Paco Alvarez: So my first question is what inspired you to look at the state of Plan B availability in Tribal clinics?
Allison Herrera: Well, back in 2019 when I was working for PRI’s The World, now PRX’s the World, I got a grant from the International Women in Media Fund to travel to Argentina to look at their abortion policies. My beat for PRI was called Across Women’s Lives, and it was reporting on gender and gender equality on a global scale, which is a huge beat. But I really wanted to focus on the issue of reproductive rights and abortion and specifically for women, not only in Argentina, but juxtaposing the policies between Argentina, where they have one of the most restrictive abortion policies, they had this law on the books since the 1800s. And then looking at the policies in the United States where abortion is legal. And at that time, in 2019, obviously, that was before the Dobbs decision, there was very much a pulling back, there was very much a scaling back and a restriction on abortion policies at the state level.
I went to Arkansas, which is basically the south. And I looked at some of their policies where women had the right to an abortion, unlike women in Argentina, yet the access for women in the United States was just so difficult. Women had to travel. Women had to know somebody to order these pills online. It was just a very patchwork of policies. Whereas in Argentina, women were able to get an abortion despite these restrictive policies. And it was really fascinating to me and it was a subject that I really wanted to pursue further.
My primary beat is Indigenous affairs. And at that time, I had written a couple of articles for High Country News, and I pitched a story to my then-editor, Tristan Ahtone —what about abortion policies for Indigenous women? What does that look like? And so I did the story for High Country News that published in 2020 that looked at the Hyde Amendment. That law passed in the late 1970s and it restricted the use of federal money for abortions. The policy was that no federal money could be used for abortions except in the case of rape, incest, or if the mother’s life was threatened. So I wanted to know how many women had sought that care at Indian Health Service. So I ended up reporting about it. And the article was published. But in the process of that, I learned that this group, the Native American Women’s Health and Education Research Center and their founder, Charon Asetoyer and one of the women who worked with them, Pam Kingfisher, had also looked at contraceptive policies at Indian Health Service and found this really big gap and also found that there was a gap when it came to tribal clinics run by tribes. So that’s how I got interested in the story.
Alvarez: What were your main findings for the investigation?
Herrera: We did a lot of calling around to tribally run clinics throughout the United States and found that at more than 100 federally funded clinics and pharmacies run on behalf of Native American tribal nations, the medication’s harder to access if it’s available at all. And we found that 54 privately run clinics spread across 11 states don’t provide emergency contraceptives. And they were in Alaska. Some of the states that have a less restrictive abortion policy ro are not restrictive when it comes to abortion, and that includes California and Minnesota, Arizona and Washington state. And then we found in other states, a state like Oklahoma, where, three of the largest tribal nations in this state, in the state of Oklahoma, don’t provide access to Plan B. We’re talking about the Muscogee Nation, the Chickasaw Nation and the Choctaw Nation, and all have what are called 638 compact clinics. And what that means is they compact with the Indian Health Service – instead of IHS having a clinic that people go to, the tribe takes that money and they set up their own health care system. And so they’re taking federal money, but they’re not subject to the same federal policies that Indian Health Service has, which is that they must provide Plan B without a prescription, without an age limit, and it must be without a doctor’s visit.
Alvarez: Related to that, what was your method for collecting the data used in the recording?
Herrera: Well, I joked with my team that I have a second career as a telemarketer. What we did was we actually took the method that the Women’s Health and Education Resource Center had. They had done these reports over the years, since the early 2000s. They had done reporting on abortion access in Indian Country and they had done reports about contraceptive access in Indian Country. And so what they did was they picked out these clinics from the Indian Health Service list and they had this little survey. So it was like, do you provide Plan B? Is it over the counter or do you need a prescription? Do you need a doctor’s visit? Is there an age restriction?
I took that formula and we set about creating this database. We took the IHS list from their website and created this database of all the tribally run clinics. And, we had a massive data clean up. We took that list and then we just went through and found all the contact information for the pharmacies or for the clinics and asked them those questions, you know, not as a reporter, but just as a person that would go into the clinic and ask for this medication. Like, do you have it? Do you offer it over the counter? You know, and oftentimes, you know, it would be a little sticky– we wouldn’t lie or be deceptive, but people would sometimes ask us, well, who are you? Who are you calling for? And we would be like, I’m just calling for my cousin, you know, I just wanted to see if you offered it.
And then because we wanted to do our due diligence, we went back in and recontacted all of those clinics, either through an email or through phone calls and asked them the same questions but going through the front door, as it were, as a reporter and saying, we found that your clinic doesn’t offer this or, you know, offers it, but there’s an age restriction. And so that’s how we did our data checks. And so we called over 500 clinics and that includes more than 200 village clinics that are in some of the most remote places in Alaska.
Alvarez: You sort of touched on this, but what were your experiences like talking to tribal clinics and pharmacies? Were they open to talking about their policies surrounding emergency contraceptives?
Herrera: Some were and some weren’t. I think you have to remember the policy for tribally run clinics and the 638 compact came out of the Indian Self-determination and Education Act, which was passed in the mid 1970s as part of a whole overhaul of looking at how the United States treated Native Americans in the Nixon administration and really looking at how can we better the lives of Native people in the United States. And passing that was part of that policy. And the goal was to give tribes more control over their health system to better determine the outcomes of their citizens. I mean, it wasn’t just with health. It was other things, too.
And so I think that is a key component of tribal sovereignty. And so when you talk to clinics, they don’t have to turn over data to us. That’s not you know, they’re not IHS, they’re not subject to the Freedom of Information Act laws. But I think when you drill down to the level of – when you get down to it and when you talk to tribal citizens, yes, sure, there is a distrust of the federal government, but tribal citizens expect a lot from their tribal government and they want accountability. And I think that’s our job. Right? Like, even though we’re not you know, I’m not a tribal citizen of the Cherokee Nation or the Chickasaw Nation. But that is my beat. And those are the people that I will work for and on. And I think asking about their policy, asking why the Chickasaw Nation or the Choctaw Nation doesn’t provide Plan B with the exception of when if the woman goes to the Sexual Assault Nurse Examination program, after they’re raped. Look, why would you make a woman go to CVS or Walgreens and pay money when you can provide that medication for free? And so I think while, you know, it’s our job to talk about some of the harmful policies that the United States government has enacted that have brutally affect Tribal nations, it’s also our job to look within Tribal nations to say, you know, your tribal citizens are asking for this and why aren’t you providing it?
Alvarez: What did your sources tell you about why Plan B access is important to them?
Herrera: Well, I mean, quite simply: Why should I have to pay for this medication that is readily available over the counter for anybody else? Or in one instance, you know, here in Tulsa, you can go to the you can go to a kiosk, you know, a little like a vending machine where you would get soda pop or snacks or whatever on the [University of Tulsa] campus. And you can get plan B, I don’t know how much you have to pay for it, but you can get it that way. Whereas like if a citizen of the Choctaw Nation or the Muskogee Creek Nation or some of the other tribal nations here that don’t provide it and go into their clinic and ask for it, they can’t get it. And I think that to them is like, we demand a level of body sovereignty and body autonomy. And I think one of my sources said to me, some tribal nations in Oklahoma, where we are very much in the buckle of the Bible Belt, she said, have adopted these really colonized way of thinking about women’s bodies. And that Plan B should be available as as abortion should be available for Indigenous women without these restrictions.
Alvarez: And yeah, I guess related to that, what are some of the factors contributing to these policies that limit emergency contraceptives?
Herrera: I think there’s a few policies. One thing that we talked about in the story is that for some clinics there’s not a demand, you know, and so you have to again, this goes back to that self-determination, the whole point of self-determination. If a tribe says we would rather spend that money on other medication that our citizens are asking for rather than emergency contraceptives, we’re going to supply that instead. And that decision is made at the highest health care level within that tribal nation. You know, like one tribe in Louisiana said, you know, we stocked it but nobody was asking for it and it would go bad. And we would rather provide this other medication for people. And in the case of somebody else, it was like, we don’t provide it because, you know, they can just go to Walgreens, they can go to CVS. And, you know, and then in some cases, we talked to this one tribe in Nevada where, you know, the woman said, who was talking about why they had a restrictive policy, and the reason was because they actually wanted to make sure people weren’t being promiscuous, wanted to make sure that – I guess they’re part of sex education and like making sure that, you know, I mean, ostensibly, like looking out for that health and welfare of Native women. But some of the groups and some of the women that I’ve talked to and the organizations that I’ve interviewed and been in touch with over the years would say, That’s none of your business.
Alvarez: Did you encounter any challenges reporting across different regions, reservations and jurisdictions?
Herrera: Yes. I mean, a lot. I mean, I’ll just say Alaska was just a very big challenge because of the time difference that we had – they’re three hours behind us. Their hours are very limited. You know, some clinics were only open until 2 p.m.. And I will say, I think Alaskan Natives, obviously there are tribal structures that are very different from, you know, from the tribal nations here in what was in the lower 48. They’re spread across the vast geography, you know, where land where, you know, even food or some of the other essentials are flown in on a weekly basis, because here’s no town within 100 miles and the only way in and out is by plane. And so talking to some of those people and learning about some of the challenges was definitely very eye opening and I think deserves more attention and more reporting.
One other challenging thing about reporting in Alaska was during the summer when you’re trying to get in touch with people at the clinic to verify our findings, a lot of people were out doing subsistence hunting. So you have a lot of people that are in key roles. And again, this is really important . These clinics are staffed with Indigenous people that know the community, but there’s limitations to that. And I think that’s part of, you know, when we talk about our reporting and our timelines and how we have to get things out really quickly and we have to do all of these things that Western journalism demands of us – that’s not the timeline that they’re working on. And I think that the story, you know, if we had had more time and to make it a series, I would have loved to have just gone up to Alaska and done some more reporting on those clinics up there and the challenges that women face. I mean, they have some of the highest sexual assault rates in the country. I mean, there’s that ProPublica series that looked at how Indigenous women fare when reporting sexual assault. And that demands our attention. But I think we are, you know, Western journalism and the confines with which we work sometimes don’t conform – many times don’t conform to the lives of Indigenous people and the timeline that they work on. And I think that sometimes our reporting suffers from that.
Alvarez: Since the investigation was published. What is the response been like?
Herrera: I mean, I’ve gotten some messages from people who who say, you know, I read your story. There’s one group, they follow me on Instagram. They’re the Four Mothers Collective. And they’re an Indigenous women’s group here in Oklahoma. You know, you may think in red state Oklahoma, gosh, we’re just so conservative down here. And we’re just, you know, there don’t allow you know, nobody’s talking about birth control and nobody’s talking about this. But people are very much committed to having this conversation. And this group reached out to me and she was like, well, we provide Plan B, we have a plan B that we can mail to people that need it or, you know, get in contact with us, kind of like a little underground system that they have.
And I saw somebody from the Cherokee Nation the other day, you know, and she was like, yeah, we read your story, it was really good. I’m like, okay, well, what does that mean? Like, did you like it? Did you not like it? And like, you know, Cherokee Nation was one. They are a very press friendly, media friendly tribal nation to talk to. You know, they have a communications department for their health department and for just the regular tribal affairs. And so it was easy to get in touch with them and say, hey, you know, we’d love to talk to you. What talk to one of your doctors about the Plan B policy. And that was great. I mean, you know, they provided insight to us and was perfect because the young woman that we profiled is Cherokee.
Alvarez: We’re recording this a few weeks after the election. I’m wondering, have you heard from your sources since the election?
Herrera: I have been in contact with a few people, here in Oklahoma about the election. I think one of the biggest concerns is – I was just at an event yesterday in Osage County, and I was speaking with the superintendent for the Osage Agency for the Bureau of Indian Affairs. And I think one of the biggest things, this is what I’m getting at, is how is the incoming administration going to – what are their policies going to be for tribal nations? We’re sometimes very much last on the list. But every major cabinet pick affects us because who gets picked for the attorney general’s office? You may not think about that, but Merrick Garland, his office came to Oklahoma and talked about the McGirt decision and talked about how the nation’s policies on criminal jurisdiction affect indigenous people and that missing and murdered Indigenous people. I mean, that’s a big topic here. So when the pick for the attorney general’s office, the pick for the U.S. attorney’s office here in in Tulsa for the northern district, that’s going to affect the, you know, prosecution and criminal jurisdiction, especially in the case of rape for indigenous women. And that’s how I think people are looking at some of these cabinet picks.
Or for the Department of the Interior. Yesterday I was just at this fee-to-trust signing for the Osage Nation. They put 43,000 acres back into trust, said that they had purchased eight years ago from Ted Turner for what’s called the Bluestem Ranch. And now they put it back into trust so that it can’t be taxed. They have criminal jurisdiction over it. But now, you know, we have a new Department of Interior head that is very much an oil and gas person. You know, how is that going to affect people?
And one thing I did actually, I was at another meeting on Sunday for the Osage Shareholders Association, and these are people who have a share in the oil and gas state and for the within the Osage Nation. And one of the people who is, you know, the head of the you know, you know, speaks a lot for the shareholders. They’re really excited about Trump is in office because they want to see less red tape and less bureaucracy for drilling for oil on the Osage Nation reservation.
But as far as policies affecting Indigenous women, I’m very curious to see who they pick for the U.S. attorney’s office here in the northern district of Oklahoma. And certainly the the Health and Human services pick. You know, how is that going to affect Indian Health Service, the IHS budget? You know, 60% of IHS budget goes to tribally run clinics in here in Oklahoma. And tribally run health care systems are some of the biggest employers in this state. So it’s not just like these policies on reproductive rights, but it’s all these other things that affect indigenous people’s lives that I think, you know, I’m curious. I’ll be watching for it within the next year