“We Don’t Just Litigate and Leave”: A Conversation with NAPW

I recently enjoyed a lively conversation with Lynn Paltrow, J.D., Founder and Executive Director of National Advocates for Pregnant Women (NAPW), and Board President Jeanne Flavin, Ph.D., on the occasion of the organization’s 10^th Anniversary Celebration, held June 6^th in New York. Lynn had just received an honorary degree from John Jay College, while Jeanne’s 2010 book, Our Bodies, Our Crimes, has garnered considerable attention and a major award. By way of disclosure, my decision to feature NAPW is not coincidental; I participate in its activities and donate monthly. For those of us who study reproduction and consider ourselves activists, NAPW is exemplary. One of a handful of forward-thinking women’s health nonprofits working beyond outmoded binaries, NAPW is deeply committed to issues of diversity and to finding inclusive ways to achieve reproductive health and justice for all women. NAPW and its supporters recognize that significant, lasting progress requires structural change at the grassroots level as well as consideration of individual women’s lives. Our discussion ran the gamut from how NAPW was founded, to connections with other movements, to strategies for organizing. Consider this interview a primer for changing the world.

Monica (MC):  Thanks to both of you for taking time to talk with me today. How was the anniversary celebration?

Lynn (LP):  It was terrific! With the help of our first Development Director, Sonya Shields, we had our first formal fundraising event. We had room for 150 people, more than 160 attended. People from every aspect of NAPW’s work were there – former board members, staff and interns, leaders from sister and brother organizations that we collaborate with and represent as amicus, women we helped represent, experts who testify and do educational forums for us, family friends as well as a whole group of young women in town with Soapbox feminists. People flew in for the event and stayed over extra days to be able to attend. The celebration reflected our diversity on every level.

MC:  That’s great! Jeanne, since I already know Lynn, tell me why you became involved with NAPW.

Jeanne (JF):  I grew up in a conservative, devout Catholic family, so being involved in reproductive justice was not a natural evolution. I became aware of the prosecutions of pregnant women who were addicted to drugs in the 1990s. I was in grad school then and wasn’t sure what to think of it.  Over time, I began to notice, having been trained as a criminologist who studies gender, that lots of women were caught up in the criminal justice system not simply for breaking laws, but they were also being punished for violating standards of what women and mothers should be like. I went to NAPW’s first conference, on “maternal-state conflicts” in 2002 not knowing anybody, and I was blown away. I was moved and disturbed by just how big this problem is and the forms that it took. Over time, I started to tune in more to NAPW’s work. The idea that reproductive justice should be about so much more than abortion resonated with me. Every time I heard the conversation being moved beyond abortion, Lynn Paltrow’s name came up. It’s not that I hold NAPW in high regard simply because I’m a Board member; I chose to become involved because I hold the organization in such high regard. Does that make sense?

MC:  Absolutely—and I can see how NAPW connects with your own research. Lynn, what prompted you to do this work?

LP:  Well, I never had any intention of running an organization! I grew up in a family where both of my parents were lawyers. They had a mom and pop legal practice called Paltrow and Paltrow. I always teased that if I joined the firm they would have to call it Paltrow and Parents. [Laughs] They were terrific lawyers and very nice people who wanted to do good. But running a business wasn’t exactly their strong suit. So I swore I would never run a business. When I started at the ACLU after law school, I was very happy to work for an organization run by other people and really thought I’d stay there forever. But I came to realize that the work I wanted to do couldn’t happen within that organization or other pro-choice and reproductive rights organizations that I eventually ended up working at or helping to found. The only way I could represent the women who needed to be represented and address the full range of issues that needed to be addressed on their behalf was to start this non-profit organization.

MC:  So how did you do it, in terms of nuts and bolts?

LP:  Around the time I left Planned Parenthood of New York City [as VP of Public Affairs], I was invited to the Lindesmith Center. A young researcher there, Phillip Coffin, asked me to give a talk about interconnections between the war on drugs and the war on abortion. Through this opportunity I met Ethan Nadelmann, who at the time was running the Center. While there I was introduced to many key people at the Open Society Institute (OSI).

MC:  What happened after your talk?

LP:  Folks at the Center liked the presentation and so I asked them to consider a proposal to fund a project that would deliberately work on these issues in a coherent, intersectional, and thoughtful way. I started asking everyone I knew who had started their own organizations if they would have coffee or lunch with me and tell me how they had done it. People were extremely generous and shared whatever knowledge and experience they had. Some advised me not to do it. More however were very encouraging and gave me important leads, like the law clinic that eventually helped me obtain NAPW’s independent nonprofit status. But I realized that I didn’t yet know how to run an organization and so approached the Women’s Law Center in Philadelphia to see if they would sponsor NAPW as a project of their nonprofit. They said yes and OSI said I could submit a proposal. When I sat down to write the proposal, it just poured out. I guess I had been thinking about this work consciously, subconsciously, and unconsciously for so long! Miraculously we got a grant from OSI for our first few years. So NAPW started as a home office in my bedroom. I wrote a law review article trying to show how underlying social justice and drug policy reform issues are connected and how the cases involving pregnant drug-using women were predictive of what would happen if Roe was overturned. Jane Roe was not different from Cornelia Whitner (arrested as a child abuser for giving birth to a healthy baby who tested positive for cocaine) who was not different from Angela Carder (critically ill and forced to have cesarean surgery that did not save the baby and that contributed to her death)—all of these women, as a result of pregnancy, were being deprived of their rights.

MC:  What cases did NAPW work on in the beginning?

LP:  One of our first major activities was preparing the Ferguson briefs for Supreme Court argument. This case involved an affirmative lawsuit against the Medical University of South Carolina, the police, and the local prosecutor for carrying out a collaborative plan in which they secretly searched African-American pregnant patients for evidence of drug use and turned that information over to the police. The hospital coordinated arrests of women from their hospital beds, some still pregnant, others still bleeding from just having given birth. With NAPW and allies at the Lindesmith Center, we made sure that the case remained about the women who had been so cruelly deprived of their rights and dignity and that the Supreme Court would know that not a single medical, public health, bioethics, women’s rights, child welfare, or other organization thought that depriving pregnant women of their Fourth Amendment rights was a good idea. In the end, we had more than 100 leading organizations and individuals signing on and opposing the policy of searching and arresting pregnant public hospital patients. Not a single group or individual filed an amicus in support of the policy. Linda Greenhouse called it ‘unusually one-sided.’

JF:  One of the best things about Lynn is that she’ll talk to anybody. I’ve been struck by this during the past couple of years, as I’ve become more involved with NAPW. This is really important: with Lynn, it’s not about ‘this is the message of the year’ or for this conference only. And it’s not about just repeating the message. It’s about creating a context where people will become more open to receiving the message, to hearing it and understanding it.

LP: NAPW became incorporated as a nonprofit in 2001. For the first two years, it was just me in my home office. I couldn’t really even have interns, since working from home meant I had only a desk or the bed to offer as workspace. [Laughs] Having a law student, Elizabeth Frankel, insist that she wanted to work for NAPW was the prompt that eventually got me to sublet NAPW’s first real office space.

MC:  Where was it?

LP:  I found a small sublet behind an independent film distributor. It was a teeny space close to the house, and I could take home cool movie posters. The second summer there, with two tiny offices and a shared space just big enough for a small conference table, four summer interns all worked sitting around that one table. They were so generous to have done that. I was the only lawyer on staff initially. But my first commitment in terms of hiring was to find an organizer who would work with the women directly affected by the increasingly punitive responses to women who were going to term in spite of a drug problem. Although I had filed the Ferguson case several years earlier, I had never had the resources to do more than the intensive litigation this case required. The situation was so bad in South Carolina that the first hire I made was Wyndi Anderson to work there with the plaintiffs in Ferguson and others to build opposition to all of the interventions that focused on punishment not treatment.

JF:  NAPW has been doing this kind of education and grassroots organizing since the beginning. It’s not just trying to reach the public through op-eds, but also reaching medical professionals, social workers, attorneys…

MC:  …community members?

JF:  Yes! All the people who should be allies and advocates but sometimes aren’t or don’t yet know enough. NAPW combines organizing, educating, and legal advocacy, because the legal approach alone often wouldn’t go so far without softening the ground first. The goal is not just to live to fight another day, but also to prevent legal cases from actually coming into existence in the first place. We don’t just litigate and leave. Oklahoma is a great example. It’s really striking to see how a year, two years after the Hernandez case, the local health care providers, attorneys, and other advocates are still in touch with one another. They are in these communities; this is their backyard. This case became an Oklahoma issue, a local issue. The sad truth is, there’s no greater level of drug treatment for pregnant women in Oklahoma than when the case started and the state has the highest rate of incarceration of women in the U.S. But because of NAPW’s education efforts, no other woman in Oklahoma has been prosecuted based on the claim that pregnant women can be held criminally liable for the course or outcome of their pregnancies.

MC: How do you get your message out to everyone?

LP:  By being as relentless as possible. We use traditional media, write articles in law reviews and public health journals, organize conferences and make speeches, sponsor continuing education programs. We have a web page and we blog, we have added Facebook and tweeting and we have lots of personal conversations in which we spend time listening to the people directly affected and people who teach us new ways of looking at things. We emphasize intersectional issues and focus on the most vulnerable people who are being most dehumanized and least adequately represented: pregnant women of color, drug using pregnant women, and low-income pregnant women. They love and care about their children and deserve to have their rights and dignity defended. It is also their experiences and stories that most compellingly and frighteningly demonstrate the extent to which claims of fetal rights and drug war propaganda can create precedent for depriving all pregnant women of their civil and human rights.

MC:  When did you realize these links?

LP:  For years I had worked on cases involving drug using pregnant women but had not been encouraged to explore the extent to which they were about more than a threat to the right to choose abortion. But increasingly racism, the war on drugs, and the abortion issue all seemed connected in deep ways. This connection was confirmed for me when I gave one of my first talks at a harm reduction conference. When I walked in the door I saw Reverend Howard Moody. This was profound for me because here he was at a conference concerning drug use but was famous for starting the clergy consultation service. It was a clergy-led form of civil disobedience in which clergy members referred their parishioners to safe abortion providers. So when I walked into that conference, seeing Reverend Moody somehow made absolute sense. Both of us had moved or progressed or maybe expanded from our work on reproductive rights issues to working on drug policy issues as well. We both had apparently come to recognize the harms of these forms of prohibition.

MC:  What are the harms?

LP:  All prohibition does is give the state power to control certain populations. Prohibition didn’t stop people from drinking alcohol, and the war on drugs has not stopped people from using drugs. What the war on drugs has done is give law enforcement and child welfare authorities power to punish and control certain people in certain communities – overwhelmingly communities of color. Like drug and alcohol prohibition, abortion prohibition didn’t and won’t work. Women of privilege were generally able to find ways to obtain safe abortions even when it was illegal. And ‘population control’ through sterilization abuse and coerced contraception has been used to limit births in communities of color, rather than empower women to be able to make healthy, safe reproductive choices. But legal or not, women will do what they have to do to control and address their reproduction, whether it’s keeping their babies when the pharaoh says throw them in the river, or when the state says you must carry every pregnancy to term no matter what. The war on drugs and the war on abortion are the same: certain women, families, and communities controlled by the state.

JF:  There is a long history of certain groups being singled out and the state valuing some people’s reproduction more than others. Eugenics, race suicide, sending children of Irish and Italian immigrants to work on farms on orphan trains…

LP: …and Native American children being taken away from their families. You know, part of the founding of NAPW was that there were very few women of color involved with the mainstream reproductive rights organizations in the 1980’s. While these organizations were doing excellent legal work and providing key health services to women, none of them were doing grassroots organizing or effective movement building to counter the growing abortion re-criminalization movement. Unlike the battered women’s movement, which was actively exploring ways to make their movement more welcoming to women of color, lesbians, and disabled women, and asking how to connect the provision of services to engaging people in activism, few were asking these questions where I was working. I went in search of effective organizing and outreach and found my way to the National Black Women’s Health Project, founded by Billye Avery and Lillie Allen. I was put on the Board of white allies and became part of Lillie Allen’s Sisters and Allies training program. I learned many things from Lillie and these trainings including the fact that you can’t sustain political movements if you don’t know who you’re marching next to. In creating NAPW I used these lessons; the two first founding Board members were women who had been part of Lillie’s trainings. There was a commitment from the beginning to understand the personal as well as the political, to be intersectional, to engage in grassroots organizing, because you cannot advance any cause if the people directly affected are not involved.

MC: Talk more specifically about how NAPW works in the communities.

LP:  Our work is about both litigating and building. We combine legal advocacy, organizing, and public education. We’ve grown to the point where we have three staff attorneys including our first Director of Legal Advocacy, the fantastic Emma Ketteringham. Our legal advocacy focuses on cases in which a woman has been arrested or otherwise deprived of her liberty (i.e., strapped down and forced to have cesarean surgery) because she is pregnant. Increasingly we are becoming involved in cases in which new mothers and children are separated based on claims of something the pregnant woman did (smoked marijuana, obtained methadone treatment) or did not do (authorize cesarean surgery, get to the hospital in time to give birth there). But litigation is extremely expensive and we really try to leverage our efforts. We can only get involved in a certain number of cases; so we try to turn criminal defense cases into ones that can set precedents affirming the rights of pregnant women and advancing maternal, fetal, and child health. We engage large numbers of amici, friends of the court, to make public statements opposing punitive approaches and we offer community members access to experts who can provide evidence based research about the harmful effects of punitive responses. Through conferences and education programs we are expanding the base of people who oppose re-criminalization of abortion and the expansion of feticide and related laws used to deprive pregnant women of their personhood.

MC:  Are there specific examples of this?

LP:  We’re committed to changing the conversation, and this has been consistent. We work to make clear that prosecution of pregnant women not only threatens their civil and human rights, but as a matter of public health it is bad for babies. Threatening pregnant women with punishment deters them from seeking help. The cases we work on do not involve criminal justice, but rather criminal punishment – and that what is being punished is not drug use or alcohol use but rather the fact that certain women are going to term in spite of a drug or other health problem. We advocate reproductive justice that is necessary before women will be able to exercise true choice, act on their rights, and obtain all of the health care, including reproductive care, they need. We know that no woman seeking an abortion is there simply to exercise her ‘right to choose.’ So we advocate for what women really want and need: healthy families, health care, safe places to live, access to education, and a living wage. We are not reframing the debate just to be clever, but to reflect the truth of women’s lives. And in terms of ‘fetal rights’ and ‘fetal personhood’ we are exposing what these really are about: radical fetal separatism, designed to treat the unborn as completely separate from pregnant women and to guarantee that pregnant women will lose not merely their reproductive rights, but their personhood.

MC:  What has been your greatest success in doing this work?

LP and JF:  [Laughing] Survival!

LP:  Seriously, though, we have won an extraordinary number of our cases. And each victory leads to charges against other women being dropped and sets precedent that can be cited to prevent other women from being arrested or forced to submit to unconsented surgery. Our work has been used to help defeat so called ‘personhood’ measures, feticide laws, and bills that would create new, special crimes for pregnant women. We have played a major role in holding back the floodtide of fetal separatism that prosecutors have sought to establish through judicial activism. We’ve created model briefs and affidavits and developed new legal and public health arguments used by lawyers and advocates across the country and increasingly, internationally as well. We have exposed the extent to which junk science has been used as the cover for depriving pregnant women of their civil and human rights and we’ve given defense lawyers and advocates new tools for challenging fraudulent medical and public health claims. Through law student writing contests, extensive public speaking by NAPW staff, and by training numerous interns and fellows over our ten years we have expanded the pool of knowledgeable activists and advocates working on behalf of reproductive justice.

MC: One of my favorite things about NAPW is that you focus on justice and not just a narrow vision of rights.

LP:  And we’ve been successful enlarging the base of people supporting reproductive justice. The 2007 Summit was extremely successful in opening dialogue and building alliances between birthing rights activists and those seeking to protect the right to abortion. We hope that we’re succeeding in making clear that attacks on Roe are not just about the right to choose abortion; but much more broadly and fundamentally about the personhood of women. We’ve given people a way to talk about issues that is much less divisive. We have shown that you can be both pro-life and pro-lives, and pro-choice and pro-lives, that you can value mothers, pregnant women, and children. Most people, even those who identify as pro-life, don’t want to see women who have abortions go to jail as murderers nor do they want to see women strapped down as Laura Pemberton was and forced to undergo unwanted and unnecessary cesarean surgery. We have recognized places of commonality. Jeanne, talk about what you did at Fordham.

JF:  Well, Fordham is a Catholic/Jesuit university. So I did something I’ve wanted to do for a while. One of the strengths of NAPW, and one of my goals as a teacher, is to help people think in more complex and complicated ways about controversial issues. So I organized a forum, Pro-life or Pro-lives: What the Difference Means for Pregnant Women and Their Families. The forum was not meant to be about abortion, but instead about all these complicated and potentially shared concerns—like forced cesarean sections or lack of good-quality reproductive health care—that too often are ignored when we focus narrowly on abortion. Lynn was the featured speaker and spoke to a standing room only audience. It was quite powerful to be there and see how well received Lynn’s remarks about pregnancy and personhood were, and also to see students from a range of perspectives come up to us, and to ask if we could organize a similar talk next year. Not that all of them totally agreed with Lynn, but it was clear that they welcomed the opportunity to think in more sophisticated ways about reproduction and justice, because these issues matter to their lives. Similarly, when you think about addiction, everyone knows someone with a problem. People recognize that it isn’t as simple as “some people are good/some people are bad.”

MC:  We’re almost of out time. Any last words?

LP:  There are so many, but one key message is that reproductive health and rights are not just about abortion. I’ve had the opportunity to listen to a lot of people, from women who have been arrested, to leaders like Byllye and Lillie, to people providing reproductive health services like Rachel Atkins who worked at Planned Parenthood of Vermont. She was very clear that when she provided services to a woman needing an abortion, she was just seeing her at one moment in her reproductive life and that at another moment she might be giving birth. NAPW recognizes that the women who have abortions are pregnant women, 61% of whom are already mothers. We recognize that 84% of women by the time they reach their forties have become pregnant and given birth. NAPW’s issues are about all pregnant women and understanding that anti-abortion activism hurts all pregnant women whether or not they seek to end a pregnancy. We can’t build an effective movement for reproductive justice if we ignore or distance ourselves from our base, women who give birth and become mothers as well as women who sometimes need to end a pregnancy. You cannot have a culture of life if you do not value the women who give that life. We recognize that whether or not a woman becomes pregnant or ever becomes a mother, all women deserve human rights.

JF:  To my knowledge I’ve never been pregnant, and I have never wanted kids, so it might seem odd that I’m deeply committed to an organization dedicated to pregnant women. But, at heart, so much of our work is about the right to be taken seriously and valued as a human being, whether or not or how you reproduce. What I appreciate about NAPW is that Lynn and her staff and allies are always about ten to twenty years ahead of the curve in recognizing the dimensions of reproductive justice. Sadly, I don’t believe that NAPW will ever be out of business, that these issues are going to go away. But in ten years, you can bet that NAPW will have advanced the conversation to a better place.