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I recently received the following question from a social work graduate student, who recently completed her first-year graduate internship (known as a field placement in social work) at an urban reproductive healthcare clinic:
I recently finished my first year in graduate school for social work. Coming into social work school, I had a big interest in being in clinical study and I’ve envisioned myself working one on one with adults. I was placed in a local clinic that deals with most healthcare needs, and I was placed in the reproductive health access department as an intern. After being in my placement, I’m starting to gain an awareness of how important access to reproductive healthcare needs are for young people and communities of color, and I’m starting to become more interested in doing community practice instead of working one on one in a clinical setting.
A few weeks ago, a few classmates and I were reflecting on our field placement experiences. When I mentioned the great experience I had at my placement, one of my classmates told me that it is unethical for social workers to assist in helping people obtain abortions and that we have a duty to report it to Child Protective Services, especially when the person wanting an abortion is a young girl who is being sexually abused. This is based on the NASW Code of Ethic, she says. My classmate said that social workers, above all things, should protect life, and that includes the life an unborn child.
While I enjoyed my field experience (and, by the way, I also assisted other healthcare needs besides abortion), I’m starting to wonder if my classmate is right. Being that you’re a social worker that has a lot of experience in reproductive rights, can you share your insights?
I was excited when this student allowed for me to share her question. There are several parts to her questions, but before I share my answers, here’s a little background on social workers and our roles in reproductive healthcare:
The National Association of Social Workers (NASW) supports policies and legislation nationally and internationally, that recognize a woman’s authority over her own sexual life and reproductive choices, free from coercion, violence, and discrimination. The NASW has also issued their Family Planning and Reproductive Health policy statement in 2006: “Self-determination means that without government interference, people can make their own decisions about sexuality and reproduction. It requires working toward safe, legal, and accessible reproductive health care services, including abortion services, for everyone.” Also, I’ve even written about how I believe social workers should be at the forefront of the reproductive justice movement.
But the student’s question lies here: According to the NASW Code of Ethics, social workers have many ethical responsibilities to our clients, including self-determination:
“Social workers respect and promote the right of clients to self-determination and assist clients in their efforts to identify and clarify their goals. Social workers may limit clients’ right to self-determination when, in the social workers’ professional judgment, clients’ actions or potential actions pose a serious, foreseeable, and imminent risk to themselves or others.”
Look at the second sentence, where I believe the student’s classmate is getting hung up on. What is the NASW’s stance on abortion?
The NASW Code of Ethics doesn’t directly state a stance on abortion access, but rather that clients have the right to choose whichever option is best for their current circumstance.
The student’s classmate also mentions how self-determination should be overruled in cases of a young person seeking abortion care. The answer to this also doesn’t lie within the Code of Ethics, but it does lie within the policies of individual states. For example, in New York State, young people have the right to confidentiality should they choose to seek reproductive healthcare services. As we know, this isn’t the case is many states.
But should social workers start contacting Child Protective Services if they feel that a client’s request to access abortion care poses a serious, foreseeable, and imminent risk to themselves or others?
Child Protective Services (and this name may be different depending on where you live) investigates allegations of child abuse and neglect by parents or other family or household members. CPS and similar services are put in place to help caregivers care for and discipline their children in ways that don’t harm them or put them at risk of abuse or neglect. Some of the services they provide referrals for may include counseling, day care, home care services, evaluation, treatment, and parenting classes.
If a CPS investigation is warranted, it can last around 30 days or longer depending on the circumstances. The investigation can include video recorded or tape recorded interviews with the child in question, interviews with other children in the home, physical examinations, and requests of mental, physical, or psychiatric records on the child and/or the child’s caregivers.
CPS can only do an investigation is there is suspected abuse or neglect of the young person in question, not because a social worker doesn’t agree with the choice the young person is making for seeking abortion care. Of course, if a social worker has reason to believe that a young person is being abused or neglected, s/he has the duty to report this, based on her/his professional judgment. There have been cases in which sexual abuse has occurred, resulting in a young person being coerced by the perpetrator to seek an abortion. If this is the case, the social worker should report the abuse of the young person in question. If a social worker simply does not agree with a young person’s decision to get an abortion (and there’s no reason to believe that the young person is being abused or neglected), it’s going to be an uphill climb to get CPS involved.
It’s quite possible to work in a reproductive healthcare clinic and not be in full support of clients wanting abortion services. For students placed in these types of settings, just like a full-time social worker has the right to seek employment elsewhere, a student has the right to advocate to being placed in another field placement setting that’s more in alignment with their values.
Should a social worker or social work student choose to stay in this type of setting, speaking with your supervisor is a great way to navigate your feelings. If a social worker feels that they cannot be objective, it’s recommended that a social worker refer clients to other professionals when they are not able to provide assistance or be effective without their bias getting in the way. In cases of social work students, your supervisor and field placement instructors should be key allies in you being able to navigate your feelings.
As social workers and social work students, we’re not here to tell clients whether we agree with their choices. We do, however, have a duty to make sure that our clients are informed of available resources at their disposal, that they understand that they are the experts of their lives that we are here for guidance, and that they understand the benefits and potential consequences of their decisions. That’s self-determination at its best.