Reproductive justice in nursing

The Penn chapter of Nurses for Sexual and Reproductive Health works to expand students’ engagement in reproductive justice.

A transgender person wearing a medical gown sits on an exam table speaking to a doctor.
Image: The Gender Spectrum Collection

Nursing is the glue that holds health care together, combining specialization and compassion. It is also constantly evolving, especially as new students bring their passion, expertise, and perspectives to the classroom setting. 

Historically, the study of reproductive health centered the health and wellness needs of cisgender women, with little regard for transgender or gender nonbinary people. Expanding the scope of reproductive health to include core tenants of the reproductive justice framework, which was developed by indigenous women, women of color, and transgender people in 1994, allows nursing students to advocate for reproductive health as a human right.

Tara Teipel, a third-year undergraduate student in the School of Nursing from Pittstown, NJ, is the president of Penn’s Nurses for Sexual and Reproductive Health (NSRH). Penn’s chapter of NSRH has more than 100 members. “I found my love of nursing when I combined my interest in science and biology with my desire to work with and help people. Nursing is the most patient-centered area of health care and there's so many different paths you can take through it.”

For Teipel, joining NSRH as a first-year student allowed her to focus on the area of nursing that most interests her—sexually transmitted infections (STIs) and community health—in an extracurricular way. She also advocates for reproductive health care to expand to the trans community. For reproductive health to reach everyone, the approach to care must be more inclusive. Under her leadership, NSRH aims to fill this gap.

Two headshots, left, Holly Harner, right, Tara Teipel
Holly Harner, Practice Professor of Nursing in Women’s Health and the Afaf I. Meleis Director of the Center for Global Women’s Health (left), and Tara Teipel, undergraduate student in the School of Nursing.

NSRH centers its focus locally, investing and interacting directly with the Philadelphia community. Prior to the pandemic, NSRH collaborated with mental health outreach organizations, founded an abortion and miscarriage doula certificate program, and hosted an in-person papaya aspiration workshop, which taught students how aspiration abortion is performed. NSRH also held fundraising events and attended local events in the reproductive landscape around Philadelphia, including a Bowl-a-Thon for an abortion funds and advocacy group, the National Network of Abortion Funds

Like most student led groups on Penn’s campus, NSRH operated remotely through most of the last academic year. Guest speakers, group meetings, and documentary screenings were held over. In spring 2021, NSRH partnered with Student Health to offer a virtual intensive STI training for student nurses at Penn. Students valued the opportunity to learn from experts and become better acquainted with resources on Penn’s campus. “A large part of NSRH is focused on abortion, but reproductive justice is broader than just abortion. We felt a focus on STIs and testing was more gender-inclusive,” says Teipel.

One of Teipel’s classes was taught by Holly Harner, a Practice Professor of Nursing in Women’s Health and the Afaf I. Meleis Director of the Center for Global Women’s Health. When reimagining the traditional obstetric nursing course, a common requirement in most undergraduate nursing programs, Harner wanted to frame student learning through the lens of reproductive justice. As a women’s health and public health advocate, she felt this was a critical perspective that students needed to consider in order to best meet the needs of individuals, families, and communities. “My nursing training, which happened in the early 90s, never addressed reproductive justice,” Harner says. “This framework expands the work that we do and calls on nurses to advocate for the needs of the people we serve. This generation of nurses and nursing students is awe-inspiring, and their passion and demand for social justice pushes me to be a better nurse educator.”

In December 2020, NSRH co-hosted a screening of the documentary, “Belly of the Beast,” which follows the experiences of several cisgender women who underwent illegal sterilization in a California women’s prison. The care of people involved in the criminal justice system is an area of expertise for Harner. In California, incarcerated women were involuntarily sterilized without their knowledge or consent. Harner notes, “Incarcerated people would go in for a procedure, such as a routine fibroid removal, and would be sterilized without their knowledge or consent. Many people only learned about this violation after they were released from prison and tried to conceive. Unfortunately, many victims have remained silent out of fear of being stigmatized or shamed.” In July, California signed a provision into its budget to offer reparations for the thousands of people who were sterilized in these institutions, without adequate consent, often because they were deemed “criminal,” “feeble-minded,” or “deviant.” It is the first program in the nation to provide compensation to survivors of prison system sterilizations.

In addition to programming around the health of incarcerated populations, NSRH supported a successful spring event that focused on maternal morbidity and mortality. A recent report from the Philadelphia Department of Public Health highlights the racial inequities that exist among pregnancy-related deaths in Philadelphia. For example, non-Hispanic Black women and birthing people make up 43% of births in Philadelphia but account for 73% of the pregnancy-related deaths. And Black women and birthing people are four times more likely to die from pregnancy related causes than white women in Philadelphia. An event held in April, “Reducing Maternal Mortality: Harnessing Multilevel Approaches to Reduce Maternal Death,” included local and national experts, including Kimberly Seals Allers, a strategist and advocate for maternal and infant health. Seals Allers discussed Irth, a new rating app for Black and brown parents to address bias and racism in maternity and infant care. 

Harner sees students like Teipel as moving the needle on how nursing faculty like herself approach their work. “Students are our best teachers. Their enthusiasm is contagious. I am eager to see the changes they make in the world as nurses and leaders and am grateful to be a part of their professional journey.”