…as ruminated on by one single person who speaks only for herself.

Today’s long and rambly title kinda reflects the episode content.

I am not a spokesperson.

As with every episode in this podcast, I’m here speaking only for myself. This podcast is a personal endeavor, and my words and voice are solely my own. I’m also neither narcissistic nor naive enough to think I could ever possibly speak for all women. Given this current Supreme Court, I feel the imperative to speak up, especially since the conservative majority on the court has made it clear they’re coming for a whole bunch of rights that belong to folks who aren’t straight white men. 

In today’s episode I’m meandering through my past as a student. I’ve been interested in the ways institutions around the country are responding to the Dobbs decision, with everything from studied silence to vehement outrage. So I’m taking some time to look at the three institutions where I  studied – three places where I was particularly vulnerable as a low-income student with no family support – and exploring their responses to Dobbs because I wonder and worry about their students now.

So! Here we go. And heads up: this is a long one. 

Ruminating on healthcare education in the wake of Dobbs

In the wake of Dobbs I’ve been interested in the ways people are using their voices to amplify institutional positions. I appreciate the way that sharing information and making it visible and accessible can be a form of leadership. The most comprehensive effort I’ve seen is from an editor at The Chronicle of Higher Education, who started a Twitter thread of all the institutional statements he’s found, regardless of the position they take. It makes for an interesting snapshot of US higher ed today, and I’ll link to it in the show notes. 

Reading through those statements got me thinking about the Dobbs decision less as an administrator and more from a student’s perspective. For the record: I am a feminist and I am fully pro-choice. I’ve had one abortion, three first-term miscarriages, two second-term premature deliveries, one loss of a twin, and two full-term deliveries. My last three pregnancies were considered high risk and required careful monitoring, daily medication, and weekly check ups and injections from a visiting nurse. The miracle that I have living children at all is 100% due to the fact that I had access to a full range of reproductive healthcare.

I’m fortunate not to have needed that care when I was an undergrad student. But what if I had? This question sent me to see how my three alma maters are responding to Dobbs. 

I am 100% the product of public education, from kindergarten through my PhD. I started my undergraduate work at the University of Utah, I completed it at the University of Washington, and then earned both my master’s and doctoral degrees at the University of Wisconsin-Madison.

I believe that education is a public responsibility. We have a moral and ethical obligation – a national responsibility – to educate our citizens – not just those with legal status as citizens but every single person who lives here. Education is the basis of our functioning as a civil society where we see our way through competing and conflicting narratives, that we are able to investigate ideas that challenge our hearts and our minds, that we have have an expansive mindset of all people as part of a living community with a vested interest in each other’s well-being. 

Given that I believe all that, well, I’m both frustrated and intrigued by the ways leaders of state institutions operate alongside politicians. That looks like really hard work to me, and so I read these statements with a lot of sympathy for the hazards and collisions leaders of state universities face in this kind of situation. But I was also genuinely curious to see how they would negotiate the complexities and horrors of this moment. 

For starters, all three universities – each a respected R1 – includes a medical school. In fact, the University of Utah is the only MD-granting institution in the state, and the only academic medical center in the Mountain West. All three of them have broad reach as institutions training healthcare professionals. So not surprisingly, each institution has posted a statement about the training of doctors in obstetrics and gynecology. 

I’ll start with the University of Wisconsin-Madison because it’s the most vague. They write that they “will continue to provide outstanding, comprehensive obstetrics and gynecology residency training […and] will continue to advance health equity by identifying ways to support marginalized populations that are disproportionally [sic] affected by barriers to accessing reproductive healthcare” while continuing “to meet all applicable legal requirements.” They don’t address the inherent tensions and contradictions of those positions, nor do they comment that it may not be possible to thoroughly train OBGYNS, fully care for marginalized populations, and obey the state law. As a Wisconsin resident, I am pretty pissed off about the way state politics are playing out here, and let me just say that I’m glad I wasn’t the person who had to write the medical school’s statement, and I don’t envy the difficulty the med school faces in figuring out how to proceed in ways that are compassionate, medically comprehensive, and legal.  

I found myself more sympathetic to the University of Utah’s statement, which clarifies the link between the federal law, Utah law, and the med school’s requirements as an accredited educational institution. They clearly state that both that didactic and clinical training require learning about pregnancy termination, and that the “procedure used for pregnancy termination is the same one used in cases of late-term miscarriage and stillbirth (fetal death)[…and thus] is part of training to be a competent obstetrician gynecologist.” They don’t indicate how they’ll provide that training if the activities themselves are illegal, but they at least take a clear stand on the importance of a comprehensive education. 

In contrast to Utah and Wisconsin, the University of Washington – the only one of the three located in a state that currently protects a woman’s right to abortion – is exceptionally clear, specific, and compassionate. As both an alum and a woman, I’m grateful for their statement that “In the wake of [the Dobbs] decision, UW Medicine leadership reaffirms our support for access to abortion care as part of a full continuum of reproductive healthcare services.” They don’t shy away from using the word “abortion” in their statement, and they actually ask and answer the question “What is UW Medicine’s position on abortion services?” They also go into detail about the implications for classroom and clinical training, as well as for telemedicine, when those activities cross state lines. 

Before I went looking for the statements these three schools were issuing I hadn’t given any thought to their med schools. I had thought a lot about how Dobbs would affect patients, and a little bit about how it would affect current practitioners, but I hadn’t really thought at all about the future of medical training, and what our country will look like if we don’t train health care professionals in the full range of reproductive health care. It’s easy enough – not pleasant, but easy enough – to imagine a future where women have to travel across state lines to get the care they seek. I had pictured clinics dealing with backlogs and long waits due to patient demand. But I hadn’t stopped to realize that if Dobbs stands, we will surely have fewer trained doctors, nurses, PAs, anesthetists – the whole range of caregivers – who are prepared to provide services to people in need. 

So now I’m sitting here wondering about the future state of healthcare education in our country more generally. The pandemic has already torn through the medical and medical education communities, with rampant burnout, resignations, and retirements reported in the news, additional challenges to securing clinical sites, and at least here in Wisconsin, a pretty significant backlog at the state level to clear nursing students for their licensure exams. On top of everything the pandemic intensified, institutions now have to consider the friction between the Dobbs decision, its local implications, and educational standards. They’ll have to consider how that friction will affect the quality of the training they provide, and how changes to their educational offerings might affect future admission cycles. I can imagine a future where some med schools are flooded with applicants, and others struggle to fill their classes. I don’t think it’s ever an easy time to be a dean, but this seems like a really rough time to be the dean of a medical school. 

Ruminating on the intersection of state legal cultures and state education

I also don’t think it’s an easy time to be a college president, and it’s probably never been easy to lead a state institution that requires ongoing engagement with the legislature. So I turned to those institution-wide statements with lots of sympathy as well. 

At the University of Wisconsin-Madison the interim chancellor issued a statement – which, by the way, shout out to UW,  is offered in summary in 6 languages – acknowledging the “wide range of feelings” evoked by the decision. At the same time, the chancellor’s stance is fairly neutral: the university will continue to follow the law while seeking full understanding of its implications for patient care, medical training, and caring for the campus community. He leaves it unspoken how they plan to reconcile these opposing positions.

Beyond the chancellor is an organization called PROFS, which is a voluntary, non-profit organization of UW-Madison faculty. PROFS statement is more specific. They address the difficulty of maintaining accreditation for the medical school, the potential challenges in attracting and retaining students and employees if Wisconsin’s prohibitive 19th-century statute stands, and the disproportionate suffering the Dobbs decision will impose on “women of color and those in low-income and rural communities.” They also called for clear action, including legislation that would protect pregnant people at the state and federal levels. 

The statements posted at the University of Utah are a stark contrast to the institutional positions at the University of Wisconsin-Madiwon – which honestly, surprised me. Let me be totally transparent here: I have a ton of baggage about Utah. I was born there, I lived there on and off as a kid, it’s where I went to high school, and nearly everyone on one side of my family lives there. I’ve been both baptized in and disfellowshipped by the Mormon Church. My feelings about Utah run deep, and are almost always deeply ambivalent. It is fair to say I turn a pretty wary eye on most things in the Beehive State. 

That said, I really did love my time as a student at the U. 

The University of Utah organizes their statement into three sections. The first is a short and simple reminder that the university is a state entity and therefore follows state and federal laws, which will now include what is commonly called Utah’s trigger law, (although it’s currently on hold “pending resolution of lawsuit from Planned Parenthood and the ACLU of Utah”).

The second section shifts to a description of the university’s role in public debate. In this section the university explicitly defends academic freedom and freedom of speech for students, faculty, and staff, while noting that in general people speak for themselves, and only “designated spokespeople speak on behalf of the institution.” And they go further, writing that “the university has a responsibility to speak and educate the community about issues that impact our campus community without directly engaging in political disagreements. Pregnancy termination is an issue of health care for our students, employees and patients. It is the subject of research from our faculty. And it is a matter of patient care for our hospitals and clinics staff and faculty.” 

The third section, called “Support for Those In Our Community,” demonstrates deep respect for pregnant people’s needs and choices, as well as a commitment to clinician’s “oaths and standards of ethical practice.” It ends by directing readers to resources on campus that can support those who are “managing the impact of this decision.” 

The page ends with a list FAQs which are direct, honest, and clear. 

Even though I know next to nothing about how the University of Utah’s leadership team operates, this page impresses me and gives me hope. It demonstrates a compassionate approach to the university’s responsibility to all Utahns to encourage civic activity, communal thinking and debate, and shared decision-making. It manages to be honest and sensitive while operating within its parameters as a state entity. I gotta give props to the Communications team who developed this page, and also to the hearts and minds of the people who promote the sentiments behind the words. It maybe doesn’t say everything I would hope for as a woman who believes in women’s rights, but it does say a lot of good things. And it highlights the glaring absence at UW-Madison of any mention of the Wisconsin Idea – the principle that education should influence people’s lives beyond the boundaries of the classroom.

Ruminating on some awesome women leading at state institutions

Here’s another piece of the picture that surprises me at Utah. About six years ago they launched a new school called Transform: The School for Cultural and Social Transformation. Transform is the academic home to Disability Studies, Ethnic Studies, Gender Studies, and Pacific Islander Studies. Decades ago, the woman who is now its dean but was then a freshly-minted PhD teaching English Literature – Kathryn Bond Stockton – taught my undergraduate self how to fall in love with the emotional and bodily pleasures of reading. As a professor she made very real for us the ways that being an intellectual feels good in your body, and she brings that same energy to her work as dean. I’m sure there are amazing schools like Transform around the country, but given what I know of, and feel about, Utah… well, I think this school is something of a miracle. I’m going to drop a link in the shownotes to a welcome speech Kathryn recently gave to the incoming class, which is striking for its radical candor and big heartedness. It’s a short YouTube video and if you’re interested in how leaders talk about meaningful intersectional issues with love and passion, I think you’ll find it’s a good way to spend six minutes. Anyway – so now when I think of the U, I picture an imposing university nestled in the foothills of the capitol of a very conservative state, willing to take on the work of caring not just for the minds but for the bodies – remember? Disability Studies, Ethnic Studies, Gender Studies, Pacific Islander Studies – of its entire community. 

So Utah? Wow. Just wow.

And all this hard fangirling brings me to the University of Washington – and particularly its president,  Ana Mari Cauce. I graduated from UDub in 1994, at which point Ana Mari was already on campus as a professor (although sadly I never found my way to her classroom). But I’ve watched her leadership development in the intervening years with interest, partly because she’s one of the few women I know of who start their career somewhere as a faculty member and stay at the same place until they are the president.Her career path is amazing and inspiring. 

But what I love about Ana Mari is that, like Kathryn Stockton at the U, she doesn’t just get promoted. She says things, in writing, and out loud, that come from her heart. Her leadership is a living testament to her values. You can see this in her presidential blog, which is a series of posts embodying inclusion, fighting for justice, showing gratitude and more. I’ll drop a link to that in the shownotes too. I know I’m biased but I don’t think you have to be an alum to find her work energizing and uplifting. 

Like the University of Utah and UW-Madison, UDub’s med school quickly responded to the high court’s decision on abortion with a position merging legal requirements, medical training responsibilities,  and state law. As president, Ana Mari took the uniquely bold step of saying some stuff out loud. She calls the Dobbs decision “profoundly distressing and concerning for many members of our community, including myself,” and notes that it “raises equally troubling concerns about what this may mean for other human rights that we believed were established and inviolable.” She goes on to “applaud the new multistate commitment to abortion access being enacted by Governors Jay Inslee, Kate Brown, and Gavin Newsom,” and closes by sharing her conviction that “progress toward freedom, equality and universal human rights will take work by all of us, but I am confident we are equal to the challenge.”

OK – it’s not at all surprising that these three institution’s responses to Dobbs are uniquely contextualized by their state’s political positions. It’s not surprising to see caution in Wisconsin and anger and a fight for justice in Washington. 

I know it’s early days – even counting the seven weeks lead time we had when the decision was first leaked in early May – and I know it takes time to determine an institutional approach to managing a crisis. We’ve all just gone through repeated crash courses in that lesson. Still, I find myself yearning for these statements to be clear and direct about what will happen to students on campus. 

Ruminating on forcibly pregnant bodies on college campuses

I’m thinking, in particular, about the potential traumas faced by pregnant students who are not pregnant by choice. There’s the practical stuff during pregnancy, like…they might need larger desks to accommodate their changing bodies, or time away from class for doctor’s appointments, or medical accommodations if they’re put on bedrest. And there’s the post-pregnancy practical stuff, like…child care, time away from classes to spend with preemies in the NICU, a place to breastfeed or pump, diaper-changing stations, family restrooms, etc. And then there’s the relatively easy emotional stuff that comes with all of that: dealing with being pregnant on a college campus, wondering what kind of judgey thoughts people are having about you, having to miss out on any number of social events that aren’t conducive with pregnancy and parenting newborns, learning how to manage life on chronic sleep deprivation.

All this will be plenty hard – for the pregnant student, and for the entire campus community. I’ve worked at women’s colleges where it’s not surprising to see students-as-mothers and students-as-caretakers. But on most co-ed campuses with a large student body of traditional college-aged students? This will all be radically different.  

As much as I worry about all that  (and I DO worry — it took me six years to finish college and I never got pregnant, let alone had a child…and given that I worked in order to pay my way through college I doubt I could have finished if I’d become a mother) … anyway as much as I worry about that, I worry even more about the terrors and traumas associated with forced pregnancies. I worry about the impregnated rape victim who is suffering through an interminable Title IX process while their rapist walks freely around campus….and who may very well sue for custody once the child is born. I worry about the mental health and physical safety of the woman who is slut-shamed for her pregnancy. I worry about the grieving parent whose child dies in utero, or the grieving spouses, friends, partners, and family members who suffer the double loss of a difficult stillbirth that also took the mother’s life. I worry about the new parent suffering from post-partum anxiety or post-partum depression who considers taking their own life. 

And how long will it take – one year? three? five?  – until the impact of all those people who are crushed under the oppressive weight of being forced into parenting, who indefinitely extend or totally give up on their college education means not just our economy tanks but our social fabric dissolves? This may sound melodramatic but it’s not. We know what this looks like, because for hundreds of years our country has been punishing people in exactly these ways: women with black and brown skin, immigrant women, queer women, women from all historically excluded categories. 

In an opinion piece written for Macleans, Melayna Williams writes about the blindspot of white women who were freaking out about The Handmaid’s Tale. She reminds us that for hundreds of years in the US black women found “…themselves captive, […] bred against their will, and […] tortured and even killed for attempting escape.” In that America, it was nearly impossible for a black woman to “be born, live, and die of old age under a social system that deemed neither her body nor the fruit of her womb to be her own.”

She’s talking about history – about teachable facts, which in turn prompted me to see the opportunity to address this terrible moment through education. I’m not advocating for indoctrinating or radicalizing students, or forcing college campuses to take pro-choice positions that are out-of-step with their missions. But regardless of our missions, we all share a commitment to education. 

Freire reminds us that “There’s no such thing as neutral education. Education functions as an instrument to bring about either conformity or freedom.” Those of us who are passionate about education are, by definition, passionate about freedom. The task before us now, as we lead our institutions in this difficult moment, is to insist upon education as liberation, and to design our responses as ways to support, educate, and liberate all of our students, including those who dissent, until none of them are suffering. 

This is a time to draw upon the liberal arts to teach students to see the intersections of democracy and economics and psychology and anatomy and mental wellness and history and human compassion. The ways we educate must ensure that our privileged students are equipped and also caring enough to fight for the rights and well-being of their classmates – both those who are among the historically-excluded, as well as those who are newly-excluded.

On June 24 2022, the day of the Dobbs v. Jackson decision, Inside Higher Ed published a news story with the title “Is it a University’s Duty to Protect Students from Harm?” I can’t answer that question as either an attorney or as a college spokesperson, as I am neither. 

But I side with figures like Freire and bell hooks, and believe it’s impossible to care for someone’s mind if you’re not also caring for their bodily well-being. There are many, many ways to protect students from harm. The one way we all share in common is education – education that prepares our students to care about, to care for, and to liberate one another. 

The Dobbs decision venerates and enshrines oppression by eliminating liberty for women. And Clarence Thomas has told us that he’s coming for a whole host of other liberties as well. (I’ve put a link to his concurrence, as well as some commentary about it, in the show notes as well.) 

I am exhausted by all of this and also ready for a righteous fight. 

As Auden reminded us on the eve of World War II, we must love one another or die.

Show Notes

Andy Thomason, Assistant Editor @ The Chronicle of Higher Education: thread on institutional statements collected to date: https://twitter.com/arthomason/status/1540724375577657344

University of Wisconsin-Madison Statements

School of Medicine and Public Health Response to U.S. Supreme Court Decision:  https://www.med.wisc.edu/news-and-events/2022/june/response-to-june-24-2022-supreme-court-decision/ 

PROFS: https://profs.wisc.edu/wp-content/uploads/2022/06/PROFS-Statement-on-Dobbs-6-28-22.pdf

UW-Madison Response to Uncertainty Created by Supreme Court Decision: https://news.wisc.edu/uw-madison-response-to-uncertainty-created-by-supreme-court-decision/

Wisconsin Idea: https://www.wisc.edu/wisconsin-idea/#:~:text=One%20of%20the%20longest%20and,the%20boundaries%20of%20the%20classroom.

University of Utah Statements

University of Utah Statement: U.S. Supreme Court’s overturn of Roe v. Wade

University of Utah Statement: U.S. Supreme Court’s overturn of Roe v. Wade

University of Washington

UW-Medicine responds to high court decision on abortion:

https://newsroom.uw.edu/news/uw-medicine-responds-high-court-decision-abortion

Ana Mari Cauce. Ruling overturning Roe v. Wade will have significant impacts, but won’t change rights in Washington or at the UW. https://www.washington.edu/president/2022/06/24/scotus-overturns-roe-v-wade/

Ana Mari Cauce, Presidential Blog. https://www.washington.edu/president/blog/

Kathryn Bond Stockton @ YouTube. Welcome Address. 

To Gether

Melayna Williams @ Macleans: For black women, The Handaid’s Tale dystopia is real – and telling. May 14, 2017

For black women, The Handmaid’s Tale’s dystopia is real—and telling

Susan Greenberg @ Inside Higher Ed: Is it an Institution’s Duty to Protect Students from Harm? June 24 2022. https://www.insidehighered.com/quicktakes/2022/06/24/it-university%E2%80%99s-duty-protect-students-harm

Quint Forgey and Josh Gerstein @ Politico: Justice Thomas: SCOTUS ‘should reconsider’ contraception, same-sex marriage rulings. Jun 24, 2022.

https://www.politico.com/news/2022/06/24/thomas-constitutional-rights-00042256

On Document Cloud: Clarence Thomas’s concurrence on Dobbs v. Jackson Women’s Health Organization. https://www.documentcloud.org/documents/22067323-dobbs-v-jackson-womens-health-organization-clarence-thomas-concurrence

W.H. Auden @ Poetry.org. September 1, 1939. https://poets.org/poem/september-1-1939