Experts Unpack the Ripple Effects Overturning Roe v. Wade Will Have On Black and Brown Communities

By now you know that the Supreme Court recently voted to repeal Roe v. Wade, the 1973 case that guaranteed abortion rights under the Constitution. But what some may not understand is how this decision could have lasting, severe, and disproportionate effects on some of the most vulnerable groups in the U.S., namely Black and Brown communities in low-income areas where abortion has already been or will soon be banned or severely restricted.

In a recent report, sociologist Amanda Jean Stevenson did the math, and she found that if a nationwide abortion ban was in place (meaning if all wanted abortions were denied), the maternal death rate for all races would increase by seven percent in the first year and by 21 percent in subsequent years. Even more alarming, the report found the number of non-Hispanic Black maternal deaths would increase by 33 percent in the years following a total abortion ban in the U.S.

While a nationwide total ban is not in effect (as the legality of abortions now falls to the individual states) the fall of Roe v. Wade will certainly impact Black and Brown communities in need of maternal health care. “Given that Black women tend to live in states hostile to reproductive health care, Roe’s overturn directly endangers Black women’s lives by exacerbating pre-existing access restrictions,” said Michelle Webb, Chief Communications Officer of the Black Women’s Health Imperative (BWHI) in a recent statement.

“There are so many other ripple effects that [overturning Roe v. Wade] is going to have on the livelihood of pregnant people,” says reproductive health equity researcher and Planned Parenthood board member Rachel Hardeman, Ph.D., M.P.H. “If there are more pregnant people who are being forced into pregnancy, there will be a larger population of folks who are at greater risk for mortality and morbidity,” she adds, explaining that in some states, Black women could see even higher maternal mortality rates, increased child poverty, and face a greater risk of prosecution for seeking abortions illegally.

For instance, even while Roe v. Wade was the law of the land, lawmakers in Texas notably made attempts to restrict abortion access, all while failing to address the high rates of uninsured adults and children in their state. Texas also has one of the highest repeat teen pregnancy rates and is home to many maternal care deserts (aka counties where maternal health care services are limited). The majority of uninsured people living in maternal care deserts in Texas are people of color, and they are already struggling from the lack of access. States with these issues that ban or limit access to abortions will set more people of color up for dangerous health risks and inhibit upward socioeconomic movement.

Hardeman is hopeful that the recent shift toward telehealth services, which was sparked by the COVID-19 pandemic, will continue to help women have self-managed abortions (aka have access to abortion pills). However, there are limitations, she says. “Generally [taking abortion pills] is very low-risk, and it’s a fairly straightforward process,” she explains. “But you have to think about what complications mean for someone who then presents at the emergency room or at a provider for help, with the risk of the police being called.” Additionally, people who live in states where abortions are or soon will be banned may not be able to access abortion pills via telemedicine, even though the Food and Drug Administration allows anyone to receive abortion pills by mail.

There’s fear that both pregnant Black people and Black health care workers may also bear the brunt of miscarriage and abortion prosecution, says Hardeman. For instance, states including Oklahoma, Missouri, and South Dakota intend to prosecute and fine people who perform or attempt to perform abortions. “You have to layer on the race piece because of how police surveillance has occurred in Black communities and Brown communities,” says Hardeman. She’s referring to what many studies show: Black people are more likely to be stopped by the police and treated more harshly during police interactions.

While Black women are quickly becoming the most educated group in the country, they are also grossly underpaid compared to white men and women. And in areas that have high rates of poverty, not having abortion access could impact upward mobility for poor families, says Theresa D. Chapple, Ph.d., a Chicago-based epidemiologist who specializes in health equity. This is especially true considering America is the only industrialized country that doesn’t currently offer paid family leave (though individual companies may offer this benefit to employees). When parents aren’t able to take paid time off to care for newborns, it can cause financial stress. In fact, if there was universal paid maternal leave for families in America, children of unmarried and Black mothers would stand to benefit the most, according to a 2015 study.

Webb echoes Chapple's statements on the relationship between poverty and abortion access. "The fall of Roe will also condemn Black women who seek abortions due to financial hardship to an inescapable cycle of impoverishment along with the poor health outcomes that accompany it," she wrote in the non-profit's statement.

Black people from low-income communities have higher rates of abortion than white people of higher socioeconomic status. Without access to abortions in certain states, they may be forced to carry an unwanted pregnancy, leading to further financial burden and health risks.

"What is the message that we're sending?" asks Chapple. "We don't care where you are in your stage of life or if this pregnancy is going to change your life course? Is this to keep people in poverty so that they have to continue to work low-wage jobs to take care of their families? Is it to stop the progress of Black women who are progressing and do that by making us take another unpaid maternity leave?"

While some may argue the solution to lack of access to safe and legal abortions is to simply avoid having sex if you don't want to or can't afford to have a child, the situation is far more nuanced than that. "Sex is a natural thing," says Chapple. "Instead of criminalizing the outcomes of sex, we should acknowledge that sex is natural, and not all sex is automatically going to end with babies."

What can’t be forgotten in this conversation is that without abortion access, children will suffer too, says Chapple. If babies are unplanned, and therefore pregnancies go unnoticed by the mother — reminder: many women don’t even know they are pregnant until they’re five to six weeks pregnant — they may be born to women who have not undergone prenatal care, who have taken drugs, smoked tobacco, or drank alcohol without knowing they were pregnant, she says. Additionally, children born to people without financial resources to care for them are at greater risk of living below the federal poverty line. This is especially true among Black and Brown communities, as mothers may face financial and logistical barriers to care.

Fact-checked by Cherisse Harris