Created by:

Kels Rizzo,
Kimberly Chen,
and Katherine
Chen

The Case for

Implementing
Accessible Medical
Abortion at
University of
Washington
Seattle's Hall
Health

CW: contains mentions

of racism, violence,
sexual assault, some
gendered language
regarding persons able
to get pregnant
 The i ntersecti ons of
capi tal i sm, race, gender,
abi l i ty, and cl ass make i t
necessary to provi de
aborti ons wi th as few
barri ers to accessi bi l i ty as
possi bl e for the most
vul nerabl e. Heal thcare for
everyone i s i mproved i f we
center the most margi nal i zed
i n our communi ti es.

“Access to medication
abortion on college
campuses is an act of
reproductive solidarity"
-Kels Rizzo
 TABLE OF
CONTENTS
Our Demands 1-2

Why Now? 3

Reproductive Justice
(RJ)
4

The History of
5-6
Reproductive Control

Reproductive Control 7
over Black Women

Welfare, Reproductive
8
Control & Eugenics

Ideologies and Control

9-10
Over Time

Next Steps? 11

Precedent: UC Berkeley's 12
Roadmap

Quotes & Images from 13

the Movement

Efforts at UW: What's done

and What's to Come
14

References 15
Our Demands:
Make medication abortion (aka the abortion pill
1 or MAB) available through Hall Health at the
University of Washington Seattle.

Make medication abortion (aka the abortion pill

2 or MAB) available through Hall Health at the
University of Washington Seattle.

Increase funding, training, and technological

support for Hall Health medical and healthcare
3 providers to establish accessible medication
abortion care and contraception for all faculty,
staff, and students.

Make Telehealth consultations available for

4 medication abortion through Hall Health.

Make digital consent forms accessible to sign

5 online for individuals seeking medication
abortion through Hall Health

1
 “Every public university
should be offering this —
it’s a no-brainer. All
students should be
demanding this from their
health centers now.”

-Ushma Upadhyay,
associate professor of
obstetrics at UCSF

2
 WHY NOW?
ROE V. WADE (1973)
Since 1973, the Supreme Court case Roe v
Wade upheld that a pregnant person’s right
to abortion is constitutionally protected
under the 14th Amendment’s right to privacy
clause (HISTORY, 2018).

DOBBS V. JACKSON (2022)

Recently since May 2022, mainstream attention
has been focused on the leaked Supreme Court
draft decision on the Dobbs v Jackson
Women’s Health Organization case. If this
majority draft decision is adopted officially, it
would overturn Roe and abortions and the
right to privacy would no longer be protected
as a constitutionally protected right; instead it
would be up to each individual state to decide
whether or not to restrict abortion access
(Gerstein et al., 2022).

HYDE AMENDMENT (1976)

It is important to note that abortion rights
have been slowly chipped away long before
Dobbs v Jackson.
The 1976 Hyde Amendment blocked federal
funding for abortion services for those
insured by Medicaid, with three narrow
exceptions since 1994: when pregnancy will
endanger person’s life if continued and
when pregnancy resulted from rape or
incest (Planned Parenthood, 2021).

ACCESSIBILITY
Abortions have not been accessible for disabled,
poor Black, Indigenous, pregnant people of color
(BIPOC) since Hyde.
34 states and DC do not provide their own
abortion coverage funding for those enrolled
under Medicaid. “This leaves 7.8 million women
aged 15–49 with Medicaid coverage but without
abortion coverage. Half of those affected are
women of color.” (Guttmacher Institute, 2021)

BARRIERS WILL ONLY WORSEN IF DOBBS V.

JACKSON BECOMES PRECEDENT.
3
 REPRODUCTIVE JUSTICE
(RJ)

What is it?
A movement that is led by Black, Indigenous,
women/trans people of color. It combines
reproductive rights with social justice, recognizing
that “women’s rights movement, led by and
representing middle class and wealthy white
women, could not defend the needs of women of
color and other marginalized women and trans
people.” (Sister Song)

Reproductive justice focuses

on access, not choice.

Rich, white cisgender women will always have

access to abortions, even if they live in a state
that currently has restrictive bans on abortion.
Marginalized pregnant individuals of color do
not have the funds to pay for childcare and
travel hundreds of miles to clinics or to other
states that still provide abortions if Dobbs
removes abortion care in their home state.

We must apply reproductive

justice frameworks to the
University of Washington’s
medical infrastructure to care for
all of our students, especially our
most marginalized.

4
LET'S TALK ABOUT THE HISTORY
OF REPRODUCTIVE CONTROL
(From Sylvia Federici's Caliban and the Witch)

To do so, we have to examine the rise of early capitalism in

16th century Europe. This era of capitalist 'primitive
accumulation' led to the rise of the modern prison industrial
state and state-sanctioned control over reproduction.

Why This Era?

The creation of the private sphere depended
upon the enclosure of the commons. Formerly
communal land was enclosed and privatized. This
isolated women within the domestic sphere,
defining them by their private relationships to
male relatives. Social reproduction, aka care
labor, was increasingly economically devalued
and normalized as 'women's labor'.

The result of transforming peasants into wage laborers—

massive food shortages and high food costs driven by the
Price Revolution, anti-vagabond laws that criminalized the
newly-created (& newly-impoverished) poor and working
class, and a population crisis due to famine, disease, and
destitution.

The Rise of the Bio-Political State

As defined by Michel Foucault, bio-power is the ability of the
state to "Make live, and let die". In other words, the state
serves a regulatory function in maintaining "population
health". The capacity of state intervention intensifies, and
starts from the moment of reproductive conception (Foucault,
1976).

In order to address the population crisis, we see the rise of

state-monitored population tracking, including census-taking
and the tracking of pregnancies, births, and deaths. The 17th
century development of the pro-natalist state and capitalist
reproductive policy led to the creation of "reproductive
crimes", which included abortions, contraception, concealing
delivery or pregnancy, hosting an unmarried pregnant woman,
non-procreative sexuality, and capital punishments for
infanticide and adultery (Federici, 2004, p. 88).

5
Surveillance of Reproduction

Surveillance and punishment for reproductive crimes took

many forms. Midwives were devalued and forced to become
spies of the state: reporting births, discovering fathers of out-
of-wedlock pregnancies, examining women suspected of a
concealed birth by looking for signs of lactation. The removal
of midwives from the delivery room and the devaluing of
women's medical knowledge in favor of male doctors
occurred alongside witch-hunts of women accused of
sacrificing children to the devil, and the heavy criminalization
of sex-work (Federici, 2004, p. 89).

The Global Expansion of Capitalism

Colonization, enslavement, and empire-building occurred during
the same era, and the development of racial capitalism created
and reified different forms of sexual exploitation along racial
lines. As Federici writes, "[W]ith the institutionalization of
slavery, which was accompanied by a lessening of the burden
for white workers, and a decrease in the number of women
arriving from Europe as wives for the planters, the situation
changed drastically. Regardless of their social origin, white
women were upgraded, or married off within the ranks of the
white power structure, and whenever possible they became
owners of slaves themselves, usually female ones, employed for
domestic work" (Federici, 2004, 108).

Therefore, it is crucial when we examine the history of

reproductive control to center the experiences and
leadership of Black women, femmes, and people with
uteruses in our current and future fights for
reproductive justice.

6
 Reproductive Control of
Enslaved Black Women
CW: slavery, anti-Black
violence, racism, sexual
abuse
From Saidya Hartman's The Belly of the World

In this section, we will discuss the reproductive

enslavement of Black women as a mechanism crucial to the
survival of slavery as an institution. The legacy of bodily
dispossession experienced by enslaved Black women
continues to this day. It is no coincidence that the most
liberatory visions of Reproductive Justice have been
created by and for Black women.

“The material relations of sexuality and reproduction

defined black women’s historical experiences to slavery.
The theft, regulation and destruction of Black women’s
sexual and reproductive capacities would also define the
afterlife of slavery” (Hartman, 2016, p. 166)

It is also important to recognize the resistance of enslaved Black

women against reproductive exploitation and their assertions of
bodily autonomy.

“Certainly we know that enslaved women [...]

plotted resistance; utilized abortifacients rather
than reproduce slaves; practiced infanticide rather
than sentence their children to social death, the
auction block, and the master’s bed” (Hartman, 2016,
p. 167)

The reproductive labor of enslaved Black women

“inaugurated a regime of racialized sexuality that
continues to place black bodies at risk for sexual
exploitation and abuse, gratuitous violence,
incarceration, poverty, premature death, and state-
sanctioned murder.” (Hartman, 2016, p. 169)

The reproductive and social labor of Black

women has been and continues to be
devalued and pathologized as non-
conforming to ideals of the white
heteronormative nuclear family.

7
 Welfare, Reproductive
Control & Eugenics
From Dorothy Roberts' Killing
the Black Body

Welfare and reproductive control in the U.S. contains two

seemingly contradictory practices: the history of sterilization and
the coercive prevention of pregnancies or forced abortions for the
disabled and people on welfare, and the refusal of the state to make
abortion-related care financially accessible to welfare recipients. It
may seem difficult to reconcile eugenics-based logics with forced
reproduction and pro-natalist policies. But, as Dorothy Roberts put
it, these two methods of repressive state control are not
ideologically opposed; “On a theoretical level, family caps [on
welfare] and the denial of funding for abortion are not
contradictory: both limit indigent women’s control over their own
bodies by making it more difficult to realize their reproductive
decisions” (Roberts, 1999, p. 235).

Preventing People on Welfare from Having Babies

During the 90s, there was an enormous legislative push to tie welfare benefits to
long-term contraception requirements. This was mostly for the insertion of
contraceptive drug called Norplant, which was exclusively tested on women from
countries in the Global South (Pimentel et. al, 2017). Although Congressional
legislation was never passed, many states added financial incentives conditional to
the insertion of Norplant.
Many states also added "Family cap laws", also known as "child exclusion" welfare
benefits, that incrementally eliminated aid to families exceeding a certain number of
children, or disqualified pregnant welfare recipients from increases in aid (Roberts,
1999, 210).
This state intervention into the bodily autonomy from poor Black and Brown folks is a
continuation of the history of slavery, eugenics, and sterilization. Therefore,
reproductive freedom and control are fundamental to white supremacist power
structures.

Banning Affordable Access to Abortion-Related Care

In 1988, the Reagan administration issued regulations prohibiting abortion
counseling in in clinics receiving federal funds under Title X of the Public Service
Act in 1970, which was upheld by the Supreme Court in a 1991 case called Rust v.
Sullivan. This became known as the 'Gag rule' (Roberts, 1999, 232).
Although Clinton repealed these regulations in 1993, the silencing of
reproductive healthcare providers for poor folks has continued to be an area of
great political contention. In 2021, Biden reversed Trump's 2019 regulation
removing Planned Parenthood from Title X providers. The cyclical political tug-of-
war over the accessibility of information on safe abortions illustrates the
disproportionately immense barriers faced by low-income BIPOC with uteruses
seeking reproductive care.
These regulations have seriously implications for people with pre-existing
medical conditions that can be accelerated by pregnancy, such as heart disease,
hypertension, diabetes, sickle-cell anemia, and cancer. Black women suffer
disproportionately from these medical conditions, and also are more likely than
white women to rely on Title X clinics (Roberts, 1999, 233).
8
 Ideologies and Control
Over Time
"The Racist Origins of the Welfare State"

The rhetoric of "deservingness" was constructed in order to exclude

Black families from receiving welfare:

"Deserving" white mothers were subsidized to enable them to

stay at home, unlike Black women, which ensured "the availability
of less privileged women to do low-wage work” (Roberts, 1999,
207).
However, once Black women were included in welfare programs
that were once reserved for whites, the programs “soon became
stigmatized as dependency [...] The image of the welfare mother
quickly changed from the worthy white widow to the immoral
Black welfare queen” (Roberts, 1999, 207).

"The Ethic of Family Responsibility"

In 1996, the Personal Responsibility & Work Opportunity Reconciliation

Act (PWORA) created a new program called Temporary Assistance for
Needy Families (TANF), emphasizing marriage as the key institution for
economic support, rather than the state. Instead of welfare transfers, the
program "divert[ed] a substantial portion of the welfare budget to the
task of extracting child support from fathers" (Cooper, 2017, 68).

In Washington state, 39% of TANF spending goes towards prevention of

"unplanned and out-of-wedlock pregnancies" through a learning
assistance program unrelated to sex education (Kroman 2020).

Justifications for shrinking the welfare state based on "responsible"

reproduction further divert funds towards practices that maintain
reproductive and ideological control, rather than income redistribution.

The Criminalization of "Non-

Normative" Black Family Structures...

... also has its history in the post-Civil War era, where following
the failure of Reconstruction, the enaction of 'Black Codes'
created "criminal sanctions for everything from vagrancy to
out-of-wedlock childbearing and failure to support one's
children" (Cooper, 2017, 81).

This trapped Black families in cycles of poverty and

incarceration, denying them access to domestic life while
actively criminalizing their 'failure' to conform to the 'traditional
family.'

9
Fetal Harm Laws:
Why Reproduction is a Carceral Issue

Surveillance, criminal sanctions and reproductive policing

keep pace with improving technologies.

Drug use during pregnancy can be criminalized as "child

abuse, chemical endangerment of a child, and delivery of
drugs to a minor" (Guttmacher Institute, 2022).

The nature of our racist carceral system and its hyper-

surveillance of Black people inevitably leads to the
disproportionate criminalization of pregnant Black people.

Statistics on Pregnancy Policing

Currently, 25 states and the District of Columbia require

mandatory prenatal testing programs, where medical
professionals must report suspected prenatal drug use to
police (Guttmacher Institute, 2022).

Black women are more likely to be tested for drugs while

pregnant and during delivery and reported, arrested,
convicted, and incarcerated for drug use while pregnant .
A mandatory prenatal testing program implemented in
South Carolina arrested 42 women, 41 of whom were
Black. Importantly, it was only implemented in public clinics
and hospitals, and the private obstetric offices within the
same hospitals were exempted, showing the active
targeting of low-income Black patients (Paltrow et. al,
2013).

Current Implications

Reproductive policing & state control are rooted in these

historical and current practices.

Making abortions accessible on campus and within the UW-

Medicine community in Washington state is an act of economic
and reproductive solidarity. For every self-managed
medication abortion, an in-person clinic appointment is made
available to serve disenfranchised and marginalized people
both within our communities and those who have to travel from
outside of the region to access safe and affordable abortion
care.

10
 With this knowledge and
urgency in mind, what are
the next steps needed to
bring medical abortion to
UW Seattle's Hall Health?

11
 Precedent: UC Berkeley's Roadmap
How UC Berkeley students efforts to bring medication

abortion to their campus health center resulted in expanding

access to every public post-secondary school in California,

setting a precedent for the nation.

Start Local
Mobilize
In March, 2016 students at University

of California at Berkeley pass a

Support
resolution through student

government to implement

medication abortion at their

University Health Services building

on campus (Greenberg, 2017)

Authors of the legislation circulated a

Image description: five college aged femmes petition and published an op-ed in

smile at the camera with their arms around the UC Berkeley school newspaper to

each other. Photo credit: Greenberg increase awareness of their efforts

and rally support for legislation

(Warner et al., 2016)

“women and gender-

nonconforming people can
Barriers never be truly free without
reproductive justice”
The Bill authors and student -Phoebe Abramowitz
advocates encountered

financial barriers from the

director of the college health

center, and were awarded a

grant to overcome these

A Legislative
barriers. They later received

additional barriers from the

university administrators and

turned to a legislative solution

Solution
(Field-Elliot, 2018)

March 17, 2017, State Senator Connie Levya

introduces a state bill entitled “College

Student Right to Access Act” to make

State Law!
medication abortion available on all public

college campuses in the state (Greenberg,

2017).

California passes Senate Bill 24, to make

abortion by medication techniques available

on-campus student health centers at all

public postsecondary educational institutes

in the state by January 1, 2023 (Bill Text -

SB-24 , 2019).

REFERENCES
Can be found on last page
12
Image Description: Screenshot posted by feminist flag corps,
blue bold letters over an image of the trans flag say:
Reproductive Justice includes Trans Rights

“As a queer youth, I am part of growing

movement built on the important work of
feminist activists before me to better
include the multitude of experiences of
people who seek an abortion. We understand
that even when the opposition to abortion is
presented through a distinctly misogynistic
lens, we choose to fight for abortion access
inclusively and without apology.”
Marandah Rain Field-Elliot (Field-Elliot, 2018)

“People have abortions

in college because

carrying a pregnancy to

term interferes with your

education and your

future. To provide

abortion on campus is a

racial justice, economic

justice, and gender

justice move.”

-Carrie Baker, professor

of women’s studies at

Smith College

Image description: a young person with orange hair, painted nails,

and with a nose ring marches with a group of protesters carrying a
cardboard sign that says "abortion is a human right in pink letters,
and the word "human" is written so the colors of the letters depict

13
a trans flag. There are also depictions of a non-binary flag, the
scientific symbol for female, and a trans flag.
Image source: Pexels- Emma Guliani
 TS @ UW
EFFOR
What's done & What's to
come
Photo c
redit: Fe
minist F
lag Corp

'22/'23
s, instag

'21/'22
ram

UW- MEDICINE ACTION

MARCH '22, MET WITH HALL

HEALTH If UW Medicine implements the

digital consent forms outlined in
Hall health is funded mostly R-28-30, Hall Health and UW-
through insurance, so direct Medicine providers can expand
insurance reimbursement is not the access to abortion pill services
biggest issue to implementing without requiring in person visits.
MAB

As of 2021, the FDA permanently
The biggest barriers are TIME, allowed patients to receive MAB
funding, digital consent forms to pills by mail instead of requiring
offer MAB remotely through them to get them in person. They
telemedicine, and security for are still required to obtain the pills
providers at Hall Health from specially certified health

providers, but now over
telemedicine (Belluck, 2021).

MAY-JUN '22 RAPID RESPONSE TO ANTICIPATED BARRIERS

LEAKED SCOTUS DRAFT OPINION

UW- Medicine has a unique multi-state

OVERTURNING ABORTION LEGALITY
agreement in Alaska, Idaho, Montana,

Hundreds of students walked out of

Washingtin and Wyoming. This
complicates the needs of Hall Health on a
class in solidarity with abortion
access in response to the leaked grander scale both legally and financially,
Supreme Court draft opinion likely requiring state legislation and
overturning Roe vs Wade (Krieg, funding.
2022).
An open letter is distributed calling
on the UW administration to install
TAKE IT STATEWIDE

otc emergency contraception There are 11 public baccalaureate

vending machines on campus and
provide MAB through Hall Health
Over 300 students, UW employees,
healthcare providers, and faculty
sign within ten days.
institutions in the state of
Washington, and 33 public
community and technical colleges
(Colleges and Institutions in
Washington | WSAC, 2022).

On June 3, 2022, the ASUW-

Our plan is to engage a grass roots
student senate unanimously voted
ground swell campaign among
to pass R-28-30 to expand access
student governments and activists
to reproductive healthcare services
across the state.
on UW campus and was sent to

UW administration and leadership. Gather legislative support to

As of this writing, UW
administration has yet to respond
to the letter or the legislation.
beginning in January, 2023.
expand these services at public
colleges and universities at a state
level in the next legislative session

“IF YOU HAVE COME HERE TO HELP ME YOU ARE

WASTING YOUR TIME, BUT IF YOU HAVE COME
BECAUSE YOUR LIBERATION IS BOUND UP WITH
MINE, THEN LET US WORK TOGETHER.”

-Lilla Watson 14
 References
Belluck, P. (2021, December 16). F.D.A. Will Permanently Allow Abortion Pills by Mail. The New
York Times. https://archive.ph/TlaUG#selection-311.0-311.52
Bill Text - SB-24 Public health: public university student health centers: abortion by medication
techniques. (2019, 10 14). California Legislative Information. Retrieved June 7, 2022, from
https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200SB24
Cooper, M. (2019). The Ethic of Family Responsibility: Reinventing the Poor Laws. In Family
values: Between neoliberalism and the new social conservatism (pp. 67–335). essay, Zone Books.
Federici, S. (2021). The Accumulation of Labor and the Degradation of Women: Constructing
"Difference" in the "Transition to Capitalism". In Caliban and the Witch: Women, the body and
primitive accumulation (pp. 61–91). essay, Penguin Books.
Field-Elliot, M. R. (2018, February 22). I'm Trying to Make Medication Abortions Available on
California Public University Campuses. Teen Vogue. Retrieved June 7, 2022, from
https://www.teenvogue.com/story/im-trying-to-make-medication-abortions-available-on-
california-public-college-campuses
Gerstein, J., Ward, A., & Alito, S. (2022, May 3). Exclusive: Supreme Court has voted to overturn
abortion rights, draft opinion shows. Politico. Retrieved June 7, 2022, from
https://www.politico.com/news/2022/05/02/supreme-court-abortion-draft-opinion-00029473
Greenberg, L. (2017, May 16). Medication Abortion at Tang: the Power of Student Activism –
Berkeley Political Review. Berkeley Political Review.
https://bpr.berkeley.edu/2017/05/16/medication-abortion-at-tang-the-power-of-student-
activism/
Guttmacher Institute. (2021, May). The Hyde Amendment: A Discriminatory Ban on Insurance
Coverage of Abortion. Guttmacher Institute. Retrieved June 7, 2022, from
https://www.guttmacher.org/fact-sheet/hyde-amendment
Guttmacher Institute. (2022). Substance Use During Pregnancy. Guttmacher Institute. Retrieved
June 9, 2022, from https://www.guttmacher.org/state-policy/explore/substance-use-during-
pregnancy
Hamdan, A. (2018, May 6). Medication Abortion Offered on Campus: A Legitimate Need? The
Public Health Advocate. https://pha.berkeley.edu/2018/05/06/medication-abortion-offered-on-
campus-a-legitimate-need/
HISTORY. (2018, March 27). Roe v. Wade. Roe v. Wade: Decision, Summary & Background -
HISTORY. Retrieved June 7, 2022, from https://www.history.com/topics/womens-rights/roe-v-
wade
Krieg, H. (2022, May 5). Hundreds of UW Students Walk Out of Class for Abortion Access. The
Stranger. https://www.thestranger.com/slog/2022/05/05/72651527/hundreds-of-uw-students-
walk-out-of-class-for-abortion-access
Kroman, D., & Syed, M. (2020, January 23). Cash assistance for families has plummeted in WA,
even as poverty remains high. Crosscut. Retrieved June 9, 2022, from
https://crosscut.com/2020/01/cash-assistance-families-has-plummeted-wa-even-poverty-
remains-high
Lynn M. Paltrow and Jeanne Flavin. “Arrests of and Forced Interventions on Pregnant Women
in the United States, 1973–2005: Implications for Women’s Legal Status and Public Health.”
Journal of Health Politics, Policy and Law 38, no. 2 (2013): 299-343.
Planned Parenthood. (2021, September 30). Hyde Amendment. Planned Parenthood Action
Fund. Retrieved June 7, 2022, from
https://www.plannedparenthoodaction.org/issues/abortion/federal-and-state-bans-and-
restrictions-abortion/hyde-amendment
Saidiya Hartman (2016) The Belly of the World: A Note on Black Women’s Labors, Souls, 18:1,
166-173, DOI: 10.1080/10999949.2016.1162596
Sister Song. (n.d.). Reproductive Justice — Sister Song. Sister Song. Retrieved June 8, 2022, from
https://www.sistersong.net/reproductive-justice/
Roberts, D. E. (1999). The Welfare Debate: Who Pays for Procreation? In Killing the black body:
Race, reproduction, and the meaning of Liberty (pp. 202–347). essay, Vintage.
Warner, M., Khan, A., & Champlin, S. (2016, April 1). Tang services should include medical
abortions for students. The Daily Californian. https://www.dailycal.org/2016/04/01/350799/

15