Clinicians, health care systems and lawmakers should approach abortion as a racial justice issue, a group of University of Minnesota School of Public Health professors and researchers argue in a new article in the New England Journal of Medicine.
The piece was authored by reproductive health equity professors Rachel Hardeman, who directs the Center for Antiracism Research for Health Equity; Katy Backes Kozhimannil, who directs the Rural Health Research Center; and researcher Asha Hassan.
The article, published Wednesday, uses history and statistics to argue that the legal status of abortion weighs most heavily on people of color, who face systemic racism that impacts their reproductive rights.
“The Dobbs decision rolls back fundamental rights for many people, and it is a direct assault on efforts to improve racial equity in health care. Indeed, abortion access is fundamentally a racial justice issue,” they wrote.
Before the June U.S. Supreme Court ruling overturning Roe v. Wade, people of color already had fewer options for reproductive care, they wrote. Rural and urban communities where people have limited access to contraceptives or abortion are the same communities where access to prenatal and obstetric care is declining, according to the article.
The authors felt compelled to write the piece because of the ruling’s impact on maternal mortality, especially for Black and Indigenous people, Hardeman said in an interview. The piece highlighted recent estimates that a nationwide abortion ban would increase the maternal mortality rate by 21% overall and by 33% among Black Americans.
“When we think about abortion bans, we have to be thinking about them through the lens of racist policy,” Hardeman said. “In a country that prides itself on being incredibly healthy, I think we have to be thinking about this, above and beyond the politics, and really think about what this means for health care, for health care delivery and for population health.”
Minnesota is seen as a sanctuary state for abortion, but clinicians have a lot of work ahead of them when it comes to equitably serving patients from surrounding states and people of color in rural communities closer to home, she said.
Hardeman said she hopes clinicians consider their professional obligations to support patients who may need access to abortion by becoming certified to administer medication abortion, for example, or by supporting colleagues who do.
“I think every single clinician has to think about what their role is personally in contributing to the broader goal of ensuring health and well-being for their communities and for the patients that they serve,” Hardeman said.