Calling In the American Health Care System for Reproductive Justice: A Conversation with Loretta Ross

Interview by Jessie Liu

HHPR Senior Editor Jessie Liu interviewed Loretta J. Ross, who is an Associate Professor at Smith College. As a 2022 recipient of the MacArthur Foundation “genius” award, she is an activist, public intellectual, and a scholar. Her passion is in innovating creative imagining about global human rights and social justice issues. As the third director of the first rape crisis center in the country in the 1970s, she helped launch the movement to end violence against women that has evolved into today's #MeToo movement. She also founded the first center in the U.S. to innovate creative human rights education for all students so that social justice issues are more collaborative and less divisive. She has also deprogrammed members of hate groups leading to conceptualizing and writing the first book on "Calling In the Calling Out Culture" to transform how people can overcome political differences to use empathy and respect to guide difficult conversations.

She started her career in activism and social change in the 1970s, working at the National Football League Players’ Association, the D.C. Rape Crisis Center, the National Organization for Women (NOW), the National Black Women’s Health Project, the Center for Democratic Renewal (National Anti-Klan Network), the National Center for Human Rights Education, and SisterSong Women of Color Reproductive Justice Collective, until retiring as an organizer in 2012 to teach about activism.

Her most recent books are Reproductive Justice: An Introduction co-written with Rickie Solinger, and Radical Reproductive Justice: Foundations, Theory, Practice, Critique. Her forthcoming book is Calling In the Calling Out Culture due out in 2022.

She has been quoted in the New York Times, Time Magazine, The Los Angeles Times, and the Washington Post, among others. Her website is www.LorettaJRoss.com.

JL: First of all, thank you so much for joining me today. It's an honor and pleasure to have you here speaking with me. We'll start with a bit of a broader overview of your work: in 1994, you were responsible for helping to design the reproductive justice framework, which has three key tenets—the right to have a child, the right to not have a child, and the right to parent children in a safe and healthy environment. What would you say led you to this work and what inadequacies did you perceive or observe in existing social justice and women's movements?

LR: Well, I could start with my childhood, as I certainly did not have the opportunity to grow up. But I was suffering childhood sexual abuse, a pregnancy through incest. And because I chose to keep my son, I ended up co-parenting with my rapist. And so that probably is the fundamental rationale for why I do all reproductive justice work anyway. Because I think girls should grow up without experiencing childhood sexual abuse. Yet, I couldn't decide if and when I had sex, or even when I had a baby once I had sex. So that draws me into the work.

JL: What would you say, then, about 1994 specifically?

LR: Well, in 1994, I wasn't even working at a women's rights organization. I was monitoring hate groups like the Ku Klux Klan at the Center for Democratic Renewal’s national anti-Klan network. I'd been invited to attend a conference in Chicago, organized by the Illinois Pro Choice Alliance, and the Ms. Foundation gave scholarships to a number of women of color to attend. And so it was at that conference, where we heard a presentation by the Clinton administration on how they were going to propose health care reform without reproductive health care. That kind of pissed us off as black women, because reproductive health care is the main reason women go to the doctor. Coming to a feminist conference and being expected to line up behind a very male-centric health care plan didn't make sense to us. So that's why we ended up strategizing in one of our hotel rooms and created the concept of reproductive justice there.

JL: And how would you say this was informed or in response to some of the other popular feminist movements of the time?

LR: Well, we didn't do it to respond to the feminist movement. As I very famously say it, if we were responding to what white women did, we would have had to put them in the center of the lens. We put ourselves in the center of the lens—it really wasn't about them at all. We asked what we want from health care reform. Part of the rationale that we felt that the abortion rights movement as well as the pro-life movement had, was that they always start with the pregnancy. And they never prioritize what's going on in a woman's life before she's pregnant, whether she's dealing with economic insecurity or violence in her life, or if she’s at risk of being pushed out of school if she can’t get an abortion; you need to pay attention to what's been going on in her life previously, before the pregnancy. And both the pro-choice and pro-life people start with the pregnancy. Well, we felt that you need to start upstream. Because if a person has bad answers to all those life challenges, they're going to turn an unplanned pregnancy into an abortion. But if they have good answers to their life's challenges, then they're likely going to turn an unplanned pregnancy into a baby. We need to focus on human rights issues in the person's life before they even become pregnant.

JL: With this goal in mind, based on your observations as a human rights activist, what do you think has changed or stayed the same in this kind of discourse from the time when you began your work and founded SisterSong, to the present?

LR: One of the most profound changes I've seen, and I think this is due to SisterSong, is that women of color feel like we finally have our rightful place in the movement. Rather than just being sidekicks, we own this movement. When SisterSong organized our first national conference on women of color and reproductive rights, we expected 200 women of color to show up—600 did. And so that was at a time when a lot of pro-choice organizations claimed that they couldn't find women of color to work with. We’re like, “Oh, we got ‘em.” The quality and quantity of women of color engaged in this work has changed.

I see the partnerships between women of color organizations and the pro-choice organizations evening, getting stronger, becoming more equal. Because there are certain times when white women need to step back, and we need to step forward. Like when there's a race-based or gender-based ban on abortion. We've had to school white women on when they needed to step back, and we needed to step forward. So that's strange, because previously, the white women thought they needed to dominate every conversation on reproductive politics, when they weren't the right messengers or the right voices for some of this stuff. The absolute proliferation of women of color organizations doing this work has also changed. Before, when we founded a SisterSong, we brought together four Native American, four Latina, four API, and four black organizations. Within a decade, we had to open up our ranks, because that structure didn't work anymore. There were far more women and men doing the work.

JL: On that note of change, I've noticed you have recently turned your attention more towards social media and our civil discourse. And more specifically, you teach about cancel culture at Smith College and you have a forthcoming book titled Calling In the Calling Out Culture. What does “calling in the calling out culture” mean?

LR: Calling in is a process of accountability that, instead of using anger, blaming, and shaming people as a way to achieve accountability, it chooses to use love and respect. So you're still pursuing accountability, but you're pursuing it without dehumanizing the person that you're trying to hold accountable. Because the first method of anger, blaming, and shaming is quite punitive, and it replicates the prison-industrial complex, where you're trying to disappear the person that has made the mistake, in your opinion, and you want to socially exile them or silence them. Calling in is a way to pursue accountability without excommunicating them from the community.

I'm concerned about people who think they're doing the right thing, but they're going about it the wrong way, because I don’t think they're doing it out of maliciousness. They actually think they're supposed to hold our social justice organizations to a standard, which is not wrong. You remember the outpouring of outrage when Trump was elected in the Women's March of 2017? And then within a few short months, they were destroying each other from within? Because, you know, everybody thinks they have the answer—and that kind of attitude is always my concern. When you're more invested in being right than being collaborative and in unity, your ego is why you're doing the work, not your willingness to serve the people.

JL: As we're talking about keeping progress in sight, I’d like to return to one of the key moments that you cited as part of your life and career, namely your experience with the Dalkon Shield IUD, which is a clear example of sterilization abuse. Thinking about that, what do you envision the role of medical professionals and institutions to be in this reproductive justice movement, as you see it moving forward?

LR: Well, as you know, there's a reproductive health section, which deals with individual providers, serving individual people, and this reproductive rights section, which is the pro-choice movement organizing to protect or defend abortion rights. And then there's the reproductive justice wing, which is the human rights-based organizing framework. So going back to the reproductive health sector and individual providers—doctors, nurses, midwives, doulas—one of the problems that I have is the way that we provide medical training in our society dehumanizes students with brutal hours, unreasonable expectations, and extraordinary costs. If you dehumanize somebody in their training, why do you think they're going to rehumanize themselves when it comes to serving clients? If you failed to protect their human rights as they were being trained, how do you expect them to protect someone else’s human rights once they graduate? I offer a critique of how we even constitute medical training in this capitalist society. This is all designed to keep the number of providers low, so that they can charge top dollar for their services, as opposed to democratizing medical information and medical services, so that everybody participates in creating a healthy community.

JL: Going back to the idea of health policy, how do you think changes in health policy might also help to achieve steps towards reproductive justice, health, or any of the sectors? And where do you believe activists’ energy might be best directed?

LR: I believe that this situation will not change without universal health care. It's just ridiculous. That here we are, an industrialized country, paying billions of dollars for health care, and still too many people don't have access to it. Those of us who have health insurance find it unaffordable. I just had some dental work that cost me $6,000 the other day, because Medicare only pays up to $200 of that. Now I have health insurance, but what would have happened to my teeth if I hadn't been able to pay that $6,000? Dental problems can lead to all kinds of infections—people die from bad teeth.

We’ve also got to deal with pharmaceuticals and their pricing. I’m paying between $1,100 and $1,200 a month for my insulin. When I retired from SisterSong, I didn't have health insurance. And I didn't become Medicare eligible for three years—and my son had to scramble to keep his mama alive.

The healthcare delivery system is a joke when it comes to accessibility, affordability, and patient-centered care. I'm convinced that the compassion and humanity is drummed out of people in medical school and nursing school. And yet, they're supposed to recapture that once they graduate and finish that residency. How's that supposed to happen? Because they’ve got all this money to pay off, they’re required to see people as cogs in their student debt system, they don't have time to spend time with any one patient—I mean, it's just designed to deliver such stark medical care. So we need a revolution in values, so that people know that healthcare is a human right, not just something for those who can afford it.

Then, it's not even guaranteed that if you can afford it, you're going to get great health care. I mean, look what happened to Serena Williams, she can afford the best health care and they still didn't believe her when she was talking about a pulmonary embolism in her body. So yeah, believing patients is another issue.

JL: Indeed, I think there are many future directions that we do need to take when moving forward on this. As we’re wrapping up, I’d like to congratulate you for being named a MacArthur Fellow! How do you feel about this, and how do you plan to use the grant?

LR: Well, that's actually in the same conversation. Since I've worked in the nonprofit world for 50 years, I don't have a pension and I don't have a long-term care plan. So I'm being very practical with this MacArthur grant; I'm stocking away enough money so that if I end up in a nursing home or needing home health care, I can afford to pay for it without selling my house. Because so many of my friends work all their lives to get a piece of real estate to sell out, try to leave a legacy for their descendants, and then they have one health crisis, and it's all gone. So I'm pleased that it provides somewhat of a cushion for dealing with that.

JL: That's a wonderful thing to have. Is there anything else you'd like to add, any stories you'd like to share that you really think should be highlighted when we're speaking within the context of health policy and reproductive justice?

LR: Well, the thing that I'm most impressed with is the fact that young people in general, and young women in particular, are realizing what is at stake for their bodies. Fighting over the reproductive rights of an old woman like me? It’s the people who are still fertile, their bodies are the battleground. And I'm glad that young people are increasingly becoming aware of that.