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Make no mistake: the conservative-leaning U.S. Supreme Court’s reported decision to overturn the 1973 decision of Roe v. Wade is an attack on poor and marginalized women of colour – one that represents another huge blow to the decades-long fight for health care equity.

A leaked majority opinion draft suggests that the court has decided it will turn the clocks back 50 years, allowing state governments to deny a woman’s right to have control over her own body by removing her ability to have an abortion.

With complete justification, women’s rights advocates are on fire, denouncing this latest move – one that former U.S. president Donald Trump had himself promised when he vowed to stack the Supreme Court with anti-abortion judges in the 2016 election. But even in the decades since the country’s highest court ruled that abortion was legal in the U.S., many individual states have created their own laws and barriers, chipping away at this freedom and restricting access.

That right has also long been conditional for Native American women. In 1976, the Hyde Amendment banned the transfer of federal funds for abortion services from Indian Health Services, the provider of Native American health care. While successive amendments over the years have allowed for some abortions under a small number of exceptional circumstances – rape, incest, a mother’s life threatened – Indigenous women in the country have effectively been denied equal abortion rights until just last year, when Joe Biden introduced a 2022 federal budget that omitted the Hyde Amendment.

Indigenous women on both sides of the U.S.-Canada border have long been fighting for truly equal reproductive rights and bodily self-determination. So we should know that even as a woman’s ability to choose what she wants to do with her body threatens to be revoked in the U.S., injustices continue – including in Canada, where a paternalistic health system that has treated Indigenous women as inferior, and commits forced sterilization of them even now, continues apace.

Inequitable access to health care and two-tier delivery are hallmarks of Canada’s health care system. For decades, Indigenous peoples were forced into federally run Indian hospitals that ran alongside the residential-school system. By the 1960s, there were 20 fully functioning Indian hospitals running across Canada. Let that sink in: 20 segregated hospitals, now closed, that were created to keep us out of so-called “universal” health care.

According to research by Wilfrid Laurier University Professor Karen Stote, by the early 1970s, 1,150 Indigenous women had been sterilized against their will over a 10-year period in these so-called hospitals, often after the mothers had given birth and were mentally and physically vulnerable.

According to the Canadian Association of Community Living and People First Canada, nearly 3,000 people were sterilized “by the mandate of the state” during the eugenics movement in the early part of the 20th century, mostly in the Western provinces, because they were “undesirable,” “unfit” or “mentally defective.” This also occurred in the United States, where upwards of 25 per cent of Native American women were sterilized in the 1970s.

Today, reproductive rights in Canada are covered under Section 7 of the Canadian Charter of Rights and Freedoms, which specifies that the security of a person includes the right to have security over your body, preventing the state from imposing unwanted medical treatments.

Yet sterilization without consent continues today, according to a report from the Canadian Senate’s committee on human rights: as of 2018, more than 100 Indigenous women across Canada have alleged that this happened to them, according to lawyer Alisa Lombard, who represents many of the women in a class-action lawsuit. And just this week, Indigenous women bravely told the Senate committee about their sterilization experiences: “I didn’t say anything to anyone because I thought no one would believe me,” one said.

So Canadians rightly disgusted by the Roe v. Wade turnover in the U.S. need to keep Indigenous and racialized women in their minds as they continue to push for health care equity and bodily autonomy. They should remember Joyce Echaquan, the Atikamekw mother who broadcast on Facebook the racist slurs and treatment she received in a Quebec hospital, and died after being neglected and wrongly diagnosed.

In the U.S. and in Canada, women have been denied their reproductive rights and their right to choose what we want to do with their bodies. The outrage over the leaked Roe v. Wade decision is righteous and necessary – yet it also shows how far Indigenous women have had to climb for any resemblance of equality in the eyes of the public and the law.

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