To Be Pro-Choice, You Must Have the Privilege of Having Choices

As a queer woman who grew up in North Carolina, I learned at an early age that my Blackness could be a source of great joy — but it could also pose a threat to my safety and autonomy.

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Systemic racism is built into every facet of our society, including sexual and reproductive health. In 1973 the U.S. Supreme Court decision in Roe v. Wade affirmed the constitutional right to abortion, barring states from banning abortion before the point of fetal viability. But too many states, especially in the South, interpreted and applied the decision as strictly as they could get away with, disproportionately affecting women of color.

In the decades since, lawmakers have enacted hundreds of dangerous restrictions that have made getting an abortion nearly impossible for many poor women and women of color. {snip}

As devastating as that outcome would be, it’s important to keep in mind that Roe never fully protected Black women — or poor women or so many others in this country. That’s because Roe ensured the right to abortion without ensuring that people could actually get an abortion. People seeking abortions in America must consider: Do I have the money? How far is the nearest clinic, and can I get there? {snip} For more privileged people, these questions are rarely a deterrent. But for many women of color and poor people, they are major obstacles. That’s how white supremacy works.

It didn’t help matters that almost as soon as Roe was decided, lawmakers started rolling it back. The Hyde Amendment, which first passed three years after Roe, bans coverage of abortion through federally funded programs like Medicaid. In addition, 34 states and the District of Columbia bar the use of their state Medicaid funds for abortions except in limited cases.

The Hyde Amendment has made it very difficult for many women to afford an abortion in America, and that affects women of color the most: In 2019 women of color made up a majority of women insured through Medicaid. {snip}

This has ripple effects on people’s lives. According to the decade-long Turnaway Study, women who seek an abortion but are unable to gain access to one are four times as likely to eventually live in poverty as women who were able to get the procedure. Their families suffer, too. Black children are three times as likely as white children to grow up in poverty and live in a food-insecure household.

On top of that, women of color in states with restrictive abortion laws often have limited access to health care generally and a lack of choices for effective birth control. Schools often have ineffective or inadequate sex education. In almost every aspect of reproductive health, women of color today are more likely to experience racism and discrimination in the U.S. health care system. We have poorer health outcomes compared with white women. Black women are three times as likely to die of pregnancy-related causes as white women. And police violence cuts short the lives of too many of the babies we do have.

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The fight for reproductive justice must be led by those most affected. To build collective power, we need a deeper investment in B.I.P.O.C.-led organizations. {snip}