The Washington PostDemocracy Dies in Darkness

Opinion Abortion bans hurt poor and Black women most

People march to protest a lawsuit in federal court to ban the abortion drug mifepristone on Saturday in Amarillo, Tex. (Justin Rex/AP)
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Whenever you hear the abortion ban crowd extol their devotion to “life” and to the protection of women (whom they incorrectly claim are victimized by laws that in fact defend their bodily autonomy), consider the mound of evidence that documents the physical, emotional, mental and economic toll imposed on women denied an abortion. That data leave little doubt: the suffering abortion bans impose falls disproportionately on certain groups of women, as two recent studies show.

The first study comes from the National Bureau of Economic Research, which relied on a mammoth storehouse of data from California — “the universe of California birth records covering years 2007—2016, linked to inpatient data with information on infant and maternal hospitalizations and infant death certificate records” and a slew of other government records. (Understanding the quality and extent of the factual material is critical to appreciate that in contrast to junk science and urban myths propagated by abortion ban advocates, the scientific studies amply substantiate the risk pregnancy poses, especially for poor women and Black women.) Two of the findings are critical for policymakers to grasp.

First, while rich women have riskier pregnancies (usually due to higher age), their infants are less likely to die than are infants of poorer women with less risky pregnancies. Likewise, poor women are more likely to die from childbirth and pregnancy than rich women. (“Thus, similar to what we find for infant mortality, we observe that high-income women are actually the least likely to die despite having some of the riskiest pregnancies.”) Money matters.

However, race matters more. The second critical finding: “Across all parental income levels, Black infants and mothers have much worse health than their non-Hispanic white counterparts.” This is true even for rich, Black women. In fact, if you consider both maternal and infant health, their health outcomes are “markedly worse” than the outcomes for the poorest White women. “This evidence implies that policies seeking to achieve racial health equity cannot succeed if they only target economic markers of disadvantage.”

Anyone who insists that African Americans no longer suffer from the legacy of slavery, Jim Crow and racial inequality needs to reckon with this reality. “The fact that Black mothers at the top of the income distribution have similar mortality rates as white mothers at the bottom of the income distribution suggests that the widely cited racial disparity in maternal mortality is unlikely to be solely or even mostly driven by differences in average income levels across the two racial groups,” the authors wrote. If you are a pregnant woman, it is better to be poor and White than rich and Black.

Additional research on the disproportionate impact of abortion denial stems from the landmark Turnaway study, about which I have previously written. The Turnaway study looked at about 1,100 women over a five-year period to examine how health, emotional, social and economic outcomes differed between women who obtained abortions and women who sought but were denied abortion due to state gestation limits on abortion (e.g. a 15-week ban). The latest analysis from Diana Greene Foster, who ran the Turnaway study, and other scientists found: “Women denied an abortion were more likely than were women who received an abortion to experience economic hardship and insecurity lasting years. Laws that restrict access to abortion may result in worsened economic outcomes for women.”

This analysis found that women seeking abortions are more likely to be in poverty than the population as a whole — “half (51%) were living below 100% of the federal poverty level; 3 quarters (76%) reported not having enough money to cover housing, transportation, and food.” (Among the women seeking abortion, 63 percent already had children.)

The economic trajectory of the two groups of women, those turned away and those who got abortions, diverged significantly:

We found large and statistically significant differences in the socioeconomic trajectories of women who were denied wanted abortions compared with women who received abortions — with women denied abortions facing more economic hardships — even after we accounted for baseline differences. Differences over time in employment, poverty, and receipt of public assistance suggest that public assistance programs served an important role in mitigating the loss of full-time employment for women denied an abortion. However, public assistance was not sufficient to support the increase in household size resulting from a new baby, and did not keep households of women denied an abortion from living in poverty.

In short, denial of an abortion led to “to almost a 4-fold increase in the odds that a woman’s household income was below the [federal poverty level]” and resulted in worse outcomes when it came to “full-time employment, increased incidence of poverty, more women raising children alone, and greater reliance on public assistance.” Moreover, “the burden of raising a child often falls to women alone rather than to couples or an extended family.”

Foster, writing recently in the journal of the American Public Health Association, concluded, “The evidence that not being able to get an abortion leads to greater poverty and a worsening of physical health outcomes means that we are about to see a deepening of existing inequalities. Poverty and poor health make it more likely that one will be denied an abortion. Being denied an abortion leads to yet greater poverty and health risks.”

In sum, when the forced birth crowd commandeers from women the decision to give birth, it inflicts economic harm on the women who already are the most vulnerable. Even worse, they set up Black women and infants for greater risk of death. That’s not “wokeness”; that’s fact. Those lawmakers who insist they are banning abortion for the sake of women and children should consult those affected. They would find out the reality is quite different.