UN Body Urges U.S. to Ensure Abortion Access and Culturally Respectful Maternal Health Care in Efforts to Eliminate Racial Discrimination

The UN Committee on the Elimination of Racial Discrimination (CERD) has issued a report urging the United States to ensure abortion access and culturally respectful maternal health in efforts to eliminate racial discrimination. 

The August 30 CERD report came after U.S. reproductive rights, health, and justice advocates presented their concerns to CERD about maternal health inequalities and the impact of abortion restrictions in U.S. communities of color.  

The advocates’ presentation—held in Geneva Switzerland in August—provided reports and testimony about pervasive obstacles to comprehensive and non-discriminatory reproductive health care and urged the CERD to hold the U.S. accountable for failing to uphold its treaty obligations. 

The presentation took place as part of a periodic review of the U.S.’s progress on eliminating racial discrimination under the International Convention on the Elimination of All Forms of Racial Discrimination (ICERD). As a party to the ICERD, the U.S. is required to implement the treaty and to undergo periodic reviews of its progress.

The CERD’s report on the U.S. review concluded that “systemic racism along with intersecting factors such as gender, race, ethnicity and migration status have a profound impact on the ability of women and girls to access the full range of sexual and reproductive health services in the State party without discrimination.” 

“The current rollback of abortion rights and access in the U.S. undermines the health and self-determination of Black, Indigenous and other communities of color,” said Monica Simpson, Executive Director of SisterSong Women of Color Reproductive Justice Collective, from the floor of the UN. “It is a form of racial discrimination that allows predominantly white politicians and other decision makers extraordinary power over the lives, families, and health outcomes of people of color.”

U.S. Delegates Represented an Array of Reproductive Health, Rights, and Justice Organizations

The reproductive rights, health, and justice delegation present at the 2022 CERD review of the U.S. included Black and Indigenous midwives, doulas, community organizers, reproductive health policy experts and educators, and leaders in abortion and maternal health care who have been directly impacted by U.S. laws, policies, and practices that violate reproductive rights. (See the list of the full delegation below.)

In addition to statements offered during briefings between the Committee and NGOs, Breana Lipscomb moderated a side briefing for CERD members focused specifically on sexual and reproductive health and rights conditions in the U.S. Lipscomb is based in Georgia and leads the Center’s U.S. maternal health advocacy work as Senior Advisor, Maternal Health and Rights.

Erin Grant, Deputy Director of the Abortion Care Network, discussed the impact of the U.S. Supreme Court’s decision overturning Roe v. Wade on independent abortion providers and the communities they serve. Jamarah Amani, Midwife and Co-Founder/Director of the National Black Midwives Alliance, and Nicolle Gonzales, Midwife and Founder of Changing Woman Initiative, described how Black and Indigenous communities have been denied the right to not only access comprehensive, respectful reproductive health care, but also to provide it within their own communities. Unlike many other countries that value and integrate midwifery care, the U.S. health and legal systems have marginalized midwifery and midwives of color in particular, with devastating consequences.  

“In order to eliminate racial discrimination and disparate outcomes in maternal health care, […] the U.S. government must build up the perinatal workforce and create more Black and Indigenous providers, such as obstetricians, midwives, and doulas that support education, birth center development, and a living wage,” said Chanel Porchia-Albert, Founder and CEO of Ancient Song Doula Services.

Coalition Urged CERD to Condemn Violations of Reproductive Rights in Review

As part of this review process, the delegation and a broad coalition of organizations also submitted a report to CERD titled Systemic Racism and Reproductive Injustice in the United States. The report evaluates U.S. progress on the human rights commitments it made when it ratified the ICERD.

Drawing on the experience and expertise of the coalition organizations, the report recommends that the U.S. government take the following steps:

• Ensure the meaningful participation of women of color in all decision-making processes that impact their reproductive health.
• Remove barriers to accessible, high quality, comprehensive reproductive health care.
• Address and eliminate racial and intersectional discrimination in reproductive health care settings, including birthing facilities and criminal and immigration detention settings.
• Ensure that communities of color can access and provide culturally aligned services that improve maternal health, including midwifery and doula care.
• Halt and remedy retrogression of the right to abortion, and ensure abortion access.
• Address the impact of environmental racism on reproductive health.

CERD Questions U.S. Government about Efforts to Remedy Harm Caused by Discrimination in Maternal Health Care and Bans on Abortion

After hearing from advocates about the grave inequities in maternal health care and outcomes, as well as the profound and disparate impact of abortion restrictions in communities of color, the CERD engaged U.S. government officials in dialogue about these violations.

During the review of the U.S. on August 12, members of CERD inquired about the impact of intersectional discrimination and systemic racism on the sexual and reproductive health and rights of women and girls of color and steps that the U.S. has taken to safeguard rights. Noting that Black and Indigenous women already face high rates of maternal mortality and barriers to reproductive health care, a CERD member asked the U.S. government to explain “what steps have been taken to address the profound and deadly impact” of the Supreme Court ruling in Dobbs v. Jackson Women’s Health Organization, including steps to address interstate travel and criminalization risks.

Another CERD member noted the importance of ensuring that Black and Indigenous people have meaningful options for accessing abortion and midwifery care and asked the U.S. if it had taken “any measures to integrate traditional community-based and culturally respectful medicine in the health system?”

CERD Recommends the U.S. Implement Solutions Offered by Reproductive Rights, Health, and Justice Advocates and Follow Guidance of the WHO

In its report, the CERD recommends that the U.S. take “intersectional and culturally respectful” approaches to improving maternal health in Black and Indigenous communities, including access to midwifery care.

The report further recommends the U.S. take “all necessary measures” to address the “disparate impact” of the Dobbs decision, “provide safe, legal, and effective access to abortion,” “mitigate the risks faced by women seeking an abortion and by health providers assisting them,” and ensure that they are “not subjected to criminal penalties.” In recommending the U.S. provide abortion access “in line with” international human rights obligations, the CERD draws the U.S.’ attention to the World Health Organization’s abortion care guidelines.

“It was an emotional moment to hear the CERD express deep concern over the retrogression in reproductive rights and the persisting harms on Black and Indigenous birthing people in the U.S.,” said Lipscomb.  “The time is now for the U.S. government to correct course and restore access to abortion care and community-based, culturally respectful midwifery care. Black, Brown, and Indigenous women have been fighting for our freedom and bodily autonomy throughout the United States’ entire history. We will not stop holding the government accountable to protect our right to health.”

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Full Delegation of U.S. Advocates:

• Monica Simpson, Executive Director of SisterSong Women of Color Reproductive Justice Collective
• Leah Jones, Deputy Director of SisterSong Women of Color Reproductive Justice Collective
• Erin Grant, Deputy Director of the Abortion Care Network
• Nicolle Gonzales, Midwife and Founder of Changing Woman Initiative
• Shayai Lucero, Board President of Changing Woman Initiative
• Jamarah Amani, Midwife and Co-Founder/Director of the National Black Midwives Alliance
• Chanel Porchia-Albert, Founder and CEO of Ancient Song Doula Services
• Dr. Joia Crear-Perry, MD, FACOG, Founder/President of the National Birth Equity Collaborative
• Ana Barreto, Director of Transnational Birth Equity at the National Birth Equity Collaborative
• Jade Below, Program Associate, Transnational Birth Equity at the National Birth Equity Collaborative
• Nicole Martin, Sex Educator and Organizer at Indigenous Women Rising
• Breana Lipscomb, Senior Advisor, Maternal Health and Rights for the Center for Reproductive Rights
• Pilar Herrero, Senior Staff Attorney on the Center for Reproductive Rights’ U.S. human rights team