Nadine Goodman founder of CASA Mexico

Lessons from Mexico: Reproductive justice doesn’t end with contraception

When Nadine Goodman, a young social worker and public health graduate from Columbia University arrived in Mexico in 1981 to learn Spanish, she had in mind to stay a few months and return. But that never happened. Instead she settled down and co-founded the Center for Adolescents of San Miguel de Allende (CASA) – one of the most impactful Mexican nonprofits advancing reproductive justice. Serving around 80,000 people a year, CASA takes a holistic care of reproductive health from providing sex education at schools to free family planning, as well as birth deliveries in their maternity hospital.

Nadine, you’ve been involved in the fight for reproductive justice for the past 40 years. How have the needs of people evolved over time?

I would say that the needs here as well as worldwide are the same, it’s just the window-dressing that is different. We all want to have a bodily autonomy,  enjoy sexuality and sensuality separated from reproduction, have control over our fertility and be able to control our destiny.

What role does contraception have in that context?

I always say if you don’t have contraception and safe abortion services, like in that board game Monopoly, you can’t pass GO, never mind collect 200 bucks. It’s the beginning of being able to find out who you are, especially if you’re a woman.

What challenges do women in Mexico face with regards to the use of modern contraception?

There has been an increasing access to contraceptives since the 1960s, including a national program for free contraceptives. But as we know, when it comes to sexual and reproductive health, access is a tricky concept. Many young people are reluctant to go to healthcare facilities because the personnel is judgmental. Sometimes distribution problems occur. It’s not just access to contraceptives and abortion. But it’s about why we feel comfortable or not comfortable with our sexuality and sensuality and how we separate that out from how many children we have or don’t.

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I think that many reproductive health nonprofits believe that increasing the access to birth control will resolve the unmet need for modern contraception but it’s not true. You can have contraception in every store but if social norms dissuade you from using it, it’s for nothing.

Obviously, the birth control pill in the 1950s made a big difference in terms of liberating women but we’re still very repressed because there’s an incredible amount of shame and embarassment to share feelings and information. Whether it’s how this contraceptive works or not, what it means to feel intimate, what it means to feel the release of an orgasm, what it means to go through post-partum depression or menopause or through moments of utter despair with young children.

We say that we share these things but we really don’t. As I’ve gotten older I’ve had a lot of women say things like: “I wish somebody had told me how my vagina is going to get more dry and intercourse is going to be more painful and what are possible ways of being intimate without having that pain.” There are so many things that we don’t talk about and that aren’t included in educational programs. There’s reluctance to share data about how active people are sexually as if it means that you are a good person or a bad person.

You’re so right!

We feel embarassed about all of these things as if we were the only one. There’s nobody in the situation where you are the only one. But if you don’t hear anybody else saying “That happened to me too”, we can’t move forward in any constructive way. It’s a simultaneous coexistence of two seemingly contradictory realities. We’ve come so far in reproductive rights, we’re moving in a positive direction but that doesn’t mean the work is done. There are still so many deep roots stuck in the ground that we need to continue to pull up to be able to make real progress.

Who do you think should open the conversation?

All of us because that’s the only way you can get an attitude change that will permeate all levels of society. Years ago when I was  training teachers about sex education, we barely touched the subject of how to teach adolescents. Instead the teachers asked me questions, such as “How come I never feel satisfied when I have sex?”, “What does satisfaction mean?”, “What is an orgasm?”, “How do you learn how to do oral sex?”, “Why is it important?”, “Is it dirty?” or “Am I going to get a disease?” These were great questions that they needed to know to help themselves before they could help their students.

Did the students ask similar questions?

Absolutely! It doesn’t matter what a fabulous or not education you’ve gotten. We all learn best through experience. If you haven’t experienced satisfactory sexual relations, it’s hard to promote healthy sexuality.

Mexico is a Catholic country and the Catholic priests are not comfortable talking about these intimate issues. Can you see any changes? 

I think a lot of people in the Church hierarchy are changing and if not publicly, at least privately do talk about these issues. Whether the subject is contraception or sexuality, my tendency is to feel that a lot of times we say that it’s a religious war but it doesn’t have that much to do with religion.

What does it have to do with then? 

I think that controlilng women’s fertility has been something that still many people want to do. I guess because we are talking about the number of human beings who then can be utilised in the labor markets and never mind to form our armies. The point is nobody has the right to make any decisions about anybody else’s body. That’s an individual decision.

When people think that they have power over somebody else’s bodily autonomy, they are abusing power. Whether it’s political, reproductive or economic, it’s all intertwined. That’s what the concept of reproductive justice is. It’s not just about whether you are going to have a child or not, it’s about how you want to have that child and whether you feel that your child will be brought up in a safe environment.

That’s exactly why CASA is here. You take care of people’s sexual and reproductive health and rights in a systematic way. You provide free family planning and sex education, run a maternity hospital, a midwifery school, a day care, a violence prevention program and a library. Have you always had this broad vision or did you keep on adding new services?

Both. I’ve always felt like you have to connect the dots. We started in the 1980s with sex education and family planning and then traditional midwives came to us. Simultaneously those of us who were working got into the reproductive age and we started thinking about what type of births we would like to have. We also needed to make sure that our infants and preschool kids were safe while we worked to earn a living so we started to have the on-site day-care.

I love it how you created this whole ecosystem of interconnected services!

It’s hard to sell (laughter). Marketing and business people have always told us to do just one thing. But who cares? It’s better to pursue what you think contributes to your own well-being and to society’s overall well-being.

And you’ve been successful! CASA serves 80,000 people a year.

I don’t know what success means. Years ago, an American lesbian woman who was an intern in CASA said to me: “One of the best ways of measuring your success is the number and size of your enemies.” Oh my goodness, I guess I am very successful!  

Do you have enemies?

Oh yes, a ton! From all sorts of worlds, shapes and sizes. If you have conviction and your opinions and ways of being are a minority position, of course, you’ll have enemies. It’s part of the game. It’s not like I go out looking for enemies. The idea that everybody has got to like you and be in an agreement with you it hasn’t been the case in my life.

I totally feel you! I’m a big advocate for nature conservation and feminism, which are also pretty unpopular things but I find them important and that’s why I do them.

Exactly! The more we work towards feeling a sense of responsibility to everyone in our community locally and globally, the better off we will be able to become. The more we have safe spaces, then hopefully we can avoid violence. If there is anybody who feels unsafe, then we are all unsafe.


Nadine Goodman is an American-born social worker, public health professional and co-founder of Center for Adolescents of San Miguel de Allendé. Check out the work of CASA here.  

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