The Reproductive Health Concerns of Asian Pacific Islander Women

For decades, abortion has dominated the national dialogue about reproductive rights in this country, which in turn has fostered a relatively narrow pro-choice agenda in the political arena. It is without question that with the confirmation of not one, but two new conservative justices to the Supreme Court, the protections of Roe v. Wade will be further diminished in the next few years. In addition, opponents continue to chip away at abortion rights through harmful state parental notification and consent laws, burdensome regulations of abortion providers, and legislation that confers legal status on fetuses. It seems that the stakes have never been higher to protect sexual and reproductive freedom.

Yet, for Asian American and Pacific Islander (API) women, conversations that focus solely on abortion tend to marginalize their stories and send hollow promises of “choice.”

“Asian American and Pacific Islander” refers to a broad category that includes over 30 different ethnic sub-populations. Despite stereotypes that characterize the API community as a one-dimensional and homogenous “model minority” – healthy, educated, financially prosperous – API women come from diverse communities all with their own languages, rich histories and cultures, reasons for immigrating to the U.S., and sexual and reproductive health care concerns. Unfortunately, the few research reports that include the experiences of API women tend to lump together these separate and unique communities, masking the differences in socioeconomic status and further perpetuating the notion that the API population is all the same.

Consider some of these alarming statistics and trends: while Japanese Americans have the highest rate of job-based health coverage within the API community (77%), Korean Americans are the most likely racial and ethnic group to be uninsured. Laotian American teens have the highest teen birth rate in California for all racial and ethnic groups, compared to Chinese American teens who have the lowest. And, the rate of cervical cancer among Vietnamese American women is five times higher than for white women, representing one of the highest rates for any racial or ethnic group.

Abortion also remains a critically important issue for API women. National data reveal that 35% of pregnancies end in abortion for API women, compared to 18% for white women, representing the second highest percentage for all racial and ethnic groups. In addition, from 1994 to 2000, abortion rates fell for all groups except API women. Despite these numbers, API women are often ignored in discussions about abortion, reinforcing the stereotype that API women do not encounter any sexual or reproductive health care problems.

In addition to those mentioned above, there are particular sexual and reproductive health care issues that are especially unique to API women and fall within a broader reproductive rights framework. For instance, with the development and marketing of new reproductive technologies, sex selection is becoming increasingly popular and widespread in the U.S. Historically, sex selection has been practiced more often in Asian and in immigrant Asian communities in the U.S., contributing to an increase in the number of abortions of female fetuses. Thus, the question becomes: how do we respectfully challenge cultural norms that pressure women to abort their female children while at the same time maintaining reproductive autonomy?

Human trafficking is another issue that intersects with reproductive health care and that has a unique impact on API women. The State Department conservatively estimates that 18,000 persons are trafficked into the U.S. each year, many of whom are women from Southeast Asia. Several studies have found that female survivors of trafficking have undergone forced abortions, carried to term unwanted pregnancies, and contracted sexually transmitted diseases and HIV/AIDS. The problems faced by trafficked women are often exacerbated by their isolation and lack of access to basic health care and reproductive health care services.

Finally, studies have found that environmental toxins and workplace exposure to chemical toxins disproportionately impact API women, particularly those who are immigrant and low-income. For instance, over 40% of licensed nail technicians nationwide are of Asian descent. In California, 80% of the industry workers are Vietnamese immigrant women. Studies indicate that prolonged exposure to phthalates, chemicals used in many cosmetics with the highest concentration found in nail polish, poses serious health and reproductive health care hazards to workers. In particular, phthalates have been linked to cancer, birth defects, infertility, and miscarriages.

It is clear that our language and priorities around reproductive rights must shift if we truly want a movement that includes API women and that is inclusive, visionary, diverse, and effective for all women. The focus on abortion alone makes it difficult to promote a broader framework of sexual and reproductive justice. Abortion rights need not and should not be isolated from other areas of reproductive or even human rights. In fact, the movement becomes broader and stronger when we can place abortion in context with the diverse issues that impact women’s sexual and reproductive health and overall well-being, including issues of race, class, sexual orientation, gender, immigration status, and all struggles for human dignity. If we can do this, the pro-choice movement will be able to ensure that all women are truly empowered to exercise meaningful reproductive choices.

For more information about the reproductive health concerns of API women, please visit NAPAWF’s website to request a copy of their report, Reclaiming Choice, Broadening the Movement: Sexual and Reproductive Justice and Asian Pacific American Women, a National Agenda for Action.

Courtney Chappell is the Policy Director at NAPAWF, where she conducts legislative advocacy at the national level around sexual and reproductive justice. She received her law degree from American University Washington College of Law and is a recipient of a Georgetown Women’s Law and Public Policy Fellowship and a New Voices Fellowship.

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