black Columbus Hill area, but the clinic only ran for three months before closing because of low attendance. Some reasons for the low patient turnout could have been because many African Americans were transitioning out of the neighborhood or because of lack of engagement with community leaders. Despite this initial failure, Sanger continued to push for more clinics in struggling areas. In 1932, she opened a successful clinic in Harlem with the support from black churches in Harlem as well as an all-black Advisory Council. Black ministers of Harlem churches spoke at public meetings and used the churches as spaces for educational lectures. The Harlem clinic's patient clientele was about half black and half white, and in the first year and a half, almost 3,000 people visited the clinics. As more black women's clubs were established and as more black women participated in these organized clubs, more black women became aware of birth control methods and information.
Early arguments for contraception for African Americans
In July 1932, Margaret Sanger published a special issue of her magazine entitled the Birth Control Review. The issue was titled the Negro Number and called on prominent African Americans to display why birth control was beneficial to the African American community. Authors such as W.E.B Du Bois and George Schuyler contributed to the magazine stating different reasons why they believed contraception was an asset for Blacks
DuBois addressed the issue of birth control as a means of empowerment for African Americans in the article Black Folk and Birth Control. DuBois believed that voluntary birth control could serve as a way for Blacks to plan their families and secure their economic futures by not producing more children than the family could afford. He also addressed the issue of African Americans and the belief that in order to gain a substantial amount of power, Blacks need to produce more offspring. DuBois stated, "They must learn that among human races and groups, as among vegetables, quality and not mere quantity counts."
George S. Schuyler based his entire article on the idea that the viability of Black offspring was more important than the overall number of children produced. Schuyler's article, Quantity or Quality, was a critique of the idea that sheer numbers, in terms of offspring, could bring African Americans the power and equality that they were working toward. Schuyler argued that the health of the Black family, and most specifically health of the black woman, should be the focus of the birth control debate. The article made it clear that if Black women were able to plan their pregnancies, then there would be a chance that the infant mortality rates would decrease. Schuyler observed, "If twenty-five percent of the brown children born die at birth or in infancy because of the unhealthful and poverty-stricken conditions of the mothers and twenty-five percent more die in youth or vegetate in jails and asylums, there is instead of a gain a distinct loss."
Early opposition
Contraception was not unilaterally accepted in the African American community during the early 20th century. Birth control to some seemed like a method of population control that could be administered by the government to suppress the Black population. Marcus Garvey and Julian Lewis were both against birth control for African Americans for this reason though the approach differed. Garvey, as a Black Nationalist, believed in the "power in numbers" theory when it came to how Blacks would obtain power in the U.S. Garvey was also a Roman Catholic. Lewis took a more "scientific" approach to denouncing contraception.
The abortion debate
In the African American community, abortion has been a highly contested topic, arguably for slightly different reasons than the reasons argued by mainstream society. Abortion and other forms of birth control have been stigmatized among African Americans because of the historical involuntary sterilizations that were performed on many African American women during the 20th century. "If ever women would enjoy the right to plan their pregnancies, legal and accessible birth control measures and abortions would have to be complemented by an end to sterilization abuse." Scholar and activist Angela Davis argued that African American women are not pro-abortion but believe in abortion rights. The impact of slavery has influenced this ideology that abortions are not morally right, but performed in acts of desperation. "Abortions and infanticides were acts of desperation, motivated not by the biological birth process but by the oppressive conditions of slavery." Impoverished African American women were another example provided by Davis for the experience of desperate conditions that could lead her to abort.
Shirley Chisholm spoke to the debate from a political perspective in 1970. Chisholm described the decriminalization of abortions as a necessary step toward the safety of women. "Experience shows that pregnant women who feel that they have compelling reasons for not having a baby, or another baby, will break the law and even worse, risk injury or death if they must get one. Abortions will not be stopped."
The role of black nationalist parties
Background
Black nationalist parties in the late 1960s and early 1970s tended to view the use of contraceptives in black populations was at best, an ill-conceived public health measure, and at worst a front for a conspiracy of black genocide. For the most part, male-dominated black nationalists were opposed to the promotion of personal fertility control and protested against government funded family planners who they viewed to be putting forth an agenda of black population control.
Much of the opposition to fertility control was sparked by the sterilization of Minnie Lee and Mary Alice in 1973. The sisters received federally funded birth control grants from the Office of Economic Opportunity (OEO). At the Montgomery Family Planning Clinic, Minnie Lee and Mary Alice, fourteen and seventeen years old at the time respectively, both underwent surgical sterilization without informed consent. Mrs. Relf, their mother was unable to read and was coerced into signing parental consent forms without being able to understand the documents. Additionally, both sisters were forced by clinic staff to sign false documents indicating that they were over twenty-one. The family later filed a complaint through the Southern Poverty Law Center citing that the treatment of the sisters at the clinic was abusive and coercive because 1) neither the mother nor her daughters gave any indication of wanting to undergo surgical sterilization, 2) neither mother nor daughters met with the physician who would perform the operation before the fact, and 3) neither mother nor daughters received information about the consequences of tubal sterilization from a physician or member of the clinic staff. The Relf case prompted many other African American, Native American, and Latina women to come forth with similar stories of coercion. In light of this case, many black nationalist groups came to conflate any birth control movement with a larger conspiracy of black population control.
The most vocal of these black nationalist groups were the Black Panthers and the Nation of Islam. These two organizations argued that white government family planners posed a threat to the black population by offering them birth control without other health care measures, namely, preventive medicine and hospitals, pre- and postnatal care, nutritional advice, and dentistry. They argued that birth control services remained harmful without adequate solutions to health care problems related to poverty.
Additionally, other black groups and black scholars vocally criticized the targeting of poor black communities as centers for population control. Ron Walters, chairman of the department of political science at Howard University, a historically black university, was one of the most outspoken critics of population control aimed at black families. He advocated that black communities ought to be responsible for defining their own fertility programs and birth control policies. Members of the Urban League, NAACP, and the Southern Christian Leadership Conference, likewise criticized birth control programs throughout the 1960s. A particular point of contention was the lack of minority representation in Planned Parenthood.
However, as the feminist message of the right to abortion and birth control began to become more widespread and as black feminists became more vocal in advocating for birth control access, the views of many Black Nationalist parties began to adapt. By the mid-1970s, the federal government had reduced funding for fertility control and family planning programs were viewed as less favorable after Roe v. Wade, the landmark Supreme Court abortion case. Additionally, vocal criticism of federal family planning programs lead the government to refashion their rhetoric to be less targeted towards poor black communities. Given this context, groups such as the Black Panther's expanded their emphasis on total health care to include birth control and abortion when voluntarily chosen.
The role of the Black Panther Party
The Black Panther Party was founded in Oakland in 1966 as a black power group with a revolutionary black nationalist and socialist agenda. Upon its inception, the Black Panthers as an organization rejected all forms of reproductive control claiming that governmentally regulated reproductive control was genocidal for blacks. The Black Panthers, and the Black Liberation Army, the military wing of the party, believed that an armed black revolution against white supremacy was possible. They were quick to believe that targeted birth control was part of a governmental plot to reduce the number of blacks in America in order to prevent an armed revolt.
This suspicious view of birth control was to change throughout the 1970s. In 1971, women in the party vocally pushed back against an anti-birth control position on the basis that large families are difficult to support. They argued that it would be difficult for both men and women to participate politically due to the burden of supporting large families. In 1974, Elaine Brown took over leadership of the party following the exile of founding member Huey Newton. With a woman in power, women's voices gained prominence in the party. Women also came to be more of a presence in the party as a result of the FBI's crackdown in the Black Power movement in the 1970s which resulted in the arrests and deaths of many male party leaders.
Brown actively placed other female members in leadership positions despite push back from male members of the party. However, masculine leadership was reasserted in the party upon Newton's return to the United States in 1976. That being said, Brown's tenure as leader of the party from 1974 to 1976 significantly changed the party's stance on birth control policies and other feminist causes. In particular, the party educated black women on the dangers of forced sterilization and published articles on documented cases of coerced sterilization by the state. In an article published by the Committee to End Sterilization Abuse, the Black Panthers asserted that as high as 20% of black women in the United States had been sterilized. Additionally, the party shifted their rhetoric to emphasize the importance of health care and legal abortion in black communities. Despite their anti-birth control views in the 1960s, in later decades, the party adopted birth control and abortion rhetoric that later played into the reproductive rights movement.
The role of the Nation of Islam
The Nation of Islam, a black political and religious movement founded in the 1930s were among the first to claim fertility control as a form of genocide in the black community in the 1960s. The group was quick to draw parallels between what they saw as genocidal population control in the United States to population control policies in third world countries. By and large, the rhetoric put forth by the Nation of Islam was viewed by many as alienating and excessively conspiratorial. While the Nation of Islam maintained a more hardline approach to birth control and abortion, they too shifted their rhetoric to push for expanded health care for black communities and greater structural solutions to health problems linked to poverty.
The sterilization movement
Early laws and influences from the eugenics movement
Widespread practices of female sterilization began in the early 1900s. Throughout the 20th century, a majority of states passed laws allowing sterilization, and even requiring it in prescribed circumstances. The first sterilization statutes were passed in Indiana in 1907, and the last was passed in Georgia in 1970. The first sterilization law passed the state of Indiana in 1907 allowed the "prevention of the procreation of, confirmed criminals, idiots, imbeciles, and rapists." The Supreme Court of Indiana declared this statute unconstitutional for a short time in 1921; however but a similar law passed in 1927 was ruled constitutional. In the next fifty years, laws resembling Indiana's sterilization statute were passed in 30 different states. These policies legalized forced sterilization for certain groups, based on race and class lines, many of which were already marginalized.
As early scientific genetic theories were emerging, eugenics (and thus sterilization) became an accepted way of protecting society from the offspring of those individuals deemed lesser than or dangerous to society - the poor, the disabled, the mentally ill, and particularly, people of color. Several states, most notably North Carolina, even went so far as to set up Eugenics Boards during this time period. These boards reviewed petitions from government and private agencies to perform sterilizations on poor, unwed, disabled women. The most popular form of female sterilization was tubal ligation, a surgical procedure that severs or seals a woman's fallopian tubes, permanently preventing her from conceiving a child. In most cases, medical providers did not have to ask for the women's consent before performing the procedure.
The Supreme Court case Buck v. Bell (1927) was a landmark case that upheld a state's right to forcibly sterilize a person considered unfit to procreate. The plaintiff, a young woman named Carrie Bell, was the first person to have been sterilized without consent under Virginia's new sterilization statute. Bell had been sterilized because her mother had been involuntarily institutionalized for being "feebleminded" and "promiscuous." Upon learning her family history, doctors assumed that Bell had inherited those same traits and saw her as unfit to procreate. After giving birth to her first child, Bell was forcibly sterilized. Ever since the Supreme Court decided in the state's favor, the case has never been overturned. Although Bell was not a woman of color, the same types of preconceived notions that led to her sterilization would justify the sterilizations of countless black women in the decades to come.
Practices during the 1960s and 1970s
Sterilization abuse of African American women inflicted by the American government and white medical establishments reached its height in the 1960s and 1970s. Coinciding with the Civil Rights Movement, a time period in which the black community was beginning to gain political autonomy, the government tried restrict blacks' freedom through another channel--preventing black women from becoming mothers.
In 1970, black women were sterilized at over twice the rate of white women: 9 per 1,000 for black women as compared to 4.1 per 1,000 for white women. A second survey taken in 1973 indicated that 43% of women who underwent sterilization in federally financed family planning programs were also black. The intersection between race and low-income status made black women even more vulnerable to forced sterilization. Many of these black women were poor and could only rely on federally subsidized clinics or Medicaid for health care. Some women had experienced sterilization without consent after a doctor had agreed to perform an illegal abortion; others were pressured into allowing sterilization after receiving a legal hospital abortion. The patterns were even worse for non-married black women; in 1978, the tubal sterilization rate for never-married black women was 529 percent greater than that of their white counterparts.
During the 1960s and 1970s, punitive sterilization laws were proposed in California, Connecticut, Delaware, Georgia, Illinois, Iowa, Louisiana, Maryland, Mississippi, Ohio, South Carolina, Tennessee, and Virginia. The purpose of such laws was to reduce the number of children born to poor, unmarried mothers. Many of these laws contained statutes that withheld welfare benefits from women with illegitimate children. As intended, these laws disproportionately affected women of color, particularly African American mothers. According to the ACLU, the Eugenics Board of North Carolina approved 1,620 sterilizations between the years 1960 and 1968. Of that number, 1023 were performed on black women and nearly 56 percent of those were performed on black women under 20 years of age.
Aside from government actions, abuses of power also took place in the American medical establishment. One of the most infamous examples of such abuses was the actions of South Carolina physician, Dr. Clovis Pierce. After accepting federal money to perform the sterilizations of 18 Medicaid patients in his clinic, he told women that he would only deliver their third pregnancy on the condition that they would submit to sterilization immediately afterwards. Pierce was able to defend himself against all lawsuits that were brought against him. Furthermore, the South Carolina State branch of the American Medical Association (AMA) unanimously supported Pierce's actions against all of the women.
Relf v. Weinberger
In 1973, one particular case brought attention to the issue of forced sterilization. Twelve-year-old Minnie Lee Relf was sterilized without her consent or consent of a parent in a federally funded Health, Education, and Welfare (HEW) health clinic--the Montgomery Family Planning Clinic--in Montgomery, Alabama. The official plaintiff was Katie Relf, the sister of Minnie Lee, and the defendant was Caspar Weinberger, Secretary of the U.S. Department of Health, Education and Welfare.
The crux of the case challenged a state eugenics statute that authorized the procedure for "mentally incompetent" individuals without requiring the girl's consent or that of a guardian. Caseworkers had diagnosed Minnie Lee as mentally retarded and thus were able to apply the statute, although the basis for their diagnosis was extremely questionable. As a result both Minnie Lee and her sister Mary Alice received tubal ligations without their consent. Their mother (who was illiterate) unknowingly authorized the procedure by signing an "X", under the false impression that her daughters were being receiving routine birth control injections.
The District Court initially decided in favor of the Relf sisters; its decision declared certain HEW regulations covering sterilizations to be "arbitrary and unreasonable" and prohibited HEW from providing federal funds to be used for the sterilization of "certain incompetent persons". The District Court also ordered HEW to amend its overall regulations. During the course of the litigation, HEW was able to withdraw the challenged regulations. Upon appeal, the Court of Appeals held that the case was now rendered inconsequential by HEW's revisionary actions and remanded the case back to the District Court for dismissal.
Anti-sterilization efforts
The issue of forced sterilization came to the forefront of activists' and scholars' minds in the 1960s and '70s when evidence of widespread sterilization abuse on women of color was uncovered. Disproportionate numbers of black women, among other minority groups like Puerto Ricans and Native Americans, were receiving sterilizations, and many were completed in federally-funded clinics. In the 20th century, 32 states had federally-funded sterilization programs in place.
Anti-sterilization efforts in the 1970s came as the result of several high-profile sterilization abuse scandals. In 1972, President Nixon failed to enact a "set of Health, Education, and Welfare (HEW) sterilization guidelines" that would have prevented women from undergoing "forced or coerced sterilization in federally subsidized clinics." This failure was exposed in 1973, when it became known that Mary Alice and Minnie Lee Relf, of Relf v. Weinberger, had undergone sterilizations without their consent at a federally-funded clinic in Alabama. It was later revealed that between 100,000 and 150,000 poor women, mostly of color, had been sterilized using federal dollars. Regulations were quickly put in place after the National Welfare Rights Organization sued HEW in 1974. These regulations "prohibited the sterilization of anyone less than 21 years of age, required a 72-hour waiting period, and protected a woman from losing her Aid to Families with Dependent Children (AFDC) support if she did not agree to sterilization." HEW, however, then created a program through which states were reimbursed for sterilizations of poor women.
The Committee to End Sterilization Abuse (CESA) was founded in 1974 to combat the abuse of sterilization on women of color. It had a strong "anti-imperialist orientation" that attracted a multiracial membership, including white, Puerto Rican, and black women. In 1975, a coalition of groups formed "an umbrella anti-sterilization abuse organization" called the Advisory Committee on Sterilization. Members of the coalition included CESA and the National Black Feminist Organization, a group committed to addressing the double burden of racism and sexism faced by black women. The coalition formed to advise the New York City Health and Hospital's Corporation (HHC) on how to prevent forced or coerced sterilization within municipal hospitals.
The Advisory Committee created a set of guidelines that mandated a 30-day waiting period and required "that consent not be given at the time of abortion or childbirth; that there be counseling on other fertility control options; that information on sterilization be given in the patient's native language; that the idea for sterilization must originate with the patient; that women could bring a patient advocate and another person of their choosing to accompany them through the process; and that the patient present written understanding of sterilization with an emphasis on its permanence." In 1975, these guidelines were passed by HHC and enforced within municipal New York City hospitals, and in a 1977 City Council vote they were extended to all NYC hospitals. Finally, in 1978, the Nadler bill, named for state assemblyman Jerrold Nadler, was passed in the New York state legislature which outlined a set of sterilization regulations similar to the original ones passed by the HHC.
CESA disbanded after the passage of the Nadler bill, and with the HEW sterilization regulations in place, anti-sterilization efforts took the back burner for many feminist activists. In 2013, North Carolina became the first state to compensate its victims of forced sterilization with a payment of $50,000. In North Carolina, 7,600 people were sterilized between 1929 and 1974, 85% of them female and 40% of them nonwhite. Virginia became the second state to provide payments in 2015, giving each living victim $25,000.
Contemporary groups that continue to address sterilization within the black community include Incite! and SisterSong. Incite! is a "national, activist organization of radical feminists of color...[dedicated to] end[ing] all forms of violence against women, gender non-conforming, and trans people of color and our communities. They believe that women, transgender, and gender nonconforming individuals live at "dangerous intersections" and are subjected to institutional violence, including sterilization abuse. SisterSong is committed to "Reproductive Justice," which they define 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."
Organizations
Women of color, frustrated by not having their issues heard by the mainstream white-led reproductive rights organizations, founded their own organizations such as the National Black Women's Health Project and African American Women Evolving directly addressing their specific needs.
National Black Women's Health Project (NBWHP)
The first National Conference on Black Women's Health Issues was held at Spelman College in 1983 and gave birth to the National Black Women's Health Project (NBWHP) with the intent of bringing African American women's voices on health and reproductive rights to national and international attention.
Founded by health care activist Byllye Avery and incorporated as a nonprofit organization in 1984, the NBWHP was the first women of color reproductive justice organization. The organization later changed its name in 2003 to Black Women's Health Imperative "to reinforce the need to move beyond merely documenting the health inequities that exist for Black women and to focus on actionable steps to eliminate them."
Byllye Avery worked in children's and women's health care in a hospital in Gainesville, Florida and joined the board of directors of the National Women's Health Network (NWHN) which informed her organizing the 1983 National Conference on Black Women's Health Issues.
Lillie Allen, a health educator concerned with reproductive health education and internalized racism, co-founded the NBWHP. She was the Rockefeller Fellow in Population at Morehouse School of Medicine in Atlanta in 1983 and part of the planning committee for the 1983 National Conference on Black Women's Health Issues.
Based in Atlanta, Georgia, the NBWHP had established chapters in 22 states by the end of 1989 and popularized its message through a network of conferences and workshops, and by publishing a magazine, manuals and educational videos. The NBWHP participated in the 1985 United Nations World Conference for Women in Nairobi, Kenya. In 1990, NBWHP opened a public policy-based office in Washington, D.C. to more actively promote public policies to improve black women's health, such as advising President Clinton's pro-choice administration's health policies and regulation. By then, the NBWHP had moved from being a grassroots organization to advertising black women's health through public policy on a national stage.
African American Women Evolving (AAWE)
African American Women Evolving (AAWE) started as a project within the Chicago Abortion Fund, a predominantly white pro-choice organization, in Chicago in 1996. AAWE was committed to holistic community health education and promoting a black women's health agenda within a primarily white-led organization. After organizing Chicago's first conference on black women's health, AAWE became an independent organization in 1999 incorporating under the National Network of Abortion Funds. The organization later changed its name to Black Women for Reproductive Justice (BWRJ). BWRJ conducted several surveys gathering data on African American women's reproductive health and making that data publicly available. As a predominantly grassroots and pro-choice organization, BWRJ emphasized making health care information and options available to African American women in the Chicago area and Illinois. The organization also worked on policy recommendations, and advised, inter alia, the National Abortion Reproductive Rights Action League (NARAL).
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