I write to express my concerns about the State of Alaska’s intent to fund a study on a Long-Acting Reversible Contraception (LARC), currently included in the Senate’s version of the Capital Budget. I first expressed my concern when this study, as standalone legislation (Senate Bill 198), was being heard in the House Health and Social Services Committee. When SB 198 was in committee, there was intentionally very limited time allocated for public testimony and, unfortunately, numerous letters of opposition were never posted as part of the public record. This disrespect for the public process has led me to write this letter today.
As we all know, Alaska has startlingly high rates of Neonatal Abstinence Syndrome (NAS) and fetal alcohol spectrum disorder (FASD). Studying the barriers to health care, education and employment for vulnerable members of our communities is critical to finding sustainable solutions. Unfortunately, as written, this study does not do that. Instead, this funding is allocated only for the identification of women with substance use disorders who are at risk of having children and providing them with highly effective birth control in an effort to prevent pregnancy. Apart from the fact that this type of contraceptive care is already provided by programs like Medicaid, this targeting of a specific population of Alaska women is very worrisome. Although I appreciate the intention of reducing the prevalence of NAS and FASD, the ambiguity within SB 198 causes serious concern because it may lead to demonizing not only women who have substance use disorders, but also women in recovery, those who are low-income, and women of color.
This study creates a troubling nexus between legitimate NAS and FASD issues and the state’s interests in saving money. It is the Legislature’s responsibility to ensure a woman isn’t coerced into seeking any particular form of contraception just because it is in the state’s financial interest. Because these concerns were not heard or addressed, my skepticism of the LARC study remains. Unfortunately, there is a long and well-documented history of government-sponsored, provider-controlled contraceptive practices coercive to the most vulnerable women in our country. These unethical practices have been particularly harmful to low-income women, women of color, and women with disabilities. With this troubling past, it is concerning to see the state considering treating women impacted by substance abuse separately from other Alaska women.
On its face, this study may seem like it is intended to ensure great care for our youth. However, upon close examination, it is rooted in patriarchal, racist and classist ideals. It comes from a place of privilege and not empathy. Rather than passing these convenient ideological condemnations onto women who long suffer from addictions — often brought on by traumatic experiences — let us instead look at the root problems and work alongside our Alaska sisters for healing and prevention.
This study should not be isolated from the public process. Input from individuals and community partners should and do provide essential perspectives on recovery and access to quality contraceptive care, something every community must be invested in addressing. I look forward to the Alaska Legislature addressing this very important issue holistically and funding essential services such as behavior health, public education, and equitable access to health care in Alaska.
I urge Alaska’s lawmakers to steer clear of the not-so-distant past of forced sterilization and remove the funding for this study in the capital budget, and prevent any such study from being funded.
• Richard Peterson is president of the Central Council Tlingit & Haida Indian Tribes of Alaska.
