Written by: Jess Kimball
Abortion access is an essential component of comprehensive reproductive health care that has been used to oppress and control people’s bodies for many years. On June 14, 2022, the right to access abortion in the United States became the decision of each independent state, not the nation as a whole. Restrictions around abortion access increased drastically when Roe v Wade was overturned. People were already in a place of having to travel far to access the abortion care they required, but now they are left traveling even farther. Half of the United States is restricting or banning access to abortion care.
United States history and current statistics show us the oppression that Black individuals face in all areas of their lives. Today, let’s take a look at healthcare, specifically reproductive healthcare. While slavery was legal there was an interest in the fertility of Black individuals because fertility meant more enslaved people. Slave owners, interested in making the highest profit, thought it was essential to have a strong male and a fertile female enslaved by them. The slave owner would force the male to rape the female, often times repeatedly in order to produce more enslaved people for the owner. Enslaved mothers were often separated from their newborn children very early on. These women faced high maternal mortality rates due to being forced back to work, sometimes just hours after giving birth. The high maternal mortality rate for Black mothers continues today, as racism in health care systems remain prevalent. Enslaved women often had back-to-back pregnancies, without enough time to fully heal in between, especially if their newborn passed away. Infant mortality was high due to the enslaved person being expected to serve as a wet nurse (instead of nursing their baby), and because of the unclean living conditions in the slave quarters. Sometimes white babies would die when slave owners would have the baby go with the enslaved women to be wet nursed and cared for all night in slave quarters.
When slavery was abolished and Black individuals had more rights over their bodies, eugenic beliefs began to appear in policies. They even became a commonly explored area of psychology by female psychologists such as Leta Hollingworth, who was actually a prominent supporter of women’s rights at that time. Many people who contributed to advancements in rights for some people were simultaneously working in fields that robbed others of their rights. Leta was more focused on giftedness and eugenics, but this ties in with racial oppression because, while Leta was doing her research on giftedness, racial disparities were being found in IQ testing, further oppressing Black individuals.
The racist foundation America was built on still seeps into our modern society because racism is systemic and institutional, not just individual. How does this tie into abortion access?
Well, when racialized groups began asserting more rights, there were still many people who did not want them to have those rights. This is deeply connected to the health disparities we see now. When a white woman went to the hospital for pelvic pain they were treated, but Black women underwent forced sterilization. Some of these women were not even aware they had been sterilized. The healthcare system was not focused on listening and believing what they were experiencing. They did not care. They focused on pushing an agenda of controlling the bodies of Black people.
Other factors play a role in the health disparities we see, such as socioeconomic factors. Distance from healthcare institutions, health insurance status, employment benefits, and state policies are just a few. Black, Indigenous, and People of Color (BIPOC) are all more likely to experience these socioeconomic barriers. In the communities where people can no longer readily obtain contraceptives, terminate an unwanted pregnancy, or access prenatal services, the community members are primarily BIPOC. The impact of restricting abortion care will hit communities in states with the highest maternal mortality, and the hardest racial inequities in maternal and reproductive healthcare, the hardest. BIPOC face disproportionate health risks when they become pregnant. The places where these risks are highest are also those places where access to care is the most restricted, for both those seeking an abortion and those seeking midwifery or obstetric care. Many areas are considered maternity care deserts, as well as abortion care deserts. You can read more about maternity care deserts here. It is important to note that the majority of people accessing abortion care are BIPOC, roughly 60%. Let’s look at some more statistics:
- Black people make up around 37% of the general population of Mississippi, but in 2019, they were 74% of those who got an abortion.
- In Alabama, less than 27% of the population is Black, but 62% of those who received abortion care in Alabama are Black.
- In Tennessee, the population is 17% and abortions received by Black people are 51% of all Tennessee abortions.
- Legal, accessible abortion care reduced maternal mortality for Black people by up to 40%.
Some states, such as Ohio, are restricting the right to use state roads to travel outside of the state to a location where abortion is legal. Many people are offering their cars and homes as support to help individuals access abortion care. This new movement of support is beginning to resemble a modern-day underground railroad. Social media and the internet allow information about safe houses and abortion care clinics to be shared more broadly and quickly, and accessed more easily, but it also opens the door to the opportunity for people to be a mole, providing police with inside information on who is helping, who is getting an abortion, etc. There is a big need for safety and privacy in reproductive healthcare, and in the modern-day abortion “underground railroad”. It is also important to note that this underground railroad will have racial disparities within it. While Harriet Tubman was focused on freeing enslaved Black people, this “underground railroad” is focused on women of all races. That focus does not mean all races will access abortion care. As previously mentioned, BIPOC individuals will be the least likely to use this modern “underground railroad” effectively, making it less of a route to reproductive freedom, and more a part of the system of oppression that supreme court judges were determined to create when they made the choice to overturn Roe v Wade, and oppress people with a uterus.
The oppression of Black individuals in reproductive health care is evident in today’s maternal health outcomes, the history of reproductive coercion, lack of autonomy or choice in the healthcare system, and even in the attacks on Black midwives.
Black Granny Midwives were birth workers in the Southern states of the United States, dating all the way back to the early 1600s, responsible for the delivery of Black and White babies. At one point, granny midwives delivered 75% of babies born in the southeastern United States, but in the 1700s, when obstetrics rose in popularity, granny midwives were pushed out of the delivery rooms. Many of the experiments and research done in obstetrics during this time were done on enslaved black women against their will. Dr. Marion Sims was named the “Father of Modern Gynecology” after developing his surgical technique by operating on a group of enslaved African-American women with fistulas between 1846 and 1849. He completed experiments on at least seven enslaved women without anesthesia.
In the early 1800s, new legislation was introduced to regulate the practice of midwifery. It required medical training and licensing. Many of the granny midwives could not comply with state law, resulting in persecution and being forced out of practice. This has led to birth injustices and an error in history where Dr. Sims is credited for reproductive health gains, instead of the granny midwives. Research shows that the midwife’s model of care and the use of doula support would reduce our maternal mortality rate.
The oppression of Black people is seen all throughout the current United States healthcare system and history. It is deeply connected to reproductive healthcare in many ways and should be looked at, to fully achieve an understanding of the restorative justice that needs to be done, and the support that is needed right now, for Black people with reproductive health needs of any kind.
At Global Foundation for Girls (GFG), we are active thought partners, serving global communities of birthing persons in order to advance and support the advocacy movement. We lead webinars and trainings for providers including doulas, social workers, childbirth educators, and more! To learn more about our upcoming trainings click here!
Jess Kimball, AS, CLC, CD, PCD, PMH-C
Sources and Additional Research to Consider Reading:
Abortion Access as a Racial Justice Issue
The disproportionate burdens of the mifepristone REMS
Juneteenth: A Time to Reflect on the Racist Roots of Abortion Restrictions
The Racist History of Abortion and Midwifery Bans
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