What Abortion Rights Mean for Health Equity—And What to Do About It

Monday’s news leak regarding the Supreme Court’s draft majority opinion on abortion—namely to overturn Roe v. Wade and Planned Parenthood v. Casey—sent a shockwave through the country. As the National Partnership for Women and Families made clear, this news represents a crisis moment for abortion access and reproductive rights. And from an Upstreamist perspective, it’s clear that this opinion will exacerbate structural violence, disproportionately harming low-income women and Black, Latina, Indigenous, Asian, and other women of color who already have a difficult time accessing the reproductive health care that meets their needs.


Even before this likely court ruling, Black women are already twice as likely, and Latina women 1.6 times as likely, to get late or no prenatal care compared to White women. Black women are about 1.5 times more likely than White women to experience preterm birth, and more than three times as likely to die through pregnancy and childbirth. Equitable health policy would increase access to abortion care without restrictions and increase access to prenatal and maternity care from trusted providers. This likely court ruling will do the opposite. 


Moments when we reel from the news are opportunities for clarity and action. So here we’ll offer some insights, links, and actions (see below) to help as you consider your response.


Whatever your personal beliefs and choice around abortion, it remains true that abortion restrictions have long been a tool of sexism and white supremacy. See reports here, here, and here. (Note that the dates on these articles, tellingly, long predate the present news.) Abortion restrictions have also engendered vigilante policing and patrolling in hospital ERs and patient examination rooms, the very spaces many of you regularly occupy as patients or clinicians.


As startling as the Supreme Court leak was, there were many who were not surprised. Among them are the community organizers and other leaders who have been fighting this fight—and the broader fight for reproductive justice—for years, and who will continue to do so after the news-cycle urgency of the moment passes.


These leaders have been preparing for shifts in the judicial landscape and pushing forward on multiple fronts—knowing that even while Roe is still here, 40% of California counties don’t have an abortion provider, people in Texas already go to Alabama for abortion services, and duplicitous crisis pregnancy centers exist without restriction. 


As always in these watershed moments, we urge you to (1) educate yourself and others on the history that is enabling this current iteration of long-standing structural violence, so that you know how to show up when you (2) find the community leaders and organizations who have been at the leading edge of change and protection for years and who will continue to build power in their communities. And then (3) think through how you can support them, individually and through the institutions you are a part of.


Organizations centering reproductive justice and BIPOC voices include: 


Learn more about the work they do. Then please, if this moment moves you, get to work yourself. Here are some starting points for education and action:


  • Abortion is still legal in the US—but abortion laws and restrictions vary by state. Here’s one review of what the end of Roe would mean. 
  • This crisis is not isolated. It is part of a longstanding concerted political effort by some legislators and judges to restrict or deny reproductive rights in the U.S.. For example, there have been 400+ anti-abortion restrictions enacted in many states over the last 10 years, with more than 100 state restrictions enacted on abortion in 2021 alone. Twenty-six states have bans that would be triggered by Roe being overturned.
  • To learn more, consider joining this upcoming webinar hosted by Families USA’s Health Action Network: Abortion Laws: A Public Health Crisis (Part I), Thursday, May 5 at 1PM ET
  • Use this reproductive legal helpline to connect people who need or want to access abortion care with attorneys and advocates.
  • And if you identify as BIPOC, consider joining the Black Sanctuary Wellness space on Tuesday, May 10 at 6PM ET to address community concerns in light of the recent leak. 


With solidarity, 

Rishi & Sadena

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