Black Women Have the Most to Lose from Abortion Bans

The strict regulation of women’s health will place an even bigger burden on Black women in the U.S.

As Missouri’s last abortion clinic struggles to keep its doors open, the reality of a United States without the right to reproductive freedom weighs heavy on American women. The coordinated assault on abortion by Republican lawmakers has led to near total bans in Georgia, Mississippi, Kentucky, Ohio, Alabama, Louisiana, Utah, Arkansas and Missouri. These laws are extreme, with some preventing abortion at 6 to 8 weeks using a “fetal heartbeat” argument and providing no exemptions for women who have become pregnant due to rape or incest.

These new legislative proposals are part of the Republican’s decades-long strategy to chip away at abortion access. From 1973, abortion has been a protected right due to the Supreme Court’s ruling in Roe v. Wade. Yet, Republicans have in the last decade initiated laws that have made it increasingly difficult for women to have access to abortion services. They’ve done this by requiring women to undergo waiting periods, forced medically unnecessary pelvic exams, and by placing unrealistic requirements on the abortion clinics themselves.

America remains one of the worst places in the industrialized world to be a mother or an infant.

As the fight to end abortion ramps up, America remains one of the worst places in the industrialized world to be a mother. According to a 2016 study by Coyne College, the cost of giving birth vaginally is $10,808 and $16,106 for a C-section on average. In comparison, most countries, including Argentina, Canada, Chile, Germany, France, Spain, the UK and Australia are all somewhere in the $2,000 to $5,000 range. Beyond that, the United States is the only developed country without federally mandated paid maternity leave.

Beyond the economic burden of birth and motherhood, reproduction can also be extremely risky for a woman’s health. According to a 2017 investigation by NPR and ProPublica, the United States has the worst maternal mortality rate of any industrialized country.

While women of all ethnicities and backgrounds have the right to be concerned, Black women bear the brunt of these health disparities. According to the CDC, maternal mortality is 3 to 4 times worse for Black women. For every 100,000 live births between 2011 and 2015, 42.8 Black women died. Research shows that controlling for socioeconomic differences doesn’t reduce these disparities. Even high profile Black women like Serena Williams have brought attention to the inadequacies in treatment received while giving birth. To put it into perspective, ProPublica found that Black women are 243% more likely than white women to die from pregnancy and childbirth related causes.

For reproductive epidemiologist Maeve Wallace, barriers to abortion access and maternal health are two sides of the same coin “To be very broad, my view is that the current maternal mortality crisis in this country is a symptom of a society that does not value women, does not uphold their full freedoms and autonomies, and certainly does not treat, listen to, or trust all women equally (privileging whiteness above all else).”

For this reason it’s telling that the states with the worst track records for maternal and infant health are the same ones so zealously restricting access to abortion clinics, and reducing funding to clinics that serve women’s reproductive health.

Not only do Black women have the highest rate of maternal mortality, they also have the highest rate of abortion. In their 2014 report Characteristics of U.S. Abortion Patients in 2014 and Changes Since 2008, The Guttmacher Institute found that 28% of abortion patients were Black, far greater than the 14% Black population. The report notes that Black women have the lowest use of long-acting reversible contraceptives, indicative of barriers to contraceptive care and family planning.

While most healthcare experts and researchers point to structural racism and poor healthcare as a cause for this disparity, the anti-abortion movement favors a different explanation.

Data from America’s Health Rankings

The Black anti-abortion movement

For Ryan Bomberger and many other anti-abortion activists, the high rate of Black abortions is due to one thing only; marketing by Planned Parenthood. “The marketing is so inarguably targeted towards the Black demographic, and it’s happened historically,” Bomberger says.

In 2011, Bomberger and his organization The Radiance Foundation placed over 60 billboards in the Oakland area to bring attention to the racial disparities in abortion rates. Bomberger, himself a Black man who was conceived in rape and later adopted, also wrote an article entitled the “National Association for the Abortion of Colored People” in which he gave specific examples of what he deemed to be the NAACP’s pro-abortion actions.

The billboards were condemned by Planned Parenthood, the ACLU and the NAACP. The NAACP also filed a lawsuit against Bomberger’s article, but a federal judge ruled that Bomberger was entitled to his free speech.

Anti-abortion advocates also point to the history of Planned Parenthood as an explanation for Black women’s high abortion rate. Last month, Supreme Court Justice Clarence Thomas wrote a 20-page opinion that purported the “use of abortion to achieve eugenics goals”, citing Planned Parenthood’s founder Margaret Sanger’s racist views on reducing unwanted populations.

Michele B. Goodwin, Chancellor’s Professor and Director of the Center for Biotechnology and Global Health Policy at the University of California, Irvine School of Law, says,

“These concerns are born out of many generations of Black people’s bodies being subjected to some of the most horrific treatments that were legalized under law. And it’s true that Margaret Sanger and some of the suffragettes were also supporters of eugenics. But the fact that that happens to be true should not serve to deny a Black woman today of her constitutional rights.”

Other historians and legal experts echo similar statements. Dr. Rachel Hardeman, a researcher who serves on the Minneapolis board of Planned Parenthood says this argument ignores the realities of healthcare in the US. Hardeman, who also teaches about eugenics, structural racism and health outcomes at the University of Minnesota, says,

“There’s a lot of history around Margaret Sanger and her role in shaping the eugenics movement. But Planned Parenthood has done a really good job of reconciling that and acknowledging it. I would argue that abortion rates are higher in communities of color because when you have structural inequity and structural forces that don’t allow people both the education and access to the resources for prevention, it’s going to result in [abortion].”

With structural racism in healthcare still plaguing Black people to this day, it’s clear that the Black community’s relationship to abortion, and more broadly, healthcare, is nuanced. However, the claim that Planned Parenthood is conspiring to control the Black population is unfounded as it ignores the reasons why Black women often resort to abortion in the first place. Worse still, it dismisses Black women’s personal agency and sets up Planned Parenthood as the “enemy”.

In fact, Planned Parenthood and family planning clinics play a huge role in reducing the number of abortions. For example, in 2009, Colorado initiated their Family Planning Initiative, which provided free and low cost intrauterine devices (IUDs) to women through Title X clinics across the state. The initiative led to a 50% reduction in teen abortions and and saved nearly $70 million in public funds.

Despite successes like these, clinics that offer access to various forms of birth control as well as  abortions are often the very target of anti-abortion legislation and defunding. In 2013, Texas’ lawmakers removed Planned Parenthood from its Texas Women’s Health Program, barring it from accessing public funding. This move resulted in “adverse changes in the rates of provision and continuation of contraception and with the increase in the rate of childbirth covered by Medicaid,” according to a study in the New England Journal of Medicine. Anti-abortion policies that seek to defund clinics mean women’s access to birth control and preventative care are also impacted, resulting in more unwanted pregnancies and potentially more abortions.  

What happens if Roe is overturned?

With five conservative Supreme Court Justices, it looks increasingly likely that Roe v. Wade will be overturned. Even so, some remain cautiously optimistic that women will find ways to self-manage their own abortions despite bans.

“If the Supreme Court bans abortion at the federal level, it’s going to be a little different than it was last time abortion was completely illegal because the pill exists now, and the internet exists now. Taking an abortion pill is safer than using a clothes hanger,” says Grace Howard, Assistant Professor of Justice Studies at San Jose University.

Medication abortion or the “abortion pill” is the term used for two medications, mifepristone and misoprostol, which taken together can end pregnancies of up to 10 weeks. There are already global organizations, like Women on Web and Aid Access, that ship medication abortion around the world to women who need it, for a fee of 80 to 100 dollars. According to Dutch physician and founder of Aid Access, Rebecca Gomperts, 21,000 American women ordered abortion pills online this past year. About ¾ of the orders were from women living in abortion-hostile states.

Abortion is highly restricted in Northern Ireland, the Isle of Man, Malta, Gibraltar and Ireland until very recently. Ruth Taylor, CEO of Abortion Support Network, which provides support for women in these regions explains the options a pregnant woman has in order to acquire an abortion either illegally within their country or legally by traveling to another country.

Despite the ease of access to medication abortion, this method is not without risk. Howard, who conducted her doctoral research into the criminalization of drug-dependent pregnant women, says women who take pills to induce an abortion could face criminal charges.

Amanda Reyes, President of the Yellowhammer Fund, a non-profit providing abortion assistance to Alabamians says, “It could be that people who try to get abortions won’t be charged under the part of the code established by HB314 (Alabama’s abortion ban), but more than likely, by other parts of the Alabama code that have been in place for years.”

Reyes is particularly concerned by Alabama’s chemical endangerment law, which could potentially criminalize women who resort to illegally procuring and taking pills to self-manage their abortion. Originally intended to protect children from abuse, the law has now become a tool for prosecutors to criminalize women who take drugs during their pregnancy. There are 38 states today that have laws similar to Alabama’s chemical endangerment law, which according to Lynn M. Paltrow and Jeanne Flavin led to 413 arrests or medical interventions.

According to a report by Michele B. Goodwin of UCI, in some cases, women have even been arrested while still bleeding and in pain from giving birth, and others like Bei Bei Shuai, have been charged with first degree murder after a failed suicide attempt while pregnant.

The criminalization of pregnant women will affect Black women most of all

Still, some abortion critics like Dr. Alveda King, niece of Dr. Martin Luther King Jr., don’t see criminalization as a major concern.

“We actually consider that the mother of the baby and the baby are both victims. The goal is not to imprison women, but the goal is to stop the doctors from doing what they already know is taking the life of a living human being.”

Dr. King, who herself has had two abortions, has since become a born again Christian and an activist to end abortion. She says she was not aware of current legislation that criminalizes pregnant women.

But history shows us that when fetuses are prioritized above women, women can and will be criminalized. And most of those who are prosecuted are women of low means and women from ethnic minority backgrounds.  

In the 1980s and 1990s, as the war on drugs ramped up, prosecutions against pregnant women who were drug-addicted increased. Instead of helping women overcome their addictions, they would often be administered a drug test, without consent, and reported by a nurse to the police. A report by Amnesty International demonstrated that these efforts led to over 160 prosecutions of pregnant women in 24 states, 75% of which were brought against women of color despite majority white populations and similar rates of drug usage among whites and non-whites.

Disproportionate sentencing for Black people is nothing new. And as abortion bans begin to take effect, it stands to reason there could be a significant increase in the criminalization of disadvantaged Black women in the future.

The dangers of denying access to abortion are myriad. Limitations to abortion can impact a woman’s economic freedom, by forcing her to incur exorbitant health costs, costs of childcare, and the costs of taking time off work with no paid maternity leave. Childbirth can also risk a woman’s life, particularly in the US where maternal mortality is among the highest of all industrialized nations. These bans will expose women who seek abortions to health risks and potentially prosecute them for excercising their bodily autonomy. As all women come to terms with a country that doesn’t respect their choices or safety, Black women need to be especially prepared for extra burdens on all fronts.

Anisa Holmes