Black doctors and abortion advocates in St. Louis say that Black women will suffer the most if the U.S. Supreme Court overturns Roe v. Wade, the 1973 ruling that made abortions legal.
If the high court rules that way, as a draft opinion obtained last week by Politico indicates, states could ban abortions. Missouri has a “trigger law” that would ban abortion in most cases. Abortion advocates say Black women seeking an abortion would have to travel to Illinois or other states where it is legal.
That would be difficult for those who have to take off work without pay, arrange child care and find transportation to other states, said Dr. Jade James, an obstetrician and gynecologist for SSM Health.
“Women are going to have to make decisions about where to go, how to get there and what to do,” James said. “In terms of seeking quality abortion care, some women unfortunately, are going to seek abortion care and are going to receive what we consider substandard care.”
Many Black women would not be able to overcome those barriers. That could force them to carry risky pregnancies to term and lead to more Black women dying during childbirth, James said.
“When we talk about maternal mortality, part of the contribution is we don't always start on a level playing field in terms of our health,” she said.
James said some of her patients have had difficult pregnancies or experienced complications during childbirth and have not recovered from their experience. That is why it is important for the nation to preserve access to legal abortions, particularly for Black women, who have high maternal mortality rates, she said.
According to the Centers for Disease Control and Prevention, Black women are more than three times as likely to die while giving birth as white women.
Banning abortions also would cause catastrophic health impacts for Black women, who have long suffered from racism in the health care system, said Pamela Merritt, executive director of Medical Students for Choice, a reproductive health nonprofit.
“It doesn't matter how educated we are, it doesn't matter how affluent we are. Everybody from my friends and cousins to Serena Williams is subject to the devastating health impacts of racism and racial health disparities,” Merritt said. “So within that framework to take away a Black woman's ability to make a determination about her ability to parent in that moment is criminal.”
If the Supreme Court overturns the ruling, a law signed by Missouri Republican Gov. Mike Parson in 2019 will immediately ban abortions after eight weeks of pregnancy.
Merritt said losing access to abortions in Missouri would be devastating to the St. Louis area because many Black women live in places where contraception is not easily accessible.
“It’s a huge challenge, and some people have access but don't have transportation to get it, other people are struggling to be able to afford it,” Merritt said. “But when push comes to shove, people need to be able to access the care that makes the most sense for them and so even in a perfect world where everybody has access to contraception, people will still need abortions.”
Merritt is worried that if abortions become illegal in Missouri, Black women who are unable to access abortions in other states where it is legal will seek unlawful abortions and could be prosecuted.
“Women of color in general are far more likely to be surveilled … and so what Black women are facing is the criminalization of pregnancy outcomes,” Merritt said. “And we know from the criminalization of all things, that when something is criminalized Black people tend to be subjected to the enforcement of that law far more than other populations.”
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