Indigenous people unite to navigate abortion access after Roe
Rachael Lorenzo calls it their “auntie laugh,” a powerful chuckle that lasts long and fills any space. Aunties are prominent figures in Indigenous culture who offer comfort when one needs help.
Aunties answer the phone when no one else does.
That’s what Lorenzo, who is Mescalero Apache, Laguna and Xicana, does as founder of Indigenous Women Rising, a national fund that covers the costs of abortions – and the traditional ceremonies that follow – for Indigenous people.
Since the reversal of Roe v. Wade a year ago, demand for the organization’s services has skyrocketed. The group funded 37 abortions in 2019, 600 in 2022 and over 300 in the first six months of this year. From January to June, it’s spent more to help people than in all of 2022.
“We’re investing more money into … airfare, bus, gas, child care, elder care, after care for the individual who’s getting an abortion,” Lorenzo said. “If there are special needs that they have, we do our best to fund that, as well.”
Indigenous people have been uniquely affected by the end of Roe.
Abortion was never readily available to Native Americans, thanks to a federal law that has prohibited nearly all abortions at Indian Health Service clinics since 1976. That’s always meant traveling long distances for the procedure.
But now states with some of the largest Indigenous populations also have some of the strictest restrictions on abortion: places like North and South Dakota and Oklahoma, home to the Cherokee Nation, the second-largest tribe in the U.S. with over 300,000 enrolled members.
Across the country, some 2 million Native Americans live in the 20 states with laws on the books banning abortion at 18 weeks of pregnancy or earlier, according to a News21 analysis.
“There are clinics closing, providers moving out of those states that we have served or serve, and so we’re seeing more people need to travel from very rural states in order to get abortion care,” Lorenzo said.
Add into the mix disproportionate rates of sexual assault and unintended pregnancy, a crisis of missing and murdered Indigenous women, high rates of maternal mortality, and poor access to preventative care and contraception, and the end of Roe has made a bad situation much worse.
“Roe has never been accessible for Native women,” said Lauren van Schilfgaarde, a tribal law specialist at UCLA who has studied abortion care in Indigenous communities. “When you add in the rates of violence and the complete gutting of tribal governments’ abilities to respond, you have a real dangerous recipe in which Native women have a lack of reproductive health.
“Dobbs has exacerbated that.”
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The federal government provides health care to Native people as part of the treaty agreements for seized land. Those living on tribal lands or in big cities can use the Indian Health Service, or IHS, an agency within the U.S. Department of Health and Human Services that covers 2.6 million Native Americans and Alaska Natives across 574 federally recognized tribes.
However, the system is perpetually underfunded, forcing facilities to limit the services they provide.
On tribal lands, the clinics can be hours away by car – a trek that comes with a price tag for Native Americans, a quarter of whom live in poverty. And once they arrive, the clinic may or may not have gynecological or obstetric services.
“Reproductive health care has always been considered, for some reason, outside of the mainstream,” said van Schilfgaarde, who is Cochiti. “It’s always the lowest-hanging fruit for budget cuts.”
The Hyde Amendment further restricted reproductive access for Indigenous women.
First approved by Congress in 1976, it banned the use of federal funds for abortion except to save the life of the mother. Exceptions were later added for rape and incest. While the measure was not directed at Native people, they are among those most affected because they rely on federal clinics.
And exceptions for abortion are rarely granted, even though Indigenous women are 2.5 times more likely to be raped than other women in the U.S., and some 34% of Native American women report having been raped at some point in their lives.
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Melissa Rose lives in Santa Fe. She’s been a midwife for 10 years, but with the end of Roe v. Wade, she has seen her role in reproductive justice change.
Now, self-managed abortion is also part of her practice. Between restrictive state laws and the availability of the abortion pill and traditional herbs used for centuries to end pregnancies, people are choosing home abortions just as they would choose a home birth, she said.
“In our communities, traditionally, we would just do that at home – in a safe and sacred way,” she said. “And so that’s not different now.”
Abortion has always been a natural part of pregnancy in Native culture, where women are viewed as sacred and, before colonization, had sovereignty over their bodies.
“Self-managed abortion is traditional,” said Rose, who is Akwesasne Mohawk and from the tribe’s territory in northern New York and Canada. “The first abortion that ever happened on the Earth was self-managed. We knew what plants to take, and we would stay home.
“We’ve only been a handful of generations separated from this being the norm. … And in some families, this knowledge has been really carefully protected and passed down and, luckily, we have all of that still.”
In Indigenous culture, unlike the western debate, there is no conflict between managing a pregnancy or ending one, she said.
“From a provider standpoint, the treatments are exactly the same for a miscarriage or an abortion,” Rose said. “And midwives have always helped people with those pregnancy transitions.”
Native people sometimes choose to have ceremonies to honor the loss and bring closure by burying the tissue. But in states with strict bans, burying remains could bring criminal charges.