Black advocates brace for maternal health disparities if Roe falls

As the Supreme Court weighs the fate of Roe v. Wade, advocates and health care providers fear that cutting off access to abortion will lead to more pregnancy-related complications and deaths that disproportionately affect Black people.

Why it matters: Black women in the U.S. are already three times more likely to die of pregnancy-related complications compared to white women. And the states poised to ban or severely limit abortion already tend to have poor health outcomes and fewer safety net programs in place for mothers and children.

State of play: Black women have less access to resources like birth control and prenatal care, in part due to income inequality, according to the National Partnership for Women & Families.

• Compared to white women, they are more likely to experience pregnancy-related complications and deaths and have a higher risk of miscarriage.
• Black women also face everyday discrimination in medical settings, such as dismissal of symptoms and false beliefs about racial differences, which can negatively impact their birthing process, said Yolanda Barksdale, press secretary of the Poor People’s Campaign.
• More states are expanding Medicaid coverage of maternity services for low-income women, including lengthening the postpartum coverage period. More than half have taken recent steps toward lengthening the postpartum coverage period beyond 60 days.
• But that hasn't abated concern about more Black women being forced to carry pregnancies to term in those states that bar access to abortions —and how that could put them at increased risk.

What they're saying: "Because of the heightened mortality and morbidity risks faced by Black women and birthing people, it is particularly unconscionable to force the continuation of an unwanted pregnancy," Jamila Perritt, an obstetrician-gynecologist who heads the group Physicians for Reproductive Health, tells Axios.

• The most dangerous medical scenario for a woman is not abortion but childbirth, noted Dázon Dixon Diallo, founder of the reproductive justice advocacy organization SisterLove. "Abortion only becomes one of the most dangerous procedures when it is no longer legal and safe."
• Abortion also matters because it's "about our right to control our bodies because we've been fighting for that since we were brought to these shores," she added.

The other side: Cherilyn Holloway, president of the racial justice-focused nonprofit Pro-Black Pro-Life, told Axios abortion won't solve the systemic inequities that force Black women to get the procedure in the first place.

• A high maternal mortality rate "is not a sufficient argument as to why abortion should be legal. That is a sufficient argument as to why we need to address the systemic racist issues in health care and implicit bias in health care," she said.
• "If you're making a choice because you feel like you have no other choice, that's not a choice," she noted. Abortion is a temporary solution —one her group hopes to make unnecessary, she added.

The big picture: Black advocates across the spectrum are already organizing, both at the national legislative level and on the ground.

• "We're going to focus on the most vulnerable women, making sure they don't die while these slow-walked legal processes take place," reproductive rights activist Loretta Ross tells Axios.

What we're watching: Doctors have warned that overturning Roe could add undue stress on an already-burdened social safety net, including the foster care system and efforts to reduce domestic violence.