Local Reproductive Freedom Index

We have a multi-round research process. NIRH staff conduct the first round of research independently, reviewing municipal websites including from the city and county government, local and state departments of health, departments of education or school districts, and other relevant government agencies and commissions, as well as publicly available information from local community-based organizations and local media. Then, we conduct phone and email interviews with people and organizations in the community, depending on their ability. This could include organizations in our partnership network, other community-based organizations, departments of health, school districts, and city and county officials in each of the cities. Then we share our initial draft of the scorecard with local advocates and the heads of city or county departments of health for review. Finally, drafts of the Local Scorecards are distributed to the mayor and heads of the city and county government. Final Local Scorecards are based on the sum of this work. 

These indicators and the policies and principles of the Model City are based on NIRH’s expertise and values after more than a decade of local advocacy, that of our partner organizations, and the work of allied social justice movements. For indicators we did not have direct expertise in, we reached out to national experts for advice starting with the first edition of the report in 2017. This includes A Better Balance, Advocates for Youth, All* Above All, Bold Futures, CityMatCH, FairVote, Fight for $15, National Latina Institute for Reproductive Justice, RepresentWomen, Sex Workers Outreach Project (SWOP) USA, and Sex Workers Outreach Project (SWOP) Behind Bars. The indicators have been refined over the years as we learned from our research and received feedback from our partner organizations and local advocates. 

NIRH takes several reasons into consideration when determining the value of an indicator. This includes the rarity of the policy – particularly the fact that, unfortunately, policies to support abortion access are relatively rare on the local level compared to other indicators we review. We also consider the difficulty it takes to pass a given policy, and its impact on reproductive freedom.  

• We modified when a city can be scored as “Preempted” for “Funding for abortion”: In 2019, Austin, TX set an innovative example by funding practical support for abortion care, such as travel and lodging, even though state law preempted funding for abortion procedures. Because Austin demonstrated that cities can allocate funding to facilitate abortion access even if their state has a similar preemption, NIRH changed our guidelines. Previously, we marked a city as “Preempted” when only funding for abortion procedures was banned; this year, cities were marked as “Preempted” only if both funding for the procedure and practical support were preempted by state law.   
• Cities need to act on “Advancing democracy” during the review year to receive points: Because this indicator was a new addition to the Local Index in the second edition of the report, in 2019, NIRH awarded points for any policy to advance democracy that was in place through December 31, 2018. For the third edition of the report and all subsequent editions, NIRH only awarded cities points for actions taken during the period of review (January 1, 2019 – December 31, 2020). This is a recognition of the many actions that cities can take to advance and protect democracy, which requires constant vigilance and responsiveness to new challenges. 
• We added “Percentage of budget spent on policing” to the Local Index: This new addition reflects the percentage of its overall budget that the city spends on policing, although it may not be complete because there are often many sources of funding in a budget that feed into police departments and policing. NIRH chose to add this indicator to the 2021 Local Index in response to the calls to action of the uprisings of 2020, sparked by the murder of George Floyd and in response to centuries of systemic racism, most specifically, anti-Black racism. The uprisings highlighted how cities and counties spend large portions of their budgets on policing, to the detriment of communities of color, while spending significantly less on social services and community resources. Advocates and officials are encouraged to use this information to think about how funding could be reallocated from police departments to reimagine public safety and invest in solutions that align with our values — like those in the “Funding and Coverage for Reproductive Health Care” section of the Local Index. NIRH acknowledges the Vera Institute of Justice as an important source of information on the percentage of city budgets spent on policing, and the Chicago Abortion Fund and the re.ad.just Coalition as advocates who encouraged NIRH to include this indicator. 
• We changed “Supportive breastfeeding policies” to “Supportive lactation policies”: NIRH has updated our 2021 indicator to use the more gender-inclusive terms of “lactation” and “chestfeeding” in alignment with the recommendations of the Academy of Breastfeeding Medicine. “Lactation” and “chestfeeding” are intended to include parents who lactate but do not identify with the gendered term “breastfeeding.” NIRH acknowledges the re.ad.just Coalition as advocates who encouraged NIRH to make this language shift.  

Our research process “defaults” to city policy, so we first check if the city has any policies or programs in place that meet our metrics. If they do, then we stop the research there. If we can’t find anything on a city level, we then research county-level policies and will also give points there. County-level policies are marked on the scorecard with an asterisk (*).  

Young people who are pregnant or parenting often face stigma and shame from their families, schools, communities, and government. Data related to teen pregnancies and births are often used to reinforce that stigma, rather than focusing on the resources that families, schools, communities, and governments can provide young people to enable them to make the decisions about their sexual and reproductive lives that are best for them. We made the determination that the indicators in “Supporting Young People” better reflected how a city is doing when it comes to supporting young people who wish to prevent pregnancy, who are pregnant, and who are already parents, without stigmatizing their actions or their families. NIRH acknowledges the leadership of Bold Futures, National Latina Institute for Reproductive Justice, and the re.ad.just Coalition for changing the framework of the conversation on young people and pregnant, and educating NIRH on the importance of removing this indicator.  

If an indicator is preempted by state policy, we remove the points for that indicator from the denominator and do not give any points in the numerator, so that it doesn’t impact the final score. NIRH considers a policy to be preempted if a state bans a municipality from taking action on that issue (such as restricting cities from setting their own minimum wage), or if a state passes a policy comprehensive enough that it does not require a city to take further action (such as a statewide comprehensive sexuality education mandate).  

We have tools for you! You can use our Self-Scoring Tool to do your own research on your city’s indicators and create a Scorecard. And you can also use the Model City and Roadmap as a framework for building a policy agenda for your city.  

Send us an email at [email protected] and we’ll add you to our research database! We will begin our research process in early 2023.  

We know we aren’t perfect – conducting original research of 50 cities and counties is hard. We welcome the opportunity to review our research with you and, if necessary, to correct our findings. If you think there might be a mistake, please email [email protected]nirhealth.org with the subject line “Proposed Correction for [CITY].”