They Waved Her Underwear in Front of a Jury and Called Her a "Slut Puppy"

THEY WAVED HER UNDERWEAR IN FRONT OF A JURY AND CALLED HER A "SLUT PUPPY"

Now Brenda Andrew is on death row, and the Supreme Court could weigh in

BY NEDA TOLOUI-SEMNANI

April 19, 20248 Minutes

The U.S. Supreme Court will decide this Friday if it will hear the case of Brenda Andrew, the only woman currently on death row in Oklahoma. The Andrew case is the second Oklahoma capital punishment case vying for the court’s attention this term, and it has potentially far-reaching ramifications—not just for the state, but for the rights of women and queer people everywhere.   

The background on the case is this: Andrew, along with James Pavatt, her former partner, were found guilty of first-degree murder in the 2001 shooting death of Andrew’s estranged husband, Rob, but the jury rejected the state’s charge that Andrew would be a “continuing threat to society.” Nonetheless, both Andrew and Pavatt were sentenced to death. Throughout Andrew’s 2004 trial, her sexuality, her dress, her demeanor, and, ultimately, her behavior as a wife, mother, and Christian were dissected and condemned. In an amicus brief filed with the Supreme Court, a former federal judge, 17 law professors, and four domestic violence advocates argue that the Andrew case was rife with gender bias that unfairly prejudiced the jury against her. 

“At a time when women’s rights generally are on the chopping block—also the rights of queer people and civil rights of minority communities—we’ve got a case that’s at the extreme end of what it means when we dehumanize these communities when we strip people of their humanity,” says Nathalie Greenfield, a lawyer with the non-profit firm Phillips Black, which filed the writ of certiorari to the Supreme Court on Andrew’s behalf. She argues that if the Supreme Court does not review the case, the justices would sanction using “assumptions, stereotypes, and tropes about people who dare to transgress perceived norms,” especially when it comes to gender, race, and identity. 

Brenda Andrew as a young woman. (Image courtesy of Phillips Black)

The trial transcript, for example, reveals that witnesses were encouraged to describe Andrew’s appearance in detail, from her dresses (“very tight, very short, with a lot of cleavage,” said one) to her make-up choices (“gothic”), and also to say whether they thought those choices were appropriate. Prosecutors also waved Andrew’s underwear in front of the jury and called her a “slut puppy,” one of the last things members of the jury heard before they began to deliberate. 

“There [were] just so many recorded instances of gendered evidence being presented every single day [of the Andrew trial],” says Greenfield. “And a lot of this was about her appearance and her extramarital affairs. The focus was on the fact that this was a woman who was transgressing gender norms by not being this chaste Christian wife.”

Oklahoma is a particularly deadly state: It has executed 124 people since 1976, when the U.S. lifted its moratorium on capital punishment. (Only Texas has killed more people.) Of these, just three were women—two of whom were prosecuted by district attorney Bob Macy, who is considered the second deadliest prosecutor in United States history. He’s responsible for 54 death sentences—more than any other prosecutor who was practicing law between 1980 and 2001. He resigned in 2001 after evidence of prosecutorial misconduct was found in 18 of those 54 cases, resulting in three exonerations. 

However, his shadow still stretches over Oklahoma’s justice system—and Macy’s assistant district attorney and protege, Fern Smith, was a prosecutor in the Andrew case. According to transcripts, Smith repeatedly asked witnesses to describe Andrew’s dress, opine over Andrew’s behavior, and state whether or not Andrew was, in Smith’s words, a “good mother.” 

This isn’t the first time a case Smith has prosecuted has been challenged. She has been repeatedly accused of failing to disclose exculpatory evidence—evidence that could be favorable to the defendant—and even of destroying evidence. In fact, she was accused of prosecutorial misconduct by name in the case of Richard Glossip, the other Oklahoma capital punishment case that will be in front of the U.S. Supreme Court this year.

At a time when women’s rights generally are on the chopping block—also the rights of queer people and civil rights of minority communities—we’ve got a case that’s at the extreme end of what it means when we dehumanize these communities when we strip people of their humanity.

The Supreme Court has already delayed deciding whether to hear Andrew’s case twice. Tomorrow, they could do one of three things: agree to hear it, decline to hear it, or “vacate and remand,” which means the Supreme Court could return her case to the appellate court to reconsider without hearing an oral argument. 

Since Andrew was sentenced, she has been the sole woman on death row; consequently, she has served the majority of her sentence—more than 16 years—in solitary confinement. According to the United Nations, prolonged solitary confinement, or more than 15 days without meaningful human contact, is defined as torture

In February 2020, Andrew was moved to the general population, where, according to her lawyers, she thrived. She got a job and joined a quilting circle. In January, two days after her attorneys filed the writ of certiorari with the Supreme Court, Andrew was returned to solitary. She wasn’t given a reason.

 

Brenda Andrew, second from left, and members of her quilting circle. (Image courtesy of Phillips Black)

“The gender bias is just so finely woven into the trial that you can’t extricate it,” argues Jessica Sutton, another attorney with Phillips Black. “It’s unique in that way. However, the real issue implicates the due process clause of the 14th Amendment. We have to ensure that trials are fundamentally fair. We want to make sure that, for the ultimate punishment, we have a reliable trial, a reliable process, a reliable conviction, and sentencing. What the prosecution did is undermine every aspect of the entire trial.” 


 

Neda Toloui-Semnani is an Emmy-winning journalist and the author of They Said They Wanted Revolution: A Memoir of My Parents.


SCOTUS Just Made Protesting Much Harder


Ye Olde Abortion Ban Hits Arizona

Plus: what bell hooks said about O.J. Simpson ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌


"I'm Here As Long As I Can Be"

"I'M HERE AS LONG AS I CAN BE"

Texas abortion provider Ghazaleh Moayedi, D.O., provides care for her neighbors—but she has to leave the state to do it

April 2, 202414 Minutes

By Susan Rinkunas

After Ghazaleh Moayedi graduated college, she got a job working on the administrative side of Whole Woman’s Health, an abortion clinic in Austin, Texas. She respected the providers who chose the work—many of whom had witnessed illegal abortions before Roe v. Wade—but also thought the patients deserved doctors who looked like them. “I didn’t have the language for it at the time,” she says “But I noticed these doctors, older white men, didn’t reflect the people that we were taking care of. I knew that we needed new doctors.” 

So, she went to med school and became an OB/GYN and complex family planning specialist in Dallas in 2018. Less than two years later, Texas lawmakers enacted abortion bans, first during the height of the pandemic, and then via the 2021 bounty hunter law known as Senate Bill 8. A few months later, Roe fell, and now Moayedi travels to Kansas to provide abortions—often to other Texans. I talked to her about what she’s doing to care for people after they return home, and her message for people living in Democratic-led states who think they’re safe from abortion bans.

Susan Rinkunas: When did you start traveling to provide abortion care? 

Ghazaleh Moayedi: I started traveling to Oklahoma in 2020 [after] Gov. Greg Abbott shut down abortion care in our state under the guise of COVID restrictions. Abortion doctors traveling is common—but never from a state like Texas to somewhere else. That is the novel piece over the last few years. It’s always a doctor who lives on one of the coasts traveling to a restrictive state. That was a moment where I was like, ‘Oh, crap. In order to take care of Texans, I’m gonna have to start traveling.’ I started working at a couple of clinics there, in addition to the clinics I was working at in Dallas, and did that until Oklahoma shut down—it was about a month or so before Dobbs. Now, I am traveling to Kansas and working in a clinic there.

Dr. Moayedi in her working through COVID era. (Photo Courtesy of Dr. Moayedi)

You’ve said it’s surreal to be a Texan leaving the state to care for other Texans leaving the state. Are you commiserating with patients? Do they know you’re from Texas?

I usually ask people when I make small talk when I’m doing an ultrasound. Like, “Where are you coming in from?” And people usually say Texas, then I ask where. “Oh, where in Dallas? I’m from Dallas, too, that’s why I’m asking.” I can just see people’s faces change. When I say, “Did you eat at that place? That place is really good,” I can see the light coming from people. It’s a moment for us both. We’re like, “Yeah, this is bullshit. It’s totally bullshit that we’re both here.” I had a patient who was like, “I wish you could have just done my abortion in the closet at this restaurant that we both knew.”

During a fall trip to Kansas, two of my patients were on the same flight I took. I’ve still been really processing that in and of itself, that we’re all on this flight together, how just stupid, pointless, [and] inhumane this is. 

Are there certain patients you can’t stop thinking about?

I’ve had patients whose partners have lost their jobs because of the time they have to take to come and travel. There’s a ripple effect of harm that happens from people needing to travel to get abortions. 

When someone does a medication abortion [as Dr. Moayedi sometimes does for Texas patients in Kansas], there are rare cases where it doesn’t work. If I’m seeing them in Texas for an ultrasound afterward but there’s still a continuing pregnancy, it’s like, “Shit, you’ve gotta go out of state again.” I can’t do anything for them, and it’s unconscionable. Before [Dobbs], someone would show up a week after their medication abortion, and I could be like, “Yep, everything looks good” or, “Nope, it didn’t work. Okay, I can do an aspiration right now for you.” Now, it’s a never-ending saga.

In other states [like Kansas], it’s “take your medication abortion, and then in five weeks, take a pregnancy test.” Some of these people are waiting five weeks to be able to fully confirm that their abortion is complete. Not only did they have probably several weeks of waiting to get an appointment, get out of state, then do their pills, then come back—but now they’re going to have to wait another month to know that it’s complete. This is like a two-month minimum cycle in someone’s life of just trying to end this pregnancy.

I’m definitely seeing people making that calculation [about medication abortion] in their mind of, “Wait, then I have to wait to know that it’s done?” They’re so stressed out—they had to do all this travel—that they’re like, “I’m just gonna do a procedure [instead] so I can leave here knowing.” You take good care of them, but states are taking people’s autonomy away, and they’re being forced to make decisions out of this insulting process. 

And you’re providing ultrasounds in Texas now?

After a Dallas abortion clinic closed in spring 2023, I started a little ultrasound practice so that, at least for folks in my general area, people don’t have to wait five weeks [to find out if their pills worked]. They can get an ultrasound with a trusted provider who isn’t going to judge them and who has deep experience in abortion care.

People really need a community-based provider that they can turn to when they come back [from an out-of-state abortion], someone that they can trust and talk to. It sucks not being able to provide abortions [in Texas]. But it is this whole new chapter of my work. It feels really good to still be able to take care of people in the ways that I legally can. 

I mean, folks are going to crisis pregnancy centers for ultrasounds before and after abortions because they’re free. People are able to schedule appointments with me via Pegasus Health Justice Center. I have a cash rate that’s $250, but I’m working with abortion funds, and pretty much everyone is able to get funded.

Abortion-rights supporters face anti-abortion protesters at a rally for reproductive rights at the Texas Capitol on May 14, 2022 (Photo by Montinique Monroe/Getty Images)

Have you thought about leaving Texas?

There isn’t such a thing as a safe state. We are one country, and these types of tactics are coming to every state. This mentality isn’t concentrated here [in Texas]. It exists in states without abortion restrictions as well. But people have this false belief that they are safe in these bubbles, and even within states like California and New York, the [anti-abortion] mentality exists. This extreme right, fascist, white-power movement exists everywhere, and abortion restrictions are an extension of that—they’re not separate from it.

After the Dobbs decision, I was feeling really low, even though we knew it was coming. It was like, “What the hell am I gonna do?” I considered moving and told my friends. I started looking at Zillow everywhere, like, “What’s New Jersey like? What’s Michigan like?” I interviewed for a few jobs in other states, and that was a couple of months of pouting and wondering what I was going to do. But I’m not going to escape from white supremacy anywhere in this country. I can move somewhere else and have a little bit more leeway in my work, but until when? We might have a president that is literally presidenting from jail.

Right, there could be a national abortion ban in January 2025.

Exactly. The reality is, I could pick up and move my whole family, and we could go somewhere “safe” for a period of time—and then what? I’m here as long as I can be. I think the idea that this is concentrated [in Texas] is really short-sighted. Everyone has a role to play in combating white supremacy and fascism within their own communities. 

There’s a ripple effect of harm that happens from people needing to travel to get abortions. 

What do you think of the talk online where people urge doctors to defy hospital orders and perform abortions in health emergencies?

It makes me incredibly annoyed and pissed off. That’s not how hospitals work. It’s not like I can just waltz into an operating room and say, “I am ready to do a surgery now.” Even when any hospital I worked at allowed it, there were still often multiple hoops I would have to jump through. Sometimes, even though it met all of the policy guidelines, there was someone who delayed the case because they needed to talk to someone who needed to talk to someone. 

Doctors don’t own the hospital. We don’t actually direct anything in the hospital or schedule cases. There are multiple layers of people that have to approve things and even once it is approved, financially and policy-wise, you can still show up on that day and your anesthesiologist refuses, the nurse refuses, the tech refuses. I can’t do it alone in a hospital. I 

could go to jail. I could lose my medical license, and then who am I going to help?

And rather than suggesting medical providers flout state laws, there are people organizing community networks for abortion pills, like Red State Access.

What pill networks are doing—that’s envisioning the future and being the future that we want and doing the work that needs to be done at the community level. That is how we change culture. That is how we address people’s needs in the moment, and we live out the future that we want. We’re saying we don’t need the courts to let us live the free lives that we can have. We actually have autonomy over ourselves. 

That is, on all these micro levels and within communities, what people need to be doing: envisioning and living within the just future that we all deserve.


The Abortion Pill on Trial

NEWS

One of its key researchers says Mifepristone was tested “with three times or more rigor” than other drugs.

March 26, 202412 Minutes

BY SAMHITA MUKHOPADHYAY

Today, the Supreme Court heard oral arguments in the first abortion case to come before the court since it overturned Roe v. Wade. The case, brought by the extremist group Alliance for Hippocratic Medicine (AHM), is challenging the U.S. Food and Drug Administration (FDA)—specifically the FDA’s 2016-2021 policies, which expanded access to the safe and effective abortion drug mifepristone, initially approved in 2000 and now the most common abortion method across the country. AHM’s main argument? That the FDA did not adequately study mifepristone’s safety risks. (We explain it more in-depth here.)

The implications of this decision could be disastrous. As Fatima Goss Graves, President and CEO at the National Women’s Law Center, told us, “Banning mifepristone would upend abortion care not just in the conservative states that have been racing to ban it—but in all 50 states, no matter their laws.” 

But the case itself is farfetched, argues Dr. Lisa Haddad, the medical director for the Population Council’s Center for Biomedical Research, the nonprofit research center that led clinical testing on mifepristone more than two decades ago. In fact, she points out, over 5 million people have successfully used it since then.

With the case now before the court, we spoke to Dr. Haddad and Dr. Beverly Winikoff, who worked at the Population Council for 25 years, where she was Program Director for Reproductive Health and Senior Medical Associate at the Council, which was the team that led clinical trials on mifepristone overseas. Now she serves as president of Gynuity Health Projects. 

Abortion rights activists rallied outside the US Supreme Court in Washington, DC. On April 14, the Court temporarily preserved access to mifepristone, a widely used abortion pill, in an 11th-hour ruling preventing lower court restrictions on the drug from coming into force. (Photo by Probal Rashid/LightRocket via Getty Images)

Samhita Mukhopadhyay: You worked with the organization that facilitated the FDA approval of mifepristone—what are you feeling right now?

Dr. Beverly Winikoff: I feel like I’m charging into the skirmish. I’m getting girded up. Can’t these people ever go away? But it is very, very encouraging to see how everyday people understand that this is a highly political, not a scientific discussion. 

Dr. Lisa Haddad: I feel very frustrated and a little bit beaten up. And while I’m inspired by some of the voices speaking up in support of mifepristone, I see this trend in reducing access for women, and I’m scared that the science and the excellent evidence that supports this as a way to improve health outcomes will be overlooked and minimized. It’s a slippery slope. 

BW: I think in the end, it’ll be okay because of the politics—the FDA is there to do a job, and it has always done it quite well in protecting the public. And this is an attack on the FDA. When you look at it that way, there are many people who are on our side, including big pharma—because if this happens, they have no [incentive] to be able to put money into new drugs because somebody could come up and decide that they don’t like that drug and they can [sue to] override the FDA, and that would be chaotic in the pharmaceutical world. It’s not just abortion; it’s every drug that gets approved. I think the politics of it is much bigger than abortion. 

That’s a good point. Can you walk us through what we need to know about the FDA approval of mifepristone? Was it the standard approval process or was it a long, hard-fought win?

BW: It was cover-your-ass time the whole way along by the FDA. That was it. That was the theme. So, every single thing was done with three times or more rigor than any other drug I’ve ever heard of. But that’s okay because the drug is very good and very safe. We also got the FDA staff to be very excited about it. People were really very interested in making sure it got through.

When we did the final studies, we had several thousand people, and it performed very, very well. We were very attached to this product because it seemed safer and more effective than you could expect. So people were very excited about it because it had the potential to be a workaround for some of the political stuff of having to go to a clinic. You were doing it at home. 

Dr. Haddad, can you speak to the significance of Tuesday’s case? Depending on the decision, what could the implication be? 

LH: An increasing number of individuals are getting access to abortion only through medication abortion. I’m in Georgia, where we have a 6-week abortion ban. Finding out that you’re pregnant, making an appointment, getting off of work, getting a way to get there, and all of that before six weeks is hard. But if people make it to the clinic, medication abortion at that very, very early gestational age is a potentially good option for individuals, and the addition of mifepristone [generally used with misoprostol] enhances the likelihood of success. Also, without mifepristone, the barriers to access are huge. It’ll make it even harder for more individuals to obtain care. 

Demonstrators march towards the US Capitol and the Supreme Court during the “Bans Off Our Mifepristone” action on March 26, the first day of oral arguments. (Photo by Jemal Countess/Getty Images for Women’s March)

And what could this case mean for misoprostol? 

BW: Well, one of the things that mifepristone does is soften the cervix. So that means that whatever’s coming out doesn’t have as hard a time. And there are a lot of pain fibers in the cervix, so it could be more painful to just use misoprostol. But you can do it for most people. It will work, but it’s not maybe as pleasant.

LH: An abortion with mifepristone is gentler on the body, it gives the person a little bit more control, and it’s more predictable in terms of how it’s going to go. 

BW: What saves the day for some of these other drugs is that they have other uses. So methotrexate is also abortifacient, but nobody’s trying to take that off the market. Nor misoprostol, actually. [Methotrexate is used for cancer while misoprostol can be used to treat ulcers and to induce labor] And so I think one of the things is maybe to get drugs that have dual purposes. 

LH: And there are opportunities for that. Mifepristone does have utility for other indications. There’s excellent evidence that it’s great for fibroids and that it can be used for contraception. There is evidence, and it’s used commonly as emergency contraception in many countries. It’s just not approved in the U.S., and so I wonder whether or not that would enhance its security. 

BW: Yeah, somebody should put it in for approval.

LH: We’re actually trying to garner support to do that right now, Beverly. But again, the evidence in the [case] is ridiculous when you break it down. It’s challenging the ability of scientists to make a decision, but not on all issues, just an issue that bothers [the plaintiffs] morally. But it’s not based on science. It’s frustrating to see because just the fact that we’ve gotten this far—I mean, it shouldn’t have a foot to stand on, and yet it is at the Supreme Court. 

BW: I think it’s a terrible thing for individuals—not just people wanting abortion, people who want to use drugs for anything.

LH: And even, I mean right now, the standard of care shows that the mifepristone regimen works better for miscarriage management. This focus on something that really shouldn’t even be questioned just highlights the [message] that women are not trusted, women need to suffer, and that doctors and scientists can’t be trusted. Also, on top of what Beverly said, I just want to highlight that it’s not just the FDA that says [mifepristone] is safe. All of the different medical agencies like ACOG and the Society of Maternal-Fetal Medicine, say that mifepristone is incredibly safe with very few adverse events. We know the risks are incredibly low, less than 0.3% of any sort of serious, major adverse events. The risk of death is almost non-existent, whereas if you compare that to forcing somebody to continue with a pregnancy, we know that those risks are. 

Over 5 million people have used mifepristone for either medication abortion or miscarriage management. This is not something that is not well evaluated. 

 

As of right now, medication abortion is still available. Learn more here


"This Isn't Speedy or Fair"

NEWS

Lauren Smith’s Waited Over Four Years for Her Day in Court

March 19, 20248 Minutes

By Neda Toloui-Semnani

 

Four months ago, I wrote in this space about Lauren Smith, a 32-year-old mother who lost custody of her youngest child in 2019 after she and her infant tested positive for THC, a cannabinoid substance, at delivery. Smith was arrested six months later and charged with felony child neglect for using marijuana while pregnant—a charge which, in Greenville, South Carolina, carries a sentence of up to 10 years in prison. 

When we published the article, Smith’s trial date was set for the week of February 19, 2024, which was, rather poetically, five years nearly to the day after she had delivered and lost custody of her youngest daughter. The child has been living with her paternal grandmother since she was three days old. 

But weeks before the trial was set to start, Smith learned her court date would be pushed for a third time. It is now scheduled for the week of April 22. 

“Isn’t everybody due a speedy, fair trial?” Smith told me earlier this month. “This isn’t speedy or fair.”

The latest holdup comes after the Greenville County solicitor’s office entered more than 125 pages of new documentation into discovery. This is called a “document dump,” a legal maneuver in which one side enters hundreds, sometimes thousands, of pages of new documentation within weeks of trial in an effort to overwhelm the opposing side. (This is the second time the prosecution has used this delay tactic. The first was last May when they entered several hundred additional pages of documentation as discovery.)

Despite the U.S. Constitution guaranteeing the right to a fast trial, Stuart Sarratt, a former Greenville County public defender familiar with the Smith case, says, “South Carolina essentially does not have any kind of right to speedy trial.” 

“We do on paper, but our Supreme Court has interpreted it as basically unless it’s been four-plus years, they’re not going to do anything about it,” he explains. “And really, you have to be in jail for them to really care about it.” 

Smith has been awaiting trial for more than four and a half years. The Meteor’s requests for comment from the Greenville County solicitor’s office have gone unanswered.

Smith’s son Aiden with his older sister. (Image via The Meteor)

However, most South Carolinians—including the state’s Attorney General, Alan Wilson, a Republican—agree that the state’s judicial system is buckling under the weight of an extraordinary judicial backlog. Wilson is asking state lawmakers to expand his budget by $1.6 million dollars to help tackle the pile of serious criminal cases, including murders, that have been languishing for years. Against the backdrop of that backlog, state prosecutors, called solicitors, have a great deal of power over which cases make the trial docket. In Smith’s case, the prosecution proposed the trial date months in advance—but then introduced new documents within weeks of that date. 

It is unclear what the prosecution hopes to prove with the entry of these documents, but they include medical records for Smith’s child. The Meteor has reviewed these records, which document her doctors’ visits from birth to the present; the most recent show that she was referred to and evaluated by an occupational therapist, who conducted a test to measure the child’s fine gross and fine motor skills—skills like grip on a spoon, object manipulation, physical reflexes, and other developmental milestones. 

Advocates for parents like Smith have concerns about bringing records so long after pregnancy into a case. “The idea that your pregnancy-related conduct could be litigated when the kid is five or six,  because, by some measure, they might not be hitting their milestones, feels so deeply problematic to me and not vested in any sort of understanding of causation versus correlation,” said Dana Sussman, the deputy executive director of Pregnancy Justice, a nonprofit who advocates for pregnant people caught in the criminal justice system. 

The Meteor spoke to three occupational therapists, all of whom agreed that evaluations like the one listed above cannot diagnose why a child’s motor skills have progressed or been delayed.

“Children don’t meet milestones for all sorts of reasons and for no reasons at all,” Sussman  notes. “I don’t think we know of a case right now that we’re working on that involves allegations that developmental milestones are not being hit, and therefore the mother deserves to be criminalized.” 

As reported in the original piece, all American medical associations recommend abstaining from using cannabis and/or cannabinoid products during pregnancy and while breastfeeding, but the precise impact of marijuana use during pregnancy on the fetus and the child is both uncertain and under-researched. As outlined in the original story, Smith’s case is closely tied to the legal theory of fetal personhood and the ways the government is increasingly policing pregnant bodies (see the Alabama Supreme Court’s ruling on I.V.F. and so-called extrauterine children).

While Smith has been waiting for her day in court, she says, she’s been working at a nursing home and living with her mother and two older children. She tells The Meteor she hasn’t been allowed to see her youngest daughter since early November. 

“This is half of a decade now of this back and forth, almost five years, and it’s just been continued and continued and continued,” Smith says. 

Still, when asked where she sees herself in five years, she says her work with senior citizens, people who are at the end of their lives and have a long view of life, has given her both perspective and confidence. She plans to be a registered nurse.  


"I grew up thinking that most physicians were Black"

Uché Blackstock, M.D., on the conflicts and challenges of being a first

Dr. Uché Blackstock at Essence Festival in 2022

 

When Uché Blackstock and her twin sister Oni graduated from Harvard Medical School in 2005, they became the school’s first Black mother-daughter legacy—their mother, a practicing physician, had received her medical degree three decades before. In her new book, Legacy: A Black Physician Reckons with Racism in Medicine, Blackstock delves deep into the systemic inequities in health care while paying homage to her late mother. I sat down to talk with her about her new book, being a “first,” and her own legacy.       

Rebecca Carroll: The subtitle of your book takes on this idea of “reckoning” around racism, a phrase that has been rampant in public discourse over the past couple of years. What has “reckoning” meant for you? 

Uché Blackstock: The subtitle is really a reflection of my own journey from child to medical student to practicing physician. It probably started in my residency, but more so when I was caring for my patients and also dealing with toxic, sexist, and racist environments—and seeing how, as patients and physicians, we get it from both sides. 

And then, in 2020, the reckoning that we saw during [that time] gave me an opportunity to delve a little bit deeper into how, despite advances in innovation, technology, and research, we are having worsening health inequities in our communities. Not better. 

RC: There's a lot of staggering data and evidence about the impact of racism on health outcomes that you've discovered in your research. What was some of the most surprising? 

UB: Black infants are more likely to die in their first year of life now than white infants, than 15 years before the end of slavery. So while the overall infant mortality rates have improved because of childbirth techniques, sanitation, [and] infection control techniques, Black babies are now more than twice as likely than white babies to die in their first year of life.

We know that there was a financial interest in keeping those babies alive during slavery, but we also know now what racism does to our bodies. When Black birthing people are pregnant, that stress actually gets transmitted to our babies. There's something called epigenetics—it's how stress influences gene expression. There's some data that even shows that the stress that enslaved Black women endured has been transferred across generations, and that impacts the infant mortality of Black babies today.

RC: You mentioned unlearning things you were taught during your formal education. How do you do that?

UB: It shouldn't be a process that we have to take upon ourselves. One thing I talk about in the book is a call to action: Medical schools need to think about educating future physicians to adequately and equitably care for Black patients in a world full of anti-Blackness. They have to be very intentional about what the curriculum looks like. It can't just be one training or one workshop.

RC: You write in the book about how your mother always made sure that you and your sister felt good about your Blackness and how you were surrounded by representation, such as Black art and Black books. Can you talk about how that may have shielded you throughout your life?

UB: I grew up thinking that most physicians were Black and that most of them were Black women—my mother, my pediatrician, we had several Black doctors. And my mother was the first Black woman in New York State to get her MD; she [became] the president of the Dr. Susan Smith McKinney Steward Society, [and she] would take me and my sister to these meetings with her. And so, for a very long time, I saw that as a very tangible possibility for me. It really wasn't until I got to college and was pre-med that I looked around and realized that there were not that many of us. And then, in medical school, there really weren’t that many of us. And then looking for my own physicians, [and] having a hard time finding people who look like me, [I recognized] that my experience growing up was such a rarity—it was a blessing, but also a rarity.

You would think that would have protected me from feeling inadequate or out of place. [But] later in my career in academic medicine, I literally got to a point where I felt undervalued and underappreciated. This is what predominantly white institutions do to us.

RC: We place a lot of emphasis on being a “first”—especially being a Black woman first—and it’s always framed as this amazing accolade for us instead of a failure on the part of the system. As a first yourself, what does it feel like to hold that moniker?

UB: I say it in a conflicted way. I say it proudly because I'm very proud of my mother and all that she accomplished…knowing that it wasn't easy for her. But also, there were so many other brilliant Black children like her growing up in central Brooklyn who should have been at Harvard Medical School with her. My sister and I graduated in 2005 and became the first Black mother-daughter legacy at Harvard Medical School. That’s ridiculous. So that speaks to the work that these institutions that are so highly respected still have to do. 

RC: What are your thoughts about what happened to Claudine Gay?

UB: I'm devastated as a Black woman, [and] as an alumni of Harvard. What happens—and we see this often as Black women—is that we are put in these positions of power, and then we are not empowered. We're not given the support that we need. I was actually nominated to be the Chief Marshall for my class reunion this May—my 25th reunion at Harvard. But I took my name off the ballot. I emailed them and said, “I don't want to be considered for this because I'm very disappointed in the lack of support that President Gay received from Harvard.” You cannot put us in these positions and then let us flail on our own. 

RC: It speaks so succinctly to the way that we, as Black women, have had to exist according to tropes, but when we are put into these positions of power and then try to function in a way that is anti-trope, it becomes very clear that that’s not what we were anointed to do.

UB: Right. Exactly. This is why I left academic medicine. I was handpicked for this DEI role in the Office of Diversity Affairs at NYU. I was so excited. I was like, finally, I'm going to do the work that I want to do. And then come to find out it's a figurehead position. And talk about that whole pet-to-threat [phenomenon], where they bring you in because you've done all these wonderful things, and then you start making these observations about the inequities in the system, and you become a threat. And then they isolate you and make things either so untenable for you that you want to leave, or they ask you to leave. This happens to Black women all the time.

RC: I think among the most frustrating things for those of us who interrogate systemic racism is identifying where there are improvements. Where do you see advancements?

UB: In the book, I talk about this birthing center, the Roots Birthing Center in Northern Minneapolis. And Northern Minneapolis has the worst racial inequities in health in every other area. This birthing center was founded by a Black midwife with the mission of serving Black birthing people with respect and dignity. That is just so simple. But what they've seen in some of the data that's come out from there is that they have had a reduction in pregnancy complications compared to the Minneapolis average.

We need to look at models within our communities that actually are working. How can we support them? How can we give them more funding? We see that redlined neighborhoods correlate with the worst health outcomes. And so on a neighborhood level, if we can look at what we call the social determinants of health—education, housing, employment, and access to healthy foods, just like creating an environment in Black communities where Black people can thrive—that actually makes a difference.

RC: And also just being in community with each other.

UB: That's a great point.

RC: And now that you are a mother, how does it feel to be passing on your own legacy? 

UB: My kids are seven and nine. I have two boys. Even though they're not really clear about what I do, they know that I'm trying to make life healthier for Black people. I would just love for my children to be able to live long, full lives, and if I can help contribute to that in some way, that makes me happy.


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A World Without Exceptions

NEWS

The devastating consequences of the Dominican Republic’s absolute abortion ban

By Mariane PearlFebruary 6, 2024

Standing on the threshold of her home, Niurki, 18, holds her fussy two-year-old baby boy in her arms and surveys the only landscape she’s ever known. The rusty tin roof on her weathered, pale yellow house barely offers protection against the elements. Niurki lives in San Cristobal in the Dominican Republic, a country that attracted seven million tourists in 2022 alone. But it also boasts one of the highest rates of teen pregnancies in Latin America, a consequence of several factors, including the total abortion ban in effect there since 1884

Niurki didn’t want a baby. Her ex-boyfriend and the baby’s father, Carlos, left her the day that she found out she was pregnant. Niurki says she didn’t consider an abortion because of her Catholic faith. But it wouldn’t have mattered; the procedure was illegal anyway.  So she had the baby, and, like 44% of teen moms in the country, eventually had to drop out of school to raise her now toddler. Today, Niurki is unable to work because she does not have access to childcare. Her ex is forced to pay child support, but it’s a paltry $35 per month. “I depend entirely on him,” she laments. “Most of the time, he’s late, and we’re left with nothing.”  

“The worst,” she tells me, her voice still childlike, “is when I don’t have money for food or milk. I make some fruit juices to calm the baby’s hunger, but he keeps crying. It’s despairing.” 

Niurki and her son. (Photo by Mariane Pearl)

Niurki had never been taught about family planning, condoms, or birth control before she had her baby. Now a mother, she’s stuck at home, unable to make a living or pursue her studies. Today, Niurki supports activists who have been campaigning for decades for what they call “las tres causales,” or the three exceptions—measures that would lift the ban in cases of rape or incest, when the life of the mother is at risk, or when the fetus is not viable. President Luis Abinader had promised to support the three exceptions during his campaign, but he has failed to make good on those promises since he took office in August 2020. In July 2021, the Senate of the Dominican Republic voted 23-3 to support a criminal reform bill stripping out any language about the three exceptions.

The United States is months away from a 2024 election, in which the two leading Republican candidates for president and many of those running for Congress have vowed to pass a national abortion ban if they win. The dire situation for women in the Dominican Republic gives us a window into what that might mean for pregnant people here—including teenagers who are denied authority over their own bodies and their families.

No choices; devastating consequences

Niurki and her son in their home. (Photo by Mariane Pearl)

In the Dominican Republic, the responsibility for every aspect of reproduction—from preventing it to raising children—falls entirely on women. “Less than one percent of men use condoms,” Dr. Lilliam Fondeur, a gynecologist and activist, tells me during a conference on reproductive rights in Santo Domingo, the country’s capital. Sexual education in schools is practically nonexistent because, doctors say, even talking about sex is perceived as encouragement. And while contraceptives are theoretically available, 46 percent of women either don’t know about them, can’t afford them, or are reluctant to ask because they fear people in their communities will find out. However, sterilization is a common method of contraception in the Dominican Republic, particularly among women who are married or in domestic partnerships (30.5 percent), but 25 percent of women who opt for sterilization don’t understand the procedure is irreversible. “On the one hand, the government tells you not to abort,” Dr. Fondeur says. “On the other, it doesn’t provide the means to avoid pregnancies.” 

And the punishment for trying to end an unwanted pregnancy is severe: In this fervently Catholic and conservative country, which bears a Bible on its flag, women risk six months to two years of jail time. Meanwhile, for health professionals like Dr. Fondeur, the punishment for helping someone terminate a pregnancy is between five and 20 years of imprisonment. “Professional secrecy isn’t worth a damn,” Dr. Fondeur says. “You can go to jail even for only providing information. You don’t want the woman to die, but you have no alternatives.” As a result, she says, “twenty percent of teenage girls, mostly from rural and lower-income populations, are mothers. [In too many cases], they have babies with men up to 50 years older who tend to abandon them by the time they’re 18.” 

But bans on abortion do not reduce the need for them. The Dominican National Health Institute estimates at least 100,000 illegal procedures occur per year. At least eight percent of all maternal deaths are estimated to be the result of those who tried to terminate their pregnancies but died from infections and bleeding, and around 25,000 more women are hospitalized every year as a likely result of unsafe abortion. 

“Professional secrecy isn’t worth a damn. You can go to jail even for only providing information. You don’t want the woman to die, but you have no alternatives.”

And as in the U.S., the consequences of criminalization are also dire for those with wanted pregnancies. Damaris, a 31-year-old Dominican woman of Haitian descent, experienced terrible pain in her abdomen 16 weeks into her third pregnancy. Her sister Juliana told me she took Damaris to more than five different hospitals and clinics—all of which claimed they didn’t have the means to perform a sonogram, something Juliana later learned was not true. In an apparent effort to avoid abortion, “they went as far as to pretend the baby was still alive when she was, in fact, dead,” she says. With the dead fetus inside her for several days, Damaris went septic and ultimately died in great pain. “She left a son who, because of her death, has refused to go to school ever since, a daughter who tried to cut her veins and survived but still has no friends,” Juliana says, “and a father who succeeded in committing suicide after various attempts.”

Those stories are everywhere in the Dominican Republic. When Rosa Hernandez’s daughter, Rosaura, began suffering from high fevers and getting bruises all over her body at 16, Rosa brought her to Santo Domingo hospital. There, on July 2, 2012, she was told that her daughter was four weeks pregnant. What she wasn’t told was that Rosaura had a deadly and fast-moving form of leukemia and needed urgent chemotherapy that was denied to her because of her pregnancy. She was suffering but wasn’t prescribed painkillers—also allegedly to protect the fetus. “Get me out of here! They’re going to kill me!” Rosaura told her mother. Rosa begged the doctors. “I humiliated myself. I went on my knees,” she remembers. Rosaura was only given chemotherapy on July 26—three weeks after her diagnosis—and died less than a month later on Aug. 17. 

There is only one organization in the countrythe Colegio Médico Dominicanothat, alongside other mandates, protects women inside hospitals where this kind of obstetric violence is rampant. Francisca Peguero, an advocate for the Colegio Médico Dominicano, told The Meteor that if women arrive bleeding because they tried to provoke an abortion or have an infection, hospitals treat them without painkillers. “They are guilted and singled out in the eyes of the community,” Peguero says. “When a woman dies giving birth, there are no investigations; it’s simply filed as internal bleeding.” She tells me about one of the most painful cases she’s seen in her 30-year career: a 14-year-old girl with a banana stuck in her uterus, the only method she had thought of to abort. The girl had been reported to the authorities by her own mother, and when she was taken to the hospital bleeding, policemen were waiting for her in the next room. Later, Peguero found out the girl had died from her injuries and that her pregnancy was the result of incest.

Francisca Peguero (Photo by Mariane Pearl)

In Estebenía, a couple of hours west of the capital, Dr. Jaime Calderon runs a modest, rural health clinic. Dr. Calderon, a bold, bespectacled man in his 40s, doesn’t like to discuss abortion, but he admits to treating girls who have tried to end their pregnancies. “They use ancestral herb beverages to induce abortion, or they introduce objects in their uterus, give blows to their abdomen, or take harmful medications,” he says. 

Clandestine clinics practicing safer abortions charge 500 US dollars—an exorbitant fee when the monthly minimum wage here is 250 US dollars. The safe abortion drug misoprostol is available on the black market (and, because it’s prescribed to fight ulcers, in select pharmacies), but it is also cost-prohibitive. “Meanwhile, the church keeps preaching abstinence,” Dr. Calderon says. “Imagine that! Abstinence in the DR!”

Performing a miracle

Nonetheless, advocates continue to push for change. And, as a young mom, Niurki joined Conamuca, The National Confederation of Country Women, in San Cristobal, the region with the highest rate of teen pregnancies and child marriage. The feminist NGO strives to teach and give a voice to girls 13 to 17. “On average, they start their sexual lives at age 12 without information about planning or sexually transmitted diseases,” says Lydia Ferrer, one of the program leaders.

At the Conamuca Center, a large group of Black teenage girls sit in a circle under a thatched roof and a single fan hanging from the ceiling. A green banner in support of women’s health has been set on the floor, surrounded by offerings of bananas, beans, tomatoes, onions, squash, and carnations. Ferrer nods proudly as she listens to “her” girls presenting their research on the prevention of domestic violence. Indeed, everyone here sounds assertivejoyful, even.  “Teaching feminism is like performing a miracle,” Ferrer says. “Educating these girls about reproductive rights and their integrity in general is saving their futures.” 

At the CONAMUCA Center. (Photo by Mariane Pearl)

Ariana, 18, considers herself lucky: Ferrer is her mother.  As a young girl, she went with her to visit vulnerable communities. She heard stories of incest pregnancies in which the girls didn’t even know that what was done to them was wrong. Most households were managed by single women, and it was often mothers who sold their daughters into forced marriages or unions out of poverty. It still is. “The man goes and promises a cow, a truck, or money, rarely more than 500 USD. But they never deliver; they say she’s not a virgin anymore. What is the community going to say?” Ferrer says. “The new family turns them into maids. When they get pregnant, they can’t have an abortion, so they are sent back to the parents who sold them in the first placewithout an education, with one or two babies, and without a penny to their names.” Ariana witnessed how difficult it is to convince grown-up women that educating their daughters is a better investment than selling them off. “But to induce change,” she points out, “it’s easier to educate ten-year-old boys than to change the mind of fifty-year-old women. ” 

It’s 4 p.m., and the baby finally falls fast asleep in Niurki’s arms, despite music blasting from a neighbor’s stereo. A drunken pair in their 40s is dancing Bachata at a makeshift bar next door. Niurki puts the baby down, and her mother, Yeimi, tells me that she, too, had her first baby at age fifteen. “What Carlos, Niurki’s ex-boyfriend, did was pure evil,” she says, barely containing her indignation. “In our patriarchal society, it’s a brag to get a teenage girl. He had no intention to stay with her or the baby. He defiled her. Like we say here, a fly doesn’t eat the meat, but it wastes it. The idea is that no one else will be her first.” Outside Niurki’s house, a truck swivels its way around the giant potholes on the unpaved road with two large stickers that say God loves you and Jesus is coming. Niurki waves to a girl who lives across the path from her. “She’s sixteen,” Niurki says.  Sitting on a red plastic chair, the girl is holding her own baby. She wears a fitted bright pink dress. She looks bored and annoyed, as if she was meant to go to a dazzling prom and was left to nurse a baby instead. 

But Yeimi smiles, displaying a gap between her two front teeth; she is hopeful. Thanks to Conamuca and the education Niurki receives there, Yeimi is now confident her daughter will make it. Niurki currently attends school on Saturdays and vows to become a psychologist.  Yeimi, too, is in school, training to graduate as a nurse; she wants to inspire her daughter. Right now, she works as a health promoter, climbing mountains and crossing rivers to spot potential teen pregnancies in remote communities. “I tell girls we have immense weaknesses, but we also have immense strength because we have suffered…we have weathered so much injustice, now we can stand strong. We’re studying, we’re rallying, demanding information, and getting economically independent. We are a new generation of feminists for the Dominican Republic.” 

Yeimi, Niurki’s mother. (Photo by Mariane Pearl)

With municipal elections scheduled for February 18th and Congressional elections in May, Dr Fondeur stresses that in the Dominican Republic, violence doesn’t only come from patriarchy and machismo. “The worst and deepest violence is structural,  it comes from the government politicizing abortion without consideration for women’s rights or for our health.” In watching the recent turn of events regarding abortion in the United States, Dr. Fondeur says, “ If the U.S. votes for a total abortion ban, we stand no chance of changing the law here,” she says. “We’ve always looked up to our neighbor, and now we’re scared.”