When I was 19 years old, I walked into a health center in Michigan knowing I was pregnant but uncertain of my future. To this day, I remember the compassion and grace of the nurse who helped me, who saw me scared and crying but calmly let me know that I had options. I could give birth and raise a child, I could pursue adoption, or I could have an abortion—an abortion that she told me was my right if I wanted it, and she reminded me that I didn’t have to carry any shame about my decision.
It was a relief. I have not always had positive interactions with doctors and nurses—an experience many other black women share, rooted in our country’s dark history. From forced sterilization to substandard care, the mistreatment of black women by some in the medical community is a horrific truth that we must actively address. Advocates are speaking out about the importance of listening to and being honest with, black patients. And health care providers across the country, like Planned Parenthood, are working to improve patient care for black women.
But now, a new rule from the Trump-Pence administration could roll back all that progress and—once again—risk the health and wellbeing of black women by forcing health care providers to withhold critical health information.
Just a couple of weeks ago, the administration released a gag rule that would undermine Title X (pdf), a federal program dedicated to ensuring that people struggling to make ends meet can still access birth control, STI testing, and breast and cervical cancer screenings. Of the four million patients who rely on Title X health centers for essential reproductive health care, 22 percent are black. Research shows that the barriers to health care many of us face often result in delayed diagnoses, higher rates of cervical cancer, and increased mortality rates for breast and cervical cancer. That’s why the preventive services provided through Title X are so essential. It is not an exaggeration to say that this gag rule threatens our survival.
The gag rule makes it illegal for health care providers in Title X to refer patients for abortion—essentially “gagging” them from being able to provide their patients with the medically accurate information they requested. There is already a long-held and very real mistrust of medicine and the health care system for so many of us. Our pain has been taken less seriously. Our sisters and friends are more likely to die in childbirth. And now the administration wants to force health care providers to violate medical ethics by not informing us of all of our care options when they treat us. Whether you’re at a community health center, your local health department, or a hospital that participates in this program, your doctor or nurse would be legally bound to withhold the full information about your health care options.
Planned Parenthood—which serves 41 percent of all the patients who get care through Title X—will never violate medical ethics by being anything less than 100 percent honest and open with patients. But that also means Planned Parenthood health centers will no longer be able to participate in the program—putting health care at risk for 1.6 million patients. People who can’t find or can’t afford another reproductive health care provider may be left with nowhere to turn.
Beyond violating medical ethics, the gag rule also imposes cost prohibitive and unnecessary “physical separation” requirements on health centers that also provide abortion. These could include forcing health centers to build separate entrances and exits, construct whole new health centers, or hire a whole second staff of doctors, nurses, and administrative staff. None of these requirements contribute to the health of patients. They’re specifically designed to block patients from coming to Planned Parenthood.
This is a targeted attack on people with low-incomes, on the black communities who rely on this program, and on access to health care. It’s not about improving health outcomes, it’s not about helping people, it’s about pushing a discriminatory ideology to dismantle reproductive health care in this country.
It is impossible to separate this attack on our health care from the countless attacks this administration has leveled against us so far. Since day one, the anti-blackness the Trump administration is steeped in has fueled hateful rhetoric, emboldened white supremacists and led to many harmful policies: voter suppression efforts that make it impossible for many black people to vote; the slashing of social programs; and ending temporary protected status for black immigrants are all aimed at making it harder for us to live full lives. This rule is no different.
Part of recognizing and rectifying the history of black women’s mistreatment by the medical community is committing to open and honest medical practices and fighting against policies that would roll back our progress. That’s why medical organizations like the American Medical Association, the American College of Obstetricians and Gynecologists, and the National Medical Association, which represents more than 50,000 black doctors and their patients, have been firm in their opposition to this dangerous rule. Planned Parenthood is standing with other health care providers, we are standing with our patients, and we are not backing down. We’re going to fight this rule through every possible avenue.
Black women deserve the truth. We deserve access to the health care that could save our lives. And we deserve the freedom to make decisions about our bodies.
If the administration won’t act, then Congress must. In November, we voted a slate of reproductive health champions into Congress. We showed up for them and it’s time for them to show up for us. Tell Congress to #ProtectX.
Nia Martin-Robinson is the director of black leadership and engagement at Planned Parenthood Federation of American where she is building a collective strategy and vision that centers black women, girls and femmes.