Race, Class, and Access to Women's Health Services:
Honoring the Intersections

I confess that I have always been uncomfortable with abortion, especially late-term abortions and the statistic that 45% of women who have abortions undergo the procedure multiple times. But I have also been uncomfortable with the strident condemnation of abortion by the most passionate elements of the pro-life movement, particularly since so many in that movement are also opposed to social policies to support underprivileged women and children.

As someone who participated in the Women's Marches across the country the day after the Trump inauguration, I have also learned to pay attention to the intersections wherein the concerns of affluent white feminists have been historically privileged over those of people of color and other socially marginalized groups. This blog article is an effort on my part to honor those intersections as they relate specifically to women's reproductive health services and access to them.

Falling Abortion Rates

Though one might not know it from the more strident rhetoric from anti-abortion advocates, abortion rates have actually fallen in recent years. According to the CDC web site, the abortion rate went down by 5% between 2012 and 2013, the latest year for which surveillance data is available and, in fact, have gone down every year between 2004 and 2013 for all age groups. Pro-life advocates attribute this decline to their relentless condemnation of the practice and to laws they've managed to pass in various states to obstruct Roe v. Wade. There is, however, another possible explanation. Data has shown that, in places where medically assisted suicide or euthanasia has been legalized, people resort to it surprisingly little. It appears that the mere availability of euthanasia as a legal option makes desperate and frightened people less likely to opt for it. Extrapolating, the mere availability of the legal option for abortion may restore to desperate and frightened women some sense of personal autonomy and control over their bodies, thereby offering them space and time to consider an option other than abortion.

But Wait...

Whatever the reason for falling abortion rates, CDC statistics also reveal something far more disturbing: while non-Hispanic white women had the lowest abortion rates, non-Hispanic black women had the highest. When one drills down into the data, non-Hispanic white women accounted for only 37% of the total abortions in 2013 despite white women's majority numbers in the American adult population; Black women accounted for nearly as many at 35.5% of abortions, far and away disproportionate to their numbers in the general population. The other two racial/ethnic groups were 1) "other," many if not most of whom would be women of color, and 2) Hispanic women, at least some of whom would be women of color. All stats considered, it seems clear that the vast majority of fetuses still being aborted are racially black or brown. Lower socio-economic status is another factor correlated with higher abortion rates, not surprisingly since it affects access to all the goods of society from health care to education and job access.

Many white women involved in the anti-abortion movement may not be aware of the racial disparity, but even those who are may use it as a political cudgel to beat down abortion access: Abortion must be eliminated because women of color are disproportionately affected by it. But here we come up against the law of unanticipated consequences, in which the very good we seek (the reduction of abortion rates and/or concern for the welfare of women of color) becomes the very thing that increases abortion's likelihood for those women who may have the least access to alternatives:

How so? Well, by law, federal funds cannot be used for abortion, yet the prolife movement has relentlessly sought the federal defunding of women's health services, including contraception and breast and other cancer screenings, provided by Planned Parenthood and other women's health clinics, whose primary clientele is the underprivileged whether here or abroad. The courts have also upheld the right of businesses such as Holly Hobby to refuse on religious grounds to include birth control in the services covered under their employee insurance programs (as if businesses could have a religion, a case of following the Citizens United "people are corporations, too" nonsense to its irrational conclusion).

At the same time they so passionately oppose abortion, many adherents of the self-styled pro-life movement share the penchant of other social conservatives for pointing the finger of reproach at disadvantaged women, among whom women of color are also disproportionately represented, for "having children they can't afford." If such a woman aborts a fetus, she's accused of "murder." If she has the baby when she can't afford to raise it - especially if she's a single mother - she's labeled a "societal leech" sucking on the public dole. Many social conservatives also don't want to spend taxpayer money on education for poor mothers so that they can get better jobs with a living wage to support a family, ignoring the clear evidence that family size goes down as education levels go up. (Actually, many conservatives are reluctant to spend taxpayer dollars on public education at all.) Nor on child care so that women can work. To me, this is not a morally consistent pro-life position; it is merely anti-abortion. it is one of our culture's enduring mysteries that so many of those who are so passionately invested in the survival of a four-month fetus seem to care so little for the future of a four-month-old baby or a four-year-old child.

This is the classic bind into which conservative opposition places underprivileged women. Whatever I may think about abortion access as a general principle or in specific cases, I, as a white woman of privilege, am opposed to what looks to me to be a form of de facto ethnic cleansing in which society accepts abortion among non-affluent women of color as collateral damage in the culture wars.

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