For many on the left, Brett Kavanaugh’s nomination to the Supreme Court has prompted worried speculation, especially in relation to reproductive health and rights. To understand what’s at stake in his potential rise to the court, though, we need look no further than the recent trends of the institution he’d be joining, which are in alignment with the Trump administration’s own priorities. The Supreme Court’s recent public sector union and crisis pregnancy center decisions, with President Trump’s appointee Justice Neil M. Gorsuch voting with the majority, will bolster the conservative assault on women’s health and economic security that has been underway for the past decade.
These recent developments will embolden conservative lawmakers to step up their attacks on both reproductive and labor rights, with detrimental impact on women and their families. Reproductive health and economic security — and, by extension, reproductive rights and labor rights — are becoming increasingly inextricable in Trump’s America. The GOP-coordinated attacks on both issues exact a devastating toll on women, with women of color paying a disproportionately steep price.
Economic inequality in the United States is greater today than at any time since the Great Depression, and that inequality is deeply racialized and gendered. White women remain trapped in a wage gap where they are paid 82 percent of what their white male counterparts are paid, with black and Hispanic women being paid 65 and 58 percent, respectively. Disparities persist even in occupations that are dominated by women, and more than eight times as many women as men work in jobs that pay poverty-level wages. Many of these jobs do not offer benefits such as paid sick leave, paid family leave or employer-based health insurance, and the race and gender wealth gap leaves women without the resources to pay for benefits not provided by their employers or the safety net. The economic insecurity that results is a pathway for a host of negative health outcomes for women and their children. One stark example: For women of color, the toxic mix of racism and economic inequality drives maternal mortality and morbidity rates that are three to four times those of white women.
Just as economic insecurity affects health, so, too, does reproductive health access affect economic opportunities. Women report that using contraception allows them to get and keep a job, to advance their careers, to further their education and take care of themselves financially. Indeed, the increased use of the birth control pill has been credited with women’s increased labor market participation. The Turnaway Study — a research endeavor that aims to understand the effect of unintended pregnancy on women’s lives — illustrates the revolving door between poverty and a lack of reproductive health access. Forty percent of the study’s participants had incomes below the poverty line. Forty percent of participants reported that they sought out abortion services because they couldn’t afford to have children. More than half of the women who had an abortion reported they were delayed in obtaining care because it took them time to raise money for the procedure, resulting in more complex and expensive procedures. And women who were denied an abortion had three times greater odds of landing in poverty than women who had the procedure (when adjusting for previous differences in income).
Unions, and especially those in the public sector, have been important sites for combating race and gender inequities, and the Janus v. AFSCME decision strikes at their heart by cementing more than a decade of GOP attacks on labor rights. The fallout will negatively affect all workers but will especially hurt women, who make up the majority of public sector workers and who are disproportionately women of color. Women represented by a public-sector union have higher wages and more comprehensive benefits, and experience smaller (although still persistent) racial and gender income gaps than those in nonunion jobs. These are all critical factors that allow women to make decisions about their health and lives.
Conservatives, who have spent the past four decades attacking public sector employment and the labor movement more broadly, are now emboldened as they work to expand an economic system that is failing the majority of Americans. The current administration has been laser-focused on weakening unions, reducing federal employment roles and chipping away at worker protections. Just two weeks after the Janus decision the Trump administration proposed a rule aimed at preventing home care workers from unionizing, adding an additional barrier to higher wages and better benefits for workers who are overwhelmingly women of color.
There’s certainly more where that came from. As women’s already precarious work becomes even more insecure, their need for publicly funded health services will increase. The problem, of course, is that conservatives also have reproductive rights — and health access more broadly — squarely in their crosshairs.
The day after the court delivered its Janus decision, it authorized crisis pregnancy centers (CPCs) to continue to lie to women about the services they provide. CPCs, often strategically located next to Planned Parenthoods or other reproductive health providers, pose as health clinics — when they don’t offer any real medical care — and lure women in solely to persuade them to continue their pregnancies. They amount to a bait and switch intended to keep vulnerable women in the dark about the safe and, for now, still legal options available to them.
The CPC decision is a notch in the belt of conservatives who have been waging a multi-front assault against reproductive health and rights. In the past seven years, states have enacted 401 abortion restrictions, accounting for more than a third of all such restrictions put in place in the 45 years since Roe v. Wade was decided. The Trump administration has amplified the GOP’s extant attacks on Title X (the federal family planning program), on sexuality education, on the critical family planning and women’s health protections guaranteed by the Affordable Care Act, and on access to health coverage and care more broadly. Trump and the GOP have every intention of using the new Supreme Court vacancy to supercharge these attacks and cement these barriers in place for decades to come.
We are witnessing the willful destruction of the institutions and infrastructure that are key to the health and well-being of women and families and also to that of our economy and our democracy. This is what the war on women — which is also a war on workers — looks like. If Trump and the GOP have their way and seat Kavanaugh on the Supreme Court, it will hasten a dramatic landscape shift that will make the United States an increasingly hostile place for women and their children.