The U.S. Supreme Court's decision to reverse decades of legal precedent by overturning Roe v. Wade — the 1973 ruling asserting constitutional protections for a woman's right to choose whether to have an abortion — triggered laws in multiple states either outright banning abortions altogether, or severely restricting the ability to access them. In most cases, these laws only allow abortions in cases where the procedure will prevent serious injury or death. Those exceptions aren't nearly as reassuring as some may believe them to be.
The maternal mortality rate in the United States is abysmal, especially for Black women who die at nearly three times the rate during childbirth as white women, according to the Centers for Disease Control and Prevention. Among developed countries, the U.S. ranks among the worst in terms of maternal mortality, according to The Commonwealth Fund, a private foundation funding research and grants around health care issues and policy. Maternal deaths have been increasing here since 2000, with two-thirds of those deaths reported as preventable, and this is partly attributable to low numbers of midwives and obstetricians/gynecologists, access to postpartum care, an absence of guaranteed paid parental leave, and systemic racism.
"We have been working to understand the Supreme Court ruling and its impact on every single state across the country. We know that this has created, and will continue to create, immense confusion and issues with patients being able to get the best care for them," said Dr. Jenni Villavicencio, a board-certified obstetrician/gynecologist who serves as the lead for equity transformation at the American College of Obstetricians and Gynecologists, leading their anti-racism, diversity, and equity and inclusion work. "I am especially focused on the impact that this ruling is going to have on the most marginalized, historically and currently, in our country. That includes Black, Indigenous, Hispanic, and other people of color, as well as people who are poor, living in rural or remote areas. We know that they are going to be impacted the most by these laws and they are already impacted by racism and the way that it manifests itself in the healthcare system." She took some time to talk about what it looks like, from a medical perspective, to make a life-saving decision during pregnancy; whether adoption is a sufficient alternative to abortion; and the very real risks of patients being forced to carry pregnancies to term without the option of abortion as part of their overall care. (This interview has been edited for length and clarity. )
