On November 15, 2018, the International Women’s Health Coalition (IWHC), together with more than 100 organizations, announced a coordinated policy vision of bold action, for the present and future, on sexual and reproductive health and rights. The vision statement is the first of its kind, and the first step in an unprecedented, collective effort to work towards policy change in several key areas, including health care access and coverage; abortion access and rights; youth health and rights, and sex education; healthy pregnancies; health care refusals; judicial nominations; clinic security; immigrants’ access to health care; supporting access to providers; sexual and reproductive health in delivery system reform; research and development; and global reproductive health.
A complete policy agenda, with legislative and administrative recommendations, will be released publicly in spring 2019.
A Call for Change: Putting People’s Health and Rights First
We, the undersigned organizations, declare our unity and dedicate our collective power to protecting and advancing sexual and reproductive health, rights, and justice in the United States and around the world. We come together to outline our vision for the future – and to draw the unbreakable link between that vision and the domestic and global policy goals that must be achieved to make it a reality.
We are committed to building a world where a person’s health doesn’t depend on who they are, how much money they have, or where they live. Every person has the basic human right to quality health care, and no individual or community should be left behind. Each of us should have the chance to live safe, healthy lives and be free to determine our own path—including if, when, and how to create a family. Each of us, too, should be able to raise and care for children with dignity and freedom from violence, discrimination, or denial of our basic human rights and needs.
Unfortunately, too many politicians at the federal and state level have been taking us in the wrong direction. From unprecedented efforts to undermine sexual and reproductive health and rights worldwide to attacks on health care in the United States, politicians have threatened to reverse decades of progress and have left countless individuals and families unable to get the care they need. We especially reject and condemn the attacks the Trump administration has launched against the humanity of women, Black people, Latinxs, Asian Americans and Pacific Islanders (AAPIs), Indigenous peoples, lesbian, gay, bisexual, transgender, gender non-conforming, and queer/questioning (LGBTQ) people, immigrants, people of the Muslim faith, and non-Muslim religious minorities, among others.
Our nation and our world cannot afford this dangerous trajectory. People across the country have made that clear. In the 2018 election, tens of millions of people—led by women of color and young people—cast their votes against these harmful policies. The election results are all the more striking given the intense and rampant voter suppression targeting people of color, Indigenous people, young people, incarcerated people, and people with disabilities. The people of this country have sent a strong message that we are ready for the attacks and the divisiveness to stop, and more than that, we are ready for positive, transformative change.
We call on policymakers across the country to reach toward progress for all people—rooted in the reality that sexual and reproductive health and rights are inextricably linked to economic justice, voting rights, immigrants’ rights, LGBTQ liberation, disability justice, and the right to community safety and racial equity. We represent people in all U.S. states and territories, from every part of life, and we call on policymakers to:
- Protect and expand access to sexual and reproductive health care;
- Safeguard and advance abortion rights and access;
- Foster fairness and equity in sexual and reproductive health; and
- Promote health, safety, and wellness for all communities.
Protect and Expand Access to Sexual and Reproductive Health Care
For too many people, access to sexual and reproductive health care is pushed out of reach by policies that discriminate based on income, race, sex (including sexual orientation, gender identity, and gender expression), disability, immigration status, or zip code. Millions across the U.S. and throughout the world are denied access to birth control and abortion because the only health care facility in their area refuses, or is prohibited from, providing such information and care. The majority of these barriers have been erected because too many policymakers put politics over people’s health and well-being. They can only be torn down by leaders who are ready to put people first, especially those people who have faced systemic and discriminatory barriers to care, including women, people with low incomes, people of color, immigrants, LGBTQ people, Indigenous peoples, people with disabilities, young people, rural communities, and people living in the Global South.
All people should have access to affordable, quality health care and as a part of that, access to health care providers that meet their needs, including their sexual and reproductive health needs. In the past two decades, we have made significant progress in improving health access through policies rooted in that principle, like the Affordable Care Act (ACA) and the Sustainable Development Goals adopted by 193 countries, including the United States. As attacks on that progress continue, lawmakers must not only defend those gains but urgently push for policies that are designed to ensure equitable access to health.
Ensure all people have quality, affordable health insurance coverage. That includes coverage for the full range of sexual and reproductive health care—including counseling and care for all contraceptive methods, infertility care, pre- and post-natal care and childbirth care, abortion care, STI prevention and treatment care, and care for reproductive cancers. It also includes coverage for gender-affirming care for transgender people. We must build on the success of the ACA to advance the goal of universal access.
Ensure all people have access to the quality health care providers they trust. Policymakers must work to protect people’s access to community providers, including Planned Parenthood health centers and independent abortion care providers. More than that, policymakers must proactively work to expand access to these community-based providers. For too many people, quality sexual and reproductive health care is out of reach because investments have not been made to ensure strong points of care—investments that will be all the more important with the looming reproductive health provider shortage, rural hospital closures in the U.S., and ongoing shortages of trained providers in the Global South. Diversifying the reproductive health workforce is also a critical factor in improving access to quality care.
End policies that allow health providers to refuse to provide care on the basis of personal beliefs. Hospitals, pharmacies, insurance companies, and other providers must not be allowed to use religious beliefs to dictate patient care, including by denying sexual and reproductive health information and care, including birth control, abortion, gender-affirming care, miscarriage management, and infertility treatment, among other services. Freedom of religion is a right that must extend to all, and religious beliefs must not be used to harm or discriminate against others.
Invest in research, innovation, and groundbreaking programs focused on expanding access to, and making progress toward equity in, sexual and reproductive health care. Launch new, cutting-edge sexual and reproductive health programs designed to support essential research, to facilitate the development of new contraceptives and other products, and to support sexual and reproductive health providers in their efforts to build new centers, to adopt and leverage new technology, and to expand access to care more broadly. These investments and initiatives should reflect the reality of how all patients—including but not limited to women of color, LGBTQ people, low-income people, Indigenous peoples, people with disabilities, people in the Global South, and immigrants—experience health care systems.
Tackle public health issues with vigor and a commitment to social justice and health for all. Lawmakers must aggressively leverage the power of policy to address public health issues that for too long have been met with inadequate, tepid responses from federal, state, and local governments. One of the most unconscionable public health issues is maternal and infant mortality and morbidity. Another is the disparate mortality rates in gynecological cancers, a public health and human rights crisis in the U.S. and around the world. Policymakers must address these issues head-on by developing solutions that center the needs of Black women in the U.S., women in the Global South, and other women living in conditions of marginalization, who are by far the most impacted.
It is also essential that lawmakers develop new policies to address the HIV epidemic and specifically incorporate strategies designed to better meet the prevention, care, and treatment needs of communities most impacted by the epidemic in the U.S. and around the world, including young men who have sex with men (MSM), women, adolescent girls, and transgender and gender non-conforming people. Of course, public health issues are often intersecting, and whether addressing substance use disorder or lack of access to mental health services, it is critical that policymakers consider the unique health care needs of those most impacted.
Safeguard and Advance Abortion Rights and Access
The ability to decide if, when, and how to have children or grow a family is fundamental to personal autonomy, overall health and well-being, and economic security. Access to abortion is not only a right, it is essential to a person’s ability to control their body, their life, and their future. That’s why the vast majority of people in the United States support access to safe, legal abortion care. Despite this, politicians have spent decades passing state and federal laws, including Executive Orders, to severely restrict access to it—restrictions that disproportionately harm people who already face unjust barriers to care. Now is the time to not only roll-back those indefensible restrictions but to advance a new policy vision focused on ensuring all people have the freedom to control our own bodies and destiny.
Champion abortion access. Lawmakers must promote policies that ensure all people have access to abortion, wherever a person lives in the United States or around the world. This includes advancing policies that ensure abortion care is safe, legal, available, and affordable. It means passing laws and policies that expand access to providers that offer abortion care, especially laws and policies that are focused on creating access in the 90 percent of U.S. counties that currently lack an abortion-providing clinic and in the six states where currently there is only one provider in the whole state. It means ensuring that people who access health care from U.S. funded programs around the world can count on accurate, comprehensive, rights-based, and non-stigmatizing information, counseling, referrals, and services for the full range of needs, including abortion. It means ensuring patients and providers can access and deliver abortion care without experiencing discrimination, stigma, intimidation, harassment, or violence. Seeking and providing health care shouldn’t put a person at risk.
In addition, no one should fear arrest or prosecution because of a pregnancy outcome. When a person decides to end a pregnancy, whether they go to a provider or manage their own abortion, they should be able to do so safely and with dignity—and without fear of arrest, jail or investigation.
Ensure coverage for abortion care in the U.S. & abortion access abroad. Policymakers must ensure people have access to safe abortion services—whatever a person’s income, zip code, immigration status, or source of insurance or care. That work must start by eliminating existing coverage and access restrictions. Abortion coverage and access bans—including restrictions such as the Helms amendment in foreign aid, the Hyde Amendment in health insurance programs, and state-level bans on abortion coverage—are designed to entrench discrimination and inequality related to race, income, and gender. Withholding coverage and funding for abortion creates lifelong hardships, especially for people already struggling to access health care, such as people with low incomes, immigrants, young people, transgender and nonbinary individuals, people of color, and people living in the Global South.
End laws that impose barriers to abortion care. Policymakers must work to end restrictions that deny or delay access to abortion care. Those restrictions include forcing health care providers to give patients medically inaccurate information and adhere to medically unnecessary health care facility requirements. They include restrictions that force patients to have medically unnecessary ultrasounds, that deny young people the ability to make their own decisions about pregnancy without parental involvement or political interference, and that require mandatory waiting periods, all of which disproportionately impact women of color and immigrants. Congress must also work to end policies that block aid to foreign organizations that use their own, non-U.S. funds to provide information, referrals, or services for legal abortion or to advocate for access to abortion services in their own country.
Fostering Fairness and Equity in Sexual and Reproductive Health
Health inequities prevent the opportunity for all people to prosper. In order for the health care systems in the U.S. and around the world to foster fairness and equity, sexual and reproductive health care must become integrated into the health care system in a way that respects all identities including those associated with income, race, sexual orientation, gender identity, gender expression, immigration status, national origin, Indigenous identity, ability, and age. While significant progress has been made to improve access to health care and promote human rights for all, disparities and inequity have grown both between and within countries, leaving too many communities behind. By centering the unique experiences and needs of those most harmed by inequity—no matter who they are or where they live in the world—U.S. policymakers can make a significant contribution to promoting health and wellness for all communities.
Secure affordable health coverage regardless of immigration status. Access to care must be accessible and available regardless of citizenship, immigration, or visa status. Federal restrictions unjustly bar immigrants from accessing public benefits and private insurance.The stakes are even higher for undocumented immigrants, many of whom forgo care instead of risking deportation when visiting a health care provider. Removing policy and legal barriers to immigrants’ ability to obtain affordable health insurance coverage would advance the health and economic well-being of immigrant women, their families, and society as a whole.
Ensure nondiscriminatory, culturally-competent health care for all people. Policymakers must work to ensure all people have access to culturally competent care and are treated with dignity and respect. For many people of color and immigrants, access to quality care includes not only language access for those who have limited English proficiency but also culturally and clinically competent care that recognizes and responds to the different values, preferences, beliefs, and needs of individuals from diverse cultural backgrounds. Additionally, LGBTQ people must have access to culturally competent care that respects their identities and specific needs. Women with disabilities must be supported to make the reproductive health care decisions that are right for them.
In addition, policymakers must actively work to address the discrimination people face in health care based on their race, income, immigration status, health status, disability or HIV status, and sex (including based on sexual orientation, gender identity, and gender expression). Racism and provider bias is the health care system is a continued challenge for too many people who are simply trying to access care in the respectful and appropriate manner that everyone deserves.
Ensure young people are supported. Our nation’s leaders must demonstrate a clear commitment to young people’s sexual and reproductive health and rights in the U.S. and around the world by affirming their right to sexual and reproductive health information, including comprehensive sexuality education and confidential health care services that are LGBTQ-inclusive. That commitment must be centered on ensuring young people have the resources and tools to lead and live healthy lives, as well as their right to parent with dignity. In addition, it is critical that youth-serving federal programs provide confidential and nondiscriminatory access to comprehensive and accurate information, health care, and education, and address barriers to access, like parental notification and family participation requirements, which may cause more harm than good.
Ensure the integrity and fairness of executive agencies and federal courts. Equity in health care cannot be realized without executive agencies and federal courts committed to enforcing the law and protecting the civil and legal rights of all people. Nominees must be principled, with a demonstrated commitment to justice, civil rights, equal rights, individual liberties, and the fundamental constitutional rights of equal protection, liberty, due process and privacy, including the right to abortion.
Promote Health, Safety, and Wellness for All Communities
Health and wellness can only be achieved by making progress throughout complex and interrelated systems and by addressing societal, environmental, and social factors that impact people’s health. Indeed, policies intended to promote and protect access to health care will not be successful without centering the experiences of people with low-incomes, women, immigrants, people of color, adolescents and youth, LGBTQ people, Indigenous people, people living in the Global South, people with disabilities, and people living with HIV, among others. For too many in these communities, a broad range of barriers—including inadequate wages, stigma, discrimination, lack of affordable housing, safe and affordable water and sanitation, and transportation, lack of paid leave, lack of childcare, and the threat of criminalization, detention, and deportation—interfere with their health.
Foster economic opportunity for all families. Everyone has the right to achieve the life of their choosing and to adequately care for themselves and their families. Policymakers must support the right of all individuals to have fair opportunity for educational and career success. Everyone worldwide should have access to a high-quality education free from barriers and school violence. In addition, policymakers should ensure basic living standards through investments that support financial, housing, and nutrition access. They must also support policies that address race and gender pay gaps, particularly for women of color—and support the passage of strong, inclusive, and sustainable paid family and medical leave plans that meet the needs of new parents (including young parents), seriously ill family members, and workers with serious health issues and disabilities. Related, policymakers must fully ensure women are not penalized in their work and careers as a result of pregnancy.
Support and develop healthy and safe environments. Every person has the right to a healthy environment that is free from toxic chemicals and includes affordable affordable access to clean drinking water, wastewater services, and safe food. Everyone has the right to know that the products they use are safe and to have information about what is in those products. Policymakers must work to build healthy and safe environments for all communities, with a focus on low-income communities in the U.S. and throughout the world who have been disproportionately harmed by environmental degradation and climate change. Additionally, the overall health and wellbeing of people across the globe is dependent on policymakers aggressively and quickly addressing the climate crisis, which has devastating effects on health, food, and livelihoods—disproportionately affecting women, children, adolescents and young people, Indigenous peoples, people in the Global South, and people of color.
Ensure all communities are free from violence. Policymakers must protect the rights of all people in the U.S. and around the world—including but not limited to Black people, immigrants, LGBTQ people, Indigenous peoples, religious minorities, people with disabilities, and young people—to live and raise children free from violence, including gun violence in schools and community institutions, gender-based violence, sexual harassment and gender-based violence in the workplace, state violence, and violence imposed through the criminal justice system. In addition, for people held in jails, prisons, and detention centers, policymakers should ensure access to comprehensive health care and to continue family visits and contact. That includes ensuring women, transgender and nonbinary individuals, young people, people with disabilities, and people of color who are incarcerated or in immigration detention facilities have access to reproductive health care, including abortion, contraceptives, non-criminalized prenatal and childbirth-related health care, and substance use disorder treatment and appropriate mental health treatment. We believe immigrants should be treated humanely and therefore support community based alternatives to detention.
Sexual violence and harassment and other forms of gender-based violence, such as interpersonal violence, are an epidemic problem in the U.S. and around the world. Deeply rooted in harmful gender norms and inequality, this violence often directly impacts individual’s reproductive health and violates their rights and bodily autonomy, including, in some cases, the right to choose if, when, how and with whom they engage in sexual activity. Policymakers must support efforts to reduce sexual and gender-based violence and ensure justice and comprehensive care for survivors of sexual and interpersonal violence, including through federal programs.
We commit to pushing our vision for change.
The undersigned organizations are committed to defending and advancing sexual and reproductive health, rights, and justice in the United States and throughout the world. Collectively, we commit to:
- Building power with and for communities most harmed by structural oppression and barriers to sexual and reproductive health care;
- Leveraging the unified power of our movement to create a world where all people have access to the resources and opportunities they need to thrive;
- Joining with our allies to advocate for policies that advance sexual and reproductive health and rights and that ensure all communities have the resources they need to thrive;
- Working across movements to advance human rights, immigrants’ rights, youth rights, disability justice, LGBTQ liberation, global development, economic justice, Indigenous peoples’ rights, and racial justice and to ensure the safety of our communities;
- Holding policymakers accountable to delivering for the people who need it most and leaving no one behind; and
- Collaborating to release, in the spring of 2019, a detailed policy impact agenda for policymakers, advocates, and the public health community to provide a roadmap for realizing these commitments.
Abortion Care Network
Access Reproductive Care-Southeast
ACCESS Women’s Health Justice
Advocates for Youth
AIDS Alliance for Women, Infants, Children, Youth & Families
All* Above All
American Association of University Women (AAUW)
American Civil Liberties Union
American Jewish World Service
American Sexual Health Association
Asian & Pacific Islander American Health Forum
Black Mamas Matter Alliance
Black Women for Wellness
California Coalition for Reproductive Freedom
Catholics for Choice
Center for Health & Gender Equity (CHANGE)
Civil Liberties & Public Policy Program
Colorado Organization for Latina Opportunity and Reproductive Rights (COLOR)
Feminist Women’s Health Center
Fund Texas Choice
Healthy and Free Tennessee
Healthy Teen Network
Ibis Reproductive Health
Illinois Caucus for Adolescent Health
In Our Own Voice: National Black Women’s Reproductive Justice Agenda
International Women’s Health Coalition
Iris House, Inc.
NARAL Pro-Choice America
NARAL Pro-Choice California
NARAL Pro-Choice Connecticut
NARAL Pro-Choice Massachusetts
NARAL Pro-Choice Minnesota
NARAL Pro-Choice Missouri
NARAL Pro-Choice North Carolina
NARAL Pro-Choice Oregon
NARAL Pro-Choice Texas
NARAL Pro-Choice Virginia
National Abortion Federation
National Asian Pacific American Women’s Forum (NAPAWF)
National Center for Lesbian Rights
National Center for Transgender Equality
National Council of Jewish Women
National Health Law Program
National Institute for Reproductive Health
National Latina Institute for Reproductive Health
National LGBTQ Task Force
National Network of Abortion Funds
National Organization for Women
National Partnership for Women & Families
National Women’s Health Network
National Women’s Law Center
New Voices for Reproductive Justice
Northland Family Planning Centers
Not Without Black Women
Oklahoma Call for Reproductive Justice
Physicians for Reproductive Health
Planned Parenthood Federation of America
Population Connection Action Fund
Power to Decide
Raising Women’s Voices
Reproductive Health Access Project
Sexuality Information and Education Council of the United States (SIECUS)
SIA Legal Team
SisterSong: National Women of Color Reproductive Justice Collective
Social Workers for Reproductive Justice
Southwest Women’s Law Center
SPARK Reproductive Justice NOW!, Inc.
State Innovation Exchange (SiX)
Texas Equal Access Fund
The Center for Sexual Pleasure and Health
Transgender Law Center
URGE: Unite for Reproductive & Gender Equity
UU Women’s Federation
Whole Woman’s Health
Whole Woman’s Health Alliance
Wisconsin Alliance for Women’s Health
Women’s Rights Empowerment Network (WREN)
Woodhull Freedom Foundation