By: Catherine Less, Leadership & Social Justice Intern, and Lalitha Pamidigantam, Advocacy Manager
Across the nation, we see a Black maternal health crisis that exemplifies the systemic racial disparities and the lack of equitable access to healthcare. The implicit biases in the American healthcare and medical systems create barriers to care that directly affect both mother and child. In post-Roe Ohio, residents are left to wonder whether stricter abortion laws will lead to more fatal pregnancy complications or other challenges due to a lack of access to essential reproductive healthcare.
To understand this, we must place reproductive rights and healthcare in a broader social justice framework. We must look at reproductive rights through the intersections of race, gender, class, and sexual orientation, with the impacts of economics and culture at its center. Acknowledging practical access within this framework is the foundation for reproductive justice, a movement built from the powerful voices of Black, Asian-American, Latinx, and indigenous women who continue to advocate for the rights of women of color and other marginalized individuals.
Justice for Black women in our community not only means adequate and equitable access to abortion and healthcare, but greater access to alternative birth options, adequate prenatal and pregnancy care, childcare assistance, and safer homes. Through the exploration of the intersecting oppressions Black women face, we analyze how reproductive autonomy can liberate communities of color.
Explaining the Racial Disparities in Healthcare
Outcomes for expecting mothers of color in the U.S. show a failure of our healthcare system and the structural problems within our communities. Black women are 3 to 4 times more likely to die from pregnancy-related complications than white women – a startling statistic, and one that does not show signs of progression under current policies and procedures.
A primary cause of the disproportionate increase in maternal and infant mortality rates in Black neighborhoods is due to healthcare providers’ unwillingness to listen to Black patients – through implicit and explicit racial biases – which can also lead to delays in diagnosis, inadequate assessments, and lack of communication or education from providers. These disparities directly affect the quality of life for both mothers and children.
Columbus has a deep-rooted history of systemic segregation that has led to a public health crisis for our Black neighbors in Central Ohio. For much of the 20th century, our community members of color were denied mortgage loans, in a practice known as redlining, leading to years of disinvestment and discrimination in neighborhoods and homes. Areas throughout Central Ohio today – including the Hilltop, Franklinton, South Linden, and the Near East Side – overlap with areas that were historically redlined and are often the same areas with the greatest risk of maternal and infant mortality today, as well as other health risks. In 2022, infant mortality rates differed by more than 10 points between Black babies and white babies in Franklin County. The mortality rate for Black babies was 15.3 per 1,000 but 4.2 per 1,000 for white babies.
Despite being at the doorstep of multiple world-renowned medical research facilities with nationally ranked physicians, nurses, and researchers, Ohio continues to fall short in infant mortality, ranking a dreadful 41st in the nation. Compared to every other wealthy nation, the United States spends the highest percentage of its gross domestic product on healthcare, and yet, among the top 11 developed countries, our nation has the highest maternal mortality rate and continues to underperform in keeping its citizens alive. While funding healthcare for marginalized communities equitably remains a concern, the problem isn’t always the dollars themselves, but rather where they are placed and how they are used.
Reproductive Autonomy is the Answer
When compared to white women, pregnant Black women experience healthcare differently, often with mistreatment and neglect. The intersectionality of race, gender, and class creates profound barriers for mothers navigating a system based on and supported by white supremacist culture. The maternal and infant mortality crisis is a direct result of the years of policy choices that are written and implemented to fuel the rampant inequality, segregation, and discrimination against Black women and families.
As efforts to eradicate reproductive rights and cut abortion access for women across Ohio continue to be dominating forces in the statehouse, we need to consider the individuals whose lives hang in the balance. A never-ending rush of anti-choice legislation has made it almost impossible to receive an abortion – even if medically necessary – and has already affected marginalized communities and their fight for better health care.
Access to abortion is a key component of women’s comprehensive health care. The ability to choose if, when, and how to give birth plays a significant role in a woman’s well-being. Reproductive justice is not only about securing access to abortion, but abortion is just an important facet in a large network of resources that broadens a person’s choice to decide and secure essential healthcare.
The conditions and context in which a child is born and the question of whether families have the resources to thrive sews the critical landscape of protecting and improving the lives of Black mothers, children, and communities. The systemic segregation and disinvestment in housing and neighborhoods impede on Black families’ right to thrive and consistently put undue stress on both mother and child, thus creating a greater risk for preterm births and health complications. Understanding that people may seek abortions because they are at greater risk of dying from pregnancy – because of health conditions, low wages, lack of access to healthcare, or an unsafe and unstable home environment, is an essential part of restoring women’s right to choose and validates our bodily autonomy.
Looking Beyond: Justice and Change
Ohioans are dangerously close to losing legal access to safe and comprehensive reproductive medical care. Right now, extremist policies are seeking to further limit Ohioans’ reproductive freedoms. Addressing the maternal and infant health crisis and racial inequities in healthcare requires an approach that encompasses advocacy for policies that support reproductive autonomy.
Ohioans for Reproductive Freedom and Ohio Physicians for Reproductive Rights are working for The Right to Reproductive Freedom with Protections for Health and Safety amendment to be placed on the 2023 statewide general election ballot. This measure calls for the power to make reproductive health decisions to be returned to the people. Support for this amendment has seen a record turnout, with over 7,000 petition signatures in the first 48 hours after it was announced, showing that Ohioans support restoring reproductive autonomy. This movement is working to reestablish the rights and protections that were destroyed in Ohio post-Roe, urging community members to restore the individuals’ right to make reproductive health decisions for themselves.
As a woman living in Columbus, it is empowering to know so many advocates and organizations are working tirelessly to save lives and change the restrictive laws barring our bodies. Collectively, we must center marginalized communities when choosing a position on policy.