This week, clinic closures in Texas have drawn media and the attention of the reproductive health, rights and justice communities to rural women's circumstances relating to accessing abortion. This attention and backlash against the closures has spurred an inspiring wave of grassroots action to help women reach those abortion providers who remain in the state, such as these covered recently in the Nonprofit Quarterly.
It is natural that those of us who have dedicated ourselves to accessible abortion care would put abortion at the center of our conversations about rural women's health, and that the loss of clinics in Texas would draw our attention to rural women. We rightly recognize access to safe abortion as essential to women's health and self-determination, and by extension, also essential to the health of communities -- rural and urban alike. It is also clear that rural women are at a geographic disadvantage because most abortion providers are in urban areas. But, as National Rural Health Day reminds us, rural communities, and rural women in particular, are at a disadvantage when it comes to nearly all forms of health care. Lower rates of insurance, long distances to specialized care -- including for chronic conditions that require ongoing management -- and an acute shortage of primary and preventative care providers are all challenges facing rural areas. As an episodic vs. ongoing or chronic event in women's lives, on a day-to-day basis abortion does not always rise to the top of rural women's healthcare access worries.
As advocates, we sometimes seem to forget that the main character in the stories we tell about our work is not abortion, it's women. At the organization I lead, Provide, a half-decade of field work in rural communities has taught us a hard-earned lesson: when we make abortion the central character, we do a disservice to rural women everywhere, who have a vast array of unique healthcare access issues facing them and their families. We've learned that if we are serious about the health and rights of rural women, we must recognize and reflect the place abortion holds, and does not hold, in their lives. This is part of what we mean when we say, borrowing the words of our Senior Program Director Wyndi Anderson, that we are out to make abortion "right sized," neither invisible, as it often is, but nor everything we see, give voice to, or care about.
This doesn't mean that abortion advocates need to take on the myriad of issues facing rural communities; what we can best bring as advocates and allies is the abortion work and resources with which we have the most expertise. But our attention and care must be to the whole story of rural women's lives, otherwise abortion becomes the main character, and we are only abortion's, not women's, allies. Abortion will not offer a day of childcare for a neighbor or a ride to the clinic, it will not reach out a supportive hand, or vote, or provide itself - it is people who do these things. We best support people when we see and acknowledge their whole stories and direct our care not only to the issue of abortion, but to the people and their vision for their communities and their lives. So it is in that spirit that we celebrate National Rural Health Day.
In support, Provide (@provide_access) is holding a Tweet Chat to highlight the intersections between rural health and abortion access from 1-2pm EST, Nov. 21, sharing information and stories about women's reproductive health as it relates to rural health concerns. These issues are related to both abortion care and the broader concerns of rural health care. Examples include:
• The need for expanded telehealth
• Allowing qualified non-physicians to provide basic care
• The importance of strong referrals networks
• Reducing stigma
More information about National Rural Health Day is available at their website http://celebratepowerofrural.org/, where you can find much information, including webinars from the past, the webinar schedule for November 21st, and examples of press releases.