While our country remains polarized over the pro-choice/pro-life debate, and the political climate becomes increasingly hostile to reproductive rights, Latinas continue to face basic health care challenges that affect their reproductive health. For Latinas, whose choices have been constrained by discriminatory policies and a high rate of poverty, the fight for reproductive justice has never been simply a matter of choice.

The long and tragic history of forced and coercive sterilization of Latinas in the United States and on the island of Puerto Rico demonstrates how Latinas have been prevented from fulfilling their reproductive choice to bear children. Thousands of Latinas, specifically Puerto Rican and Mexican-American women, suffered from forced or coercive sterilization during the 1960s and 1970s. Many of these women were sterilized in public hospitals immediately following childbirth without their knowledge or fully-informed consent. Other Latinas were coercively sterilized during this time as a condition to receiving probation or welfare benefits. Although forced sterilization has been largely eliminated thanks to the work of activists in the 1970s, including the pioneer Latina reproductive rights activist Dr. Helen Rodriguez-Trias, current family cap laws raise similar reproductive control concerns for the growing Latina welfare population.

Latinas have been constrained in their ability to prevent or terminate unwanted pregnancies because of financial barriers and restrictive state and federal laws. For example, the Hyde Amendment, which Congress passed in 1977 and the Supreme Court upheld in 1980, drastically curbed abortion access by prohibiting federal funding for abortion except in the case of rape, incest and life endangerment. The first woman to die after the Hyde Amendment became law was Rosie Jimenez, a young, single-mother who was forced to get a back alley abortion because she could not afford to go to a licensed physician without Medicaid funding.

Many states have similar laws that deny funding for abortion, even in cases of medical necessity. At the same time, federal and state governments are limiting funding for family planning clinics, which provide essential pregnancy prevention and reproductive health services. These restrictive funding policies, as well as state laws that require women to wait 24 or 48 hours and minors to obtain parental consent before undergoing an abortion, affect the reproductive choices of Latinas, especially those who live in rural areas.

While abortion laws place significant constraints on Latinas' ability to exercise our reproductive rights, many of the disparities that Latinas suffer stem from an inability to access basic reproductive health care services. For example, lack of health insurance prevents many Latinas from receiving essential reproductive health care, including sexually transmitted infections (STIs) testing and prenatal care, and it reduces the likelihood of routine check-ups. Latinas have the highest uninsured rate of any racial or ethnic group, with over one-third (37 percent) currently uninsured.

Welfare laws that have been tied to immigration status also affect the reproductive health of immigrant Latinas by limiting access to health care programs. Under federal law, legal immigrants who have arrived after 1996 do not have access to federal public health care programs for their first five years in the United States. Undocumented immigrants only have access to emergency care, which does not include prenatal care. Language barriers also pose a significant problem in accessing reproductive health care for the many immigrant and non-immigrant Latinas who are limited English proficient.

Finally, religious beliefs, social customs, and the lack of accurate and comprehensive sex education at home and in school affect how well Latinas are able to prevent unintended pregnancies and access the services and information they need to make healthy decisions.

The result of these compounding obstacles is that Latinas have worse reproductive health outcomes than other groups. For example, Latinas have the highest teen pregnancy birth rate of any racial or ethnic group, and we also have higher rates of cervical cancer, STIs and HIV infection than white women. In addition, at least 28 percent of Latinas do not receive prenatal care during their first trimester.

Recognizing the importance of addressing the range of problems that affect Latinas' reproductive health, Latina reproductive rights activists are currently mobilizing a new, national reproductive rights movement that centers on Latinas' unique reproductive health issues. We are fighting for reproductive rights from a broad social justice framework, acknowledging that one's reproductive health status is profoundly affected by the intersectionality of identities, such as race, ethnicity, social class and immigration status. As our health disparities continue to grow, Latinos must voice our concerns to ensure the health and well-being of our communities.

Angela Hooton is a legislative staff attorney with the Mexican American Legal Defense and Educational Fund in Washington, D.c=