Heather Michon

Heather Michon
June 25
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Editor’s Pick
MARCH 14, 2012 11:49AM

Native American Women Denied Plan B After Rape

Rate: 21 Flag

After weeks of debate over personhood, Planned Parenthood funding, transvaginal ultrasounds, fetal pain, Fluke-fest, aspirin-between-the-knees, and the little matter of 130,000 economically disadvantaged Texas women losing access to basic health care starting today, discussions about the accessibility of Plan B seem so...December 2011. Ancient history.

But for one group of women, access to emergency contraception is an urgent and tragically unmet need:  the hundreds of thousands of Native American women who live on reservation lands. Their struggle for a better standard of care is the subject of a recent roundtable discussion by the Native American Women's Health Education Resource Center (NAWHERC)

The statistics are stark. More than 1 in 3 Native American women will be sexually assaulted their lifetimes, a rate much higher than the general population. In one study, a stunning 92% of young women reported they had been forced to have sex against their will on a date.

One of the primary fears of any rape victim is an unintended pregnancy. The first line of defense against that possibility is, of course, the prompt administration of emergency contraception.

And this is where things get tricky for many Native women. Most receive their health care from the Indian Health Service and affiliated tribal health centers. Of 157 IHS facilities, only 10% surveyed stock Plan B in their pharmacies, and only 37.5% carried some alternative form of emergency contraception. In the Albuquerque Area, which covers almost all of New Mexico and Utah, only two of its 15 facilities stocked Plan B.  

"If you are living on the reservation or on the Pueblos without insurance, or the money to pay for EC or transportation to get you to town, you are out of luck, because you do not have accessibility through our own health care provider," says Charon Asetoyer, a Comanche from Lake Andes, South Dakota and Executive Director of NAWHERC.

And that assumes women even know to ask or find it. "A lot of women in our communities aren't aware that Plan B even exists or they associate it with the abortion pill RU486, they don't realize the difference because the media and the opposition have projected this: it's an abortion pill, when it really is a contraceptive," Asetoyer notes. This was amplified when it became clear that several of the health care workers who participated in the roundtable were themselves unclear about the difference between the two.

The so-called “conscience clause” also comes into play. "We have had rape victims given prescriptions to get EC, but at IHS they wouldn't administer it, because the Pharmacy Director and her staff didn't believe in it, so she wouldn't administer EC," says Lisa Thompson-Heth of the Lower Brule Sioux Tribe in Fort Thompson, South Dakota.

Access to EC is just one part of a systemic failure of the Indian Health Service to provide a consistent standard of care for victims of sexual violence; Asetoyer and others note that IHS staffers find the process of testifying in court so cumbersome that they often fail to collect rape kits in a timely, legally-admissible manner. Attempts to standardize and enforce policies are complicated by dealings with the Federal government and with often male-dominated tribal governments. Female sexuality is still a taboo subject within many tribes, not just because of indigenous beliefs but because many are strongly Catholic or Southern Baptist, lending to a general unwillingness to tackle issues like date rape, incest, domestic violence and contraception itself.

But it’s also one of the easier problems to fix. The roundtable came up with several actionable steps, among time requiring IHS formularies to include Plan B and to buy in generic in bulk to lower the costs; to work with tribes to educate the public about Plan B and to raise awareness of sexual assault; and to promote the adoption of Standardized Sexual Assault Policies (SSAP).  

Failure to improve the current system is not just about preventing unintended pregnancy. Native women are being denied full access to health care and legal protections due to them under Federal law and the UN charters governing the rights of indigenous peoples. 

"It's not an aspirin; it's not cold tablets,” says Asetoyer. “It's withholding services from a victim.”

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Congratulations on the Editor's Pick. This is just another example of native people being marginalized. All women are endangered by the recent climate surrounding our reproductive rights.
A very good, succinct article. Thank you
At some point ignorance stops being blissful. Congrats on the EP and on a very good article.
You are addressing an important issue. PBS recently aired a program highlighting sexual assault on the Pine Ridge Reservation. These issues are generations old, however, and it is important to identify the roots of the current issues you address. Although none of us lived on a reservation, my mother and two of my three sisters were subjected to sexual assault. My mother's rapist was her father. He was raped in an Indian boarding school run by the church. The source of the issues you document began several centuries ago. I commend your efforts, but feel the need to remind any readers that sexual assault has been a major means of conquest throughout history, especially with American Indian populations.
With apologies to my Christian Indian Brothers and Sisters, and IMHO...I have to say that ALL Indians...and especially Indian Women, have been hurt by the abusive policies, protocols and beliefs of the Christian Church...and this is just one more.

While I understand the need for faith and the need for belief, I feel as though I have to remind everyone that there has never been much good that has come to Indians from Christianity. From the beginning with the priests and missionaries through the awful abuses of the Indian Schools and then to the "religious objections" of IHS Pharmacists: Indians keep getting the short end of the stick.

It's bad enough that Indian women have very little other (if any) recourse for medical care and prescriptions--worse that they suffer so much more rape (all kinds), domestic abuse, and violence of all kinds. To top that, when raped they can't (in most cases) get EC or even have their rape kits taken or processed in a timely manner--and any complaints are largely heard by male-dominated tribal councils.

What REALLY upsets me is that these tribal councils are male-dominated at all, when historically many tribes gave women more equality and command than they do NOW. I have a feeling that much of this behaviour changed POST-Church contact, when the males saw how much control the religious men kept over their wives and daughters, etc. and thought they'd try it for themselves.

Where are the Clan Mothers? Where are the councils that allow the voices of tribal women to be heard? The biggest sin that the Church has committed against the Native American Tribes is to convince them that it must be CHURCH FIRST, FAMILY AND TRIBE SECOND. This is shameful, especially considering what little the Church has actually DONE to help Indians in the modern day...(I mean ASIDE from taking their language, their hair, their beliefs and their virginity in their damned hellhole schools!)

If my brothers and sisters sincerely believe that their way to Great Father is to belong to a group that suborns, abuses and objectifies Earth Mother (and all Her daughters), it is not my place to tell them differently...but I would strongly ask that any of us consider first the needs of our Families, our Clans and our Tribes (and the women in them, too!) before they make their decision.

There is a great need for self-examination here...because we've never had much help from outside the Tribes, so we need to find our own strength and purpose to solve the problems that affect Indians so disproportionately: joblessness...hopelessness...despair...alcoholism...drug abuse...teen pregnancy...domestic abuse and rape...self-hatred.

No matter how difficult these problems we face, I know there is an answer, and that we will find it in ourselves. We are Indians...Native Americans...Children of the Earth, of Sky Father and Earth Mother. If we can't fix it...who will?
Thank you for drawing attention to this important issue. Rated.
Suppress entire nations, provide little to no resources... is this surprising? It is reprehensible, but not surprising.
I don't have many words to describe my frustration on this issue,but I will send this post to a friend who currently works as a teacher in a reservate area in Alberta,CA.
It is incomprehensable that these people still get ignored .It's probably too shameful to start on a serious rehabilitation project.

I very much hope for a broad audience on this topic.

Rated with hope and sympathy for the Deprived.
I am just so sorry for the natives and all the injustice coming down on them. Thanks for supporting them with this fine article.
.........(¯`v´¯) (¯`v´¯)
............... *•.¸.•* ♥⋆★•❥ Thanx (ツ) & ♥ L☼√Ξ ☼ ♥
⋆───★•❥ ☼ .¸¸.•*`*•.♥R
A great article, thank you for sharing it, you are making me proud that i am e women
Thank you for sharing this post. Sometimes it's hard to realize just how wide the standards of care are between different communities in the US. The comments here are very informative, too.
Ironic, given that half a century ago they were forcibly sterilized.
Thanks for drawing some attention to this! [r]
Megwhich (thank you). I am a native woman from Canada. I follow your politics closely . I am wondering how come I see very little if anything about the native people's in your country, where do your political parties stand on native issues. Great article, it brings back many sad memories for me and my sisters and aunties