The overturning of Roe denies safe abortions to anyone who seeks one, regardless of potential health risks or complications. Minority women are overrepresented in unintended birth and abortion rates due to disproportionality in adequate healthcare and contraceptive access stemming from systemic racism within the healthcare system (Jones & Jerman, 2022). This disproportionality is coupled with cultural and historical messages regarding the social position of Black women as both female and Black, which determines their inadequacy to make decisions about their bodily autonomy (Brown et al., 2022). The overturning of Roe reinstitutes historical practices involving minority women which enforces the deprivation of their bodily autonomy because of their social position and disproportionately impacts and deepens negative power dynamics between both minority women and white women as well as minority women and the racist and sexist healthcare system that disadvantages them.
Historically, minority women, specifically Black women, have not had control over their reproductive decisions because people and systems of greater societal position have granted themselves this control instead. For example, enslaved women were forced to reproduce to contribute to the demands and success of white people, particularly white men. The overturning of Roe reinforces efforts to remove minority women’s power in making reproductive decisions, and rather rest that power in the hands of those in greater power and position than them. A study interviewing 23 Black-identifying women over the age of 18 about their experiences with abortion and the impact of structural racism on their lives found that in a system and country that was not built for Black people, choice, and specifically reproductive choice, is a privilege that is often constrained and restricted by barriers linked to structural racism. (Brown et al., 2022). Participants voiced their wavering feelings about abortion and healthcare in our racist society which has instilled into the Black community stigmatized messages and practices about pregnancy, abortion, and healthcare. This example highlighted structural racism as a determinant for many choices that Black women have because although an option might appear viable, a system built against Black people has already made the decision for them. The findings of this study reinforce practices and messages surrounding structural racism’s role in disproportionately affecting minority women after the overturn of Roe (Brown et al., 2022). Cultural and historical messages perpetuated in society in regards to the social position of Black women as both female and Black are a determinant in making decisions about their bodily autonomy. Choice is a privilege that is not granted to minority women in a system built upon the complete control of their autonomy.
To give a historical perspective, an investigation of the criminalization of abortion and the regulation of Black women’s bodies in South Carolina from 1940-70 highlighted the lived experiences of multiple women, as well as explored the more expansive intergenerational trauma and regulation of Black women’s bodies (Ware et al., 2020). The investigation correlated the intense focus on illegal abortion control in the 20th century to the historical focus on the regulation of Black women’s bodies, specifically referring to reproduction and abuse during enslavement, but also extending to the exploitation of Black women through historical medical malpractice. Partially through participant testimony, the investigation discussed connection between ideologies passed down through generations of women of color who were forced to withstand and brave the neverending degradation of their bodies and marginalization within society as acceptable reproductive women (Ware et al., 2020). The generalized distrust of the medical field throughout the Black community was explored and found to have deep roots due to generational trauma and neglect. In a country built upon the enslavement of Black people and their forced reproduction to uphold white supremacy, the social position of Black women as both a marginalized gender and race does not grant them power or respect. Historically, their bodies and reproductive decisions were completely regulated by white men; more recently, they were admitted choice over their bodily autonomy and reproductive decisions; now, their bodily autonomy and choice is stripped of them again. The overturning of Roe reinforces practices of governance over the bodies of all women, but more clearly reinforces historical practices of depreciating and fortifying the social position of Black women in society.
Prior even to the topic of reproductive regulation, both of these studies mention the hesitation and distrust that people of color feel in regard to the medical field because of previous medical malpractice involving people of color given their social position as more marginalized races and ethnicities. The health implications of distrust to medical professionals are potentially lesser health outcomes such as dying from preventative diseases, sicknesses, or complications because seeking care is not as much of an acceptable, feasible, or wanted choice, which comes into play in relation to seeking abortion and pregnancy care. Minority women already have historically worse pregnancy and birth outcomes than white women partially because of their hesitancy to seek care. The overturning of Roe will only further disadvantage the health outcomes of minority women and create greater disparities for them based on their social position in relation to a society which rests upon the upholding of white supremacy.
The overturning of Roe deepens and enhances power dynamics between minority women and the healthcare system related to the quality of care or lack thereof provided due to institutionalized bias and racism. Even before the overturning of Roe, minority women were disproportionately provided inadequate healthcare, specifically related to pregnancy and birth, in comparison to their white counterparts. This disproportionality also extends into negative health outcomes related to pregnancy and birth because of racism within the healthcare system. This lack of concern or priority for minority women from healthcare providers will inevitably heighten with the overturning of Roe because of the intertwined power dynamics.
An analysis of data gathered from three different sources of study to compare abortion rates between 2008-2014 found that women of color and those living below the federal poverty level, who are generally women of color, have the highest rates of abortion compared to their white counterparts and those of higher income level (Jones & Jerman, 2022). These women also have the highest rates of unintended birth which is correlated with disparities in contraceptive options and preventative care (Jones & Jerman, 2022). The study concluded that groups who are overrepresented in abortion rates, like minority women and those below the poverty line, will be disproportionately affected by restrictive abortion laws and policies (Jones & Jerman, 2022). The power dynamics of a racist healthcare system and its minority patients create disparities in inadequate care to these minority women in the form of a lack of provision and sequential access to contraceptive options and preventative care, therefore creating an imbalance in representation in abortion rates. Those who are overrepresented in abortion rates, women of color and women living below the federal poverty level, are therefore at risk of being disproportionately affected by restrictive abortion laws like that of the overturning of Roe because they do not have power over their access to proper reproductive care, instead, the healthcare system dictates their access.
A law review discussing the disproportionality that people of color would experience if Roe was to be overturned explored the political outcomes of the racial and gender injustices that would arise from the overturn by considering different public health perspectives. The authors concluded that if Roe was overturned, because of their marginalization within healthcare access, Black people would have lesser opportunity within the healthcare network than white people to obtain safe abortions from healthcare providers who were still willing to perform them (Bridges, 2022). Moreover, because of this unequal opportunity and the fact that Black people have higher abortion rates overall, they will attempt unsafe abortions at higher rates than their white counterparts and will therefore have higher rates of death (Bridges, 2022). The authors also discussed the desperation for an abortion that women hold when carrying an unwanted pregnancy and how this will disproportionately impact vulnerable and lower income populations (Bridges, 2022). The power dynamics between the healthcare system and minority women contribute to their marginalization and disproportionate access to adequate care. This contributes to the lack of opportunities that minority and lower class women will have to receive safe abortions in the wake of the overturn of Roe compared to their white and higher class counterparts, who in general will have privilege and find access to abortions regardless of its legalization. Institutionalized bias and racism with the healthcare system as a whole elicits unequal access to safe abortions and disproportionate attempts at unsafe abortions by minority and lower class women and their consequential disproportionate deaths.
The root of the varied representation of abortion rates between those living below the poverty line and white women are power dynamics stemming from the healthcare system which result in disparities in access to proper preventative care, sexual education, and other reproductive resources. Less of this preventative care and education, which is controlled by the healthcare system, leads to more unwanted pregnancies, which can be detrimental to the mental and physical lives of those carrying the weight of the unwanted pregnancies. Fatal physical ailments can arise in an unwanted pregnancy and without proper medical care because of a lack thereof in a particular underserved community or a lack of trust for the medical community within a minority group because of generations of medical abuse, these ailments can be deadly. Moreover, the most extreme health outcome that will arise from this disparity in unwanted pregnancies is an increase in the deaths of women as a result of trying to perform unsafe abortions on their own. This will come as a result of the lack of safe options for abortions because the power dynamics of the healthcare system have the upper hand and have executed their ultimate power.
Although alarming, these disproportionalities can be lessened through structural reworking. Systems change is essential for the health and wellbeing of all, but especially those who are systematically disadvantaged and discriminated against, like minority women. Medical schools and hospitals can work to ensure that anti-racism is taught and upheld in practice to begin to deconstruct systemic racism within the healthcare system. Healthcare initiatives through the government can work to ensure that minority and lower-income communities are provided with proper access to contraceptive options. Access and opportunity to safe abortion providers can be adequately communicated to minority and lower-income communities to prevent disproportionate attempts at unsafe abortions. Exposing racism is important, but our togetherness in creating change is what will save lives.
References
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