Lack of reproductive care spotlighted

“If you want to get rid of abortion, you darn well better make sure there’s a ton of family planning ... . ”

Johanna Caicedo pays regular visits to metro Atlanta’s Latin American consulates. There, she initiates conversations with immigrant women about reproductive health care and family planning — something she says many have limited access to.

“Their socioeconomic status is just like either they pay for their rent, for their food, or they go and get birth control,” Caicedo said. “Most of these families, you know, they have unplanned pregnancies.”

Although Caicedo works mostly with unauthorized immigrants, a mostly Hispanic population, advocates say barriers to reproductive health care exist across marginalized immigrant communities, including groups with legal status such as refugees. Changes to the state’s abortion law could further restrict and complicate their choices.

“People should have the freedom to pursue whatever they think is right for them … but all the barriers to access health services are very real, like transportation, income, language, understanding of the processes,” said Gigi Pedraza, executive director of the Latino Community Fund Georgia.

Caicedo’s consulate visits are part of her work with another group: the Lifting Latina Voices Initiative (LLVI), which bills itself as the “only Latinx-led program in Georgia that focuses on addressing comprehensive reproductive and sexual health issues faced by Latinx families.” Caicedo’s goal is to dispense sexual health education and raise awareness for the services offered at LLVI’S parent organization, the Atlanta-based Feminist Women’s Health Center. Those range from birth control prescriptions and gynecological examinations to testing for sexually transmitted diseases and abortions.

Caicedo says that the immigrant women she works with are unable to access the tools needed to control the timing of their pregnancies for several reasons, including limited income, limited English proficiency and a lack of both legal immigration status and health insurance.

Many of those socioeconomic factors would also keep abortion disproportionately out-of-reach for these women if Georgia issues abortion restrictions that make travel outside the state necessary to access the procedure in the aftermath of the U.S. Supreme Court’s overturning of Roe v. Wade.

“We continue encountering a lot of moms who will say, ‘I don’t want to have more kids, but I cannot afford to go to a gynecologist to get pills or get any contraceptive method,’” Caicedo said.

Pedraza says the Latino Community Fund is “really close” to the issue of reproductive health care — and the barriers restricting access to it — because a majority of the community members LCF Georgia works with are women.

“It really is fascinating when you realize that a huge number of our community members do not even know about birth control [options]” she added. “We have to also remember that a lot of our communities come from very [male-dominated] systems in which limiting information and access to birth control and reproductive health care, it’s a way of oppression.”

Given those pre-existing barriers to reproductive health care, the likely implementation of a six-week abortion ban in Georgia will narrow down immigrant women’s options even more and “affect our communities significantly,” according to Pedraza.

In a statement, Georgia’s largest Asian American civil rights organization, Asian Americans Advancing Justice-atlanta, called the Supreme Court decision “devastating” for women’s right to choose.

Nationwide, women of color account for a disproportionately high share of abortions, according to data from the Centers for Disease Control and Prevention. In Georgia, non-white women accounted for 79% of all abortions in 2019, the most recent year for which data is available.

As most states bordering Georgia are also expected to sharply restrict abortions, long journeys will be required for Georgia women who learn of their pregnancies only after it’s too late to get an abortion at home.

According to the Guttmacher Institute, a research nonprofit that supports abortion rights, the average one-way drive for a Georgia woman to get an abortion will increase from 17 to 203 miles. The nearest state that’s expected to continue to allow abortions will be North Carolina.

“They would be driving without a driver’s license and risking detention and possibly even deportation,” Pedraza said.

Undocumented Georgia women’s limited autonomy over their reproductive decisions made national news in 2020, when detainees of a South Georgia immigration jail said they were pressured into unwanted hysterectomies. The federal government moved all its immigration detainees out of that facility last fall.

Refugees also impacted

Struggles accessing reproductive health care aren’t limited to immigrant women without legal status. Advocates such as Hogai Nassery say refugee women have issues of their own.

Last fall, in the wake of the Taliban takeover in Afghanistan, Nassery co-founded the Afghan American Alliance of Georgia (AAAGA).

Nassery says many of the refugee women the AAAGA supports have expressed an interest in birth control, but they are not aware of the reproductive health care services and resources available to them. That’s despite the fact that their status as refugees

means they are more likely to be insured and have access to a primary care provider.

“There’s a lot of stigma,” Nassery said. “People say, ‘Well, they need to talk to their primary care doctor.’

To me, that’s basically punt- ing the issue. First we need to actually create a dialogue and make them aware that this is an option.”

Efforts to raise awareness about family planning tools will gain significance in a post Roe v. Wade Georgia.

“If you want to get rid of abortion, you darn well better make sure there’s a ton of family planning everywhere,” Nassery said. “It has to be easy to access, affordable, safe.”

Nassery says she would like to see local health departments invest in outreach efforts focused on reproductive health and specifically targeted to immigrant communities. Vanesa Sarazua agrees. She is the founder and executive director of Hispanic Alliance Georgia, a nonprofit based in Gainesville that aids immigrants.

If access to contraception doesn’t expand as new abortion restrictions kick in, Sarazua says some of the women she works with would seek to termi- nate pregnancies in illegal and potentially hazardous settings.

“Since the beginning of times, women have done what they felt they needed to do to best take care of themselves,” she said. “In general, when it comes to women’s health, what we’re doing right now is going backwards.”

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HYOSUB SHIN/HYOSUB.SHIN@AJC.COM Protesters march in June to protest the decision to overturn Roe v. Wade in Atlanta. Undocumented women’s limited autonomy over their reproductive decisions in Georgia made national news in 2020, when detainees of an immigration jail said they were pressured into unwanted hysterectomies.