Reproductive Rights

The Dobbs Decision Exacerbates Existing Inequities In The Health Care System

  Kristin Tolentino

To many, the Supreme Court’s ruling in Dobbs v. Jackson Women’s Health Organization marked a new beginning of reproductive injustice. But for others, it is a harrowing reminder that the health care system has always been inadequate in addressing the needs of all women and people capable of pregnancy. Waves of underlying systemic issues make it so that people of color will endure the worst of what is to come.

Dobbs overturned the federal right to an abortion, meaning that each state will be at the liberty to establish laws to protect or restrict abortion in the absence of a federal standard. Twelve states have already banned abortion – Alabama, Arkansas, Georgia, Mississippi, Missouri, Ohio, Oklahoma, South Dakota, South Carolina, Tennessee, Texas and Wisconsin.

More than 18 million people capable of pregnancy ages 18-49 live in these states where abortion is banned – 22% are Hispanic, 14% are Black, and 4% are Asian. Moreover, almost half of all Native American women within this age range live in these states.

More than half of abortions are sought by women of color. Almost four in ten abortions are among Black women (38%), one-third among white women (33%), one in five among Hispanic women (21%) and 7% among women of other racial and ethnic groups.

The reason behind these higher rates is systemic, due to a lack of health care resources and contraceptives. Even before the Dobbs decision, Black, Hispanic, Indigenous, Asian and Pacific Islander women have faced disproportionate struggles in accessing reproductive and sexual health care. From the pervasiveness of stereotyping, language barriers, dismissive treatments and cultural stigmas, women of color are no strangers to the inequity within the system. Moreover, people of color are more likely to be insured under Medicaid, where abortion coverage is limited to cases of rape, incest or life endangerment.

To that end, traveling out of state to get an abortion isn’t an option many can afford. The out-of-pocket cost for abortion alone can exceed $500, and with additional expenses like transportation, childcare, and accommodations, along with unpaid leave, it is simply not a viable option for low-income people.

One of the most dangerous consequences of the bans is that private citizens may now take on the role of bounty hunters. Physicians will be penalized and unable to fulfill their professional obligations in ensuring the wellness of their pregnant patients. It leaves pregnant people with few options. To that end, there are prescription drugs available to induce a self-managed abortion. If someone is found to be in possession or using the drugs in a state where the ban is in effect, they risk being criminalized and imprisoned. The judicial system already disproportionately criminalizes people of color, so this principle will resonate ten times over.

An ongoing study by the University of California-San Francisco examines the effects on people within states that impose gestational limits on abortion. As a result, they face higher rates of domestic abuse, financial debt and both short- and long-term health complications like eclampsia, postpartum hemorrhages, chronic migraines and gestational hypertension, to name a few. On all fronts, reduced access to abortions and reproductive and sexual health care only exacerbates what inequities exist within the health care system.

Fighting for separation of church and state means fighting for reproductive freedom. Religious freedom promises bodily autonomy – the right to make your own decisions about reproductive health care based on your own beliefs. Church-state separation ensures that multiple viewpoints and beliefs on abortion can exist without being weaponized against each other. It is a reassurance that we can determine what is best for ourselves according to our principles and present circumstances. AU will never give up this critical fight.

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