Implications for racial inequities in maternal health if Roe v Wade is lost

A Supreme Court draft decision was leaked recently that indicates that Roe v. Wade is to be overturned sometime this month. It is well established that racial inequities plague maternal health. How is the impending reversal of Roe v. Wade going to impact maternal health across the nation?

Lown Institute Health Communications Specialist Brenna Miller co-authored a new piece in The Lancet analyzing the potential implications of the fall of Roe v. Wade.

A total abortion ban will increase maternal deaths

Pregnancy is significantly more deadly than an abortion. This is especially true for Black women, who face a maternal mortality 3 to 4 times that of white women – regardless of educational status or financial class. Many of the states banning abortion have a significant Black population that already does not have equitable obstetrical care. By restricting access to abortion, states are forcing Black pregnant people to risk their lives carrying to term. A new study estimates that a total abortion ban across the United States could results in an estimate 21% increase in maternal deaths across race, and a 33% increase in maternal deaths amongst Black individuals. With an ongoing maternal mortality crisis, it is clear that overturning Roe v. Wade will exacerbate circumstances and result in extra, needless maternal deaths, especially concentrated amongst the Black American population.

Restricting access does not eliminate abortions

Up to 28 states have some variation of trigger laws in place that would effectively make abortion illegal the moment Roe v. Wade is overturned. While illegality may serve as a deterrent, pregnant individuals with financial means will still be able to access whatever care they need by traveling to another state or country. Pregnant individuals without financial means will face two options: continue with the pregnancy and risk death, or figure out a way to get an abortion without a physician’s guidance. The development of mifepristone and misoprostol has provided a safer option for self-managed abortions and drastically decreasing fatalities from “illegal” abortions. The effects of these medications are identical to those of a natural miscarriage and thus are undetectable by law enforcement. With increased access to these medications through mutual aid funds and other abortion networks, these restrictions will only serve to harm poor pregnant people or push them to taking their care into their own hands.

Should the Supreme Court overturn Roe v. Wade – and it looks likely that they will – the evidence shows that those impacted most will be poor, Black pregnant people. Imposing forced birth on individuals at increased risk of death will only make the ongoing maternal mortality crisis worse. Read the full commentary in The Lancet.