Opinion | Banning Abortion Doesn’t Protect Women’s Health

During its coming term, the United States Supreme Court will review the constitutionality of a Mississippi anti-abortion law that criminalizes abortions after 15 weeks of pregnancy. Already in Mississippi, only one abortion clinic remains to serve the entire state. This new law, one of the most restrictive anti-abortion measures yet, provides no exemptions in cases of rape or incest. Many see it as the gravest threat to Roe v. Wade ever taken up by the Supreme Court. They are not wrong.

But this effort to dismantle Roe is not new, nor is it isolated. More than 550 anti-abortion restrictions have been put in place across the country since 2011. Each is part of a concerted, sweeping effort across Republican-dominated state legislatures to dismantle reproductive rights — often presented in the name of protecting women. Take Mississippi’s Attorney General Lynn Fitch, who argued that “the Mississippi Legislature enacted this law … to promote women’s health and preserve the dignity and sanctity of life.”

But if concern for women’s health were truly driving this legislation, it would not be targeting abortion. A person is 14 times more likely to die by carrying a pregnancy to term than by legally induced abortion.

Black women bear the brunt of reproductive politicking in the United States. Nationally, they are over three times as likely to die because of pregnancy and labor complications as white women. That figure multiplies in states hostile to abortion rights. The 2019 Health of Women and Children Report ranked Mississippi 50th among the states overall in promoting the health of women, infants, and children. Using abortion surveillance data compiled nationally, it quickly becomes clear that it is far more dangerous for Black women to give birth in Mississippi than it is for them to terminate a pregnancy.

There are implicit and explicit racial biases underpinning coercive reproductive rights legislation. In the middle of the last century, Black girls and women throughout the South experienced forced sterilizations, euphemistically referred to as Mississippi appendectomies. What we see today reflects centuries-old patterns of control and bargaining over the reproductive autonomy of Black women, dating back to slavery, denying Black women the dignity to govern their bodies and families. Black girls and women were commodities to be acted upon, and their reproductive capacities served as means of wealth maximization. However, slavery was not the endpoint, only the beginning of coercive policing of Black women’s reproduction.

And while Americans are coming to understand slavery’s enduring impact manifesting in the present (including but not limited to policing, wealth disparities and segregation), Black women have urged a deeper and more nuanced understanding about its continuity in reproductive policies and politics (for example, forced reproduction, compulsory sterilization and now anti-abortion laws that deny them the right to terminate an unwanted pregnancy).

It is not a coincidence that anti-abortion legislation is often accompanied by wide racial disparities in Black women’s health. Indeed, Mississippi lawmakers could learn a great deal from the state’s Department of Health, which, as published in the Mississippi Maternal Mortality Report, found that from 2013 to 2016, Black women accounted for “nearly 80 percent of pregnancy-related cardiac deaths.”

According to the U.S. Department of Health and Human Services, Black women are 60 percent “more likely to have high blood pressure, as compared to non-Hispanic white women.” For Black women experiencing economic and political vulnerabilities, these conditions may be compounded in states like Mississippi by stresses associated with the inability to afford child care, the rising costs of housing, food insecurity, a criminal justice system that has too frequently been an outsize presence in their lives and a political system historically designed to suppress their agency.

Yet even while Mississippi is at the bottom overall in women’s health, it is not the deadliest place to be pregnant in the United States. Texas, Georgia and Louisiana are even more dangerous. Like Mississippi, in recent years they have dramatically chipped away at reproductive health and rights, resulting in the closure of clinics that provide abortions as well as contraception, counseling, sexually transmitted infection testing and breast and cervical cancer screenings. The result is not only fewer abortion clinics in those states but also real-world, deadly consequences of diminished health care.

These problems have arisen even in states attentive to reproductive health, rights and justice. Consider California, one of the earliest states to enact legislation to protect reproductive health care and embed reproductive privacy in its Constitution. From 2006 to 2010, nearly 150 incarcerated women were coercively sterilized, in violation of prison rules. According to one report, “the women were signed up for the surgery while they were pregnant” and were targeted for the procedure based on perceived risks of recidivism. California finally banned the practice in 2014.

Given this backdrop, Black women cannot take seriously the claims that anti-abortion laws have anything to do with promoting their health and protecting their rights. If lawmakers want to promote women’s health, they should be passing laws that address these enormous disparities in the safety of carrying (wanted) pregnancies to term and the illnesses that arise at the intersection of entrenched racism and economic vulnerability.

In the end, Black pregnant women pay steep costs of the enduring legacies of systemic racism and the political whims and agendas of men who govern their reproductive health and rights. And the dangers that lurk at the Supreme Court, where there has yet to be a Black woman to serve as a justice, could not be more pronounced.

Michele Goodwin is a chancellor’s professor of law at the University of California, Irvine, and the founding director of the U.C.I. Law Center for Biotechnology and Global Health Policy and its Reproductive Justice Initiative.

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