The People and Communities That Stand to Be Most Affected if Roe v. Wade Is Overturned

People of color, marginalized communities and those in low-income areas are among those who are likely to be most affected by lack of abortion access.

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Individuals from all walks of life stand to be impacted by the effort sweeping the nation to rollback a half-century of progress on abortion and reproductive rights should the Supreme Court uphold a draft opinion to overturn Roe v. Wade.

In a 2016 report from the Guttmacher Institute, researchers found that three-fourths of abortion patients were considered low income, with 49% living at less than the federal poverty level. In a separate study—a now-famous piece of research known as the Turnaway Study—a group of scientists from the University of California, San Francisco found that being denied an abortion results in worse financial, health, and family outcomes.

And perhaps most concerning of all,hundreds of women dieeach year due to complications related to pregnancy and childbirth.

The reality is that communities and individuals across the nation would be left reeling if states assume control of abortion rights.

"The leaked opinion is horrifying. The consequences of this impending Supreme Court decision will be swift and devastating for communities nationwide," Meera Shah, MD, MPH, chief medical officer of Planned Parenthood Hudson Peconic and national medical spokesperson at the Planned Parenthood Federation of America, told Health.

Here's a closer look at some of those who would be particularly impacted by the sea change in reproductive freedoms now sweeping the nation.

Immediate Fallout

Though, as of right now, abortion is still a legal right, overturning Roe v. Wade would mean 26 states could swiftly move to ban abortion, including 13 states with laws that could immediately go into effect. If that were to occur, 36 million women—nearly half of the women of reproductive age in the U.S.—could soon lose abortion access, said Dr. Shah.

Overturning Roe would have major impacts on a broad swath of demographics and individuals, including people of color, people who are marginalized and living in low-income areas, those who may be chronically ill or disabled, and a large population in the Midwest and South, Lisa Masterson, MD, a board-certified OB/GYN in Santa Monica, California who specializes in infertility, adolescent gynecology, and family planning, told Health.

"Also...a large population in the Midwest and South. It will worsen some of the barriers to care that already exist because a woman may now have to have more money and travel, get time off work, or get childcare if she has children," said Dr. Masterson.

Undoing abortion rights would also increase the life or death situations faced by Black women, who already face a mortality rate already three times that of white women, Dr. Masterson added. "We already know racial disparities in pregnancy outcomes are only made worse by restricting access to reproductive care," said Dr. Masterson.

LGBTQ advocates have also expressed fears about Roe v. Wade being overturned, pointing out that reproductive rights and abortion rights are central to that community, particularly for transgender individuals.

And often overlooked in such discussions, people with disabilities, who have specific needs and challenges when it comes to reproductive health, may also face tragic consequences should equitable access to abortions become a thing of the past.

"Access to abortion care and maternal health is particularly important to some people with disabilities who are at a heightened risk of pregnancy-related health complications, or who may rely on medications that are contraindicated during pregnancy," according to a joint report from the National Partnership for Women & Families and the Autistic Self Advocacy Network.

And the ramifications don't end there. A separate study found that individuals who were turned away from having an abortion and went on to have the baby faced an increase in household poverty, increased debt ,and an increase in negative public financial records, such as bankruptcies and evictions. These individuals are also more likely to remain in contact with a violent partner.

"Abortion rights benefit everyone. Everyone with ovaries will be affected by this decision," Carrie SiuButt, CEO of SimpleHealth, told Health.

Impact on Maternal Mortality Rates

Among the most chilling ramifications of overturning Roe v. Wade—and the related measures to set early gestational limits on abortion procedures no matter what the circumstances for the pregnant patient—is the potential impact on mortality rates. The court's move toward overturning the historic ruling comes at a time when pregnancy-related death rates for individuals in the U.S. had already been rising, compared to other developed countries where mortality rates are on the decline.

In the latest update to a decades-long trend, the National Center for Health Statistics reported that in 2020, nearly 24 mothers died per 100,000 births in the United States, which amounts to 861 deaths in total. A decade ago, the maternal mortality rate during childbirth was 16 deaths per 100,000 births. For Black people, there were 55 maternal deaths per 100,000 births—almost triple the rate for whites.

Experts say a lack of access to abortions will almost certainly make matters worse for the Black community, in particular. For instance, a review by the Commonwealth Fund reported Black people in Texas were almost twice as likely to die from pregnancy-related complications than white people in 2018. Experts predict S.B. 8, a new Texas abortion law that imposes restrictions on reproductive rights, could cause Black maternal mortality rates to rise to 33% in the next year.

It's also worth noting that maternal mortality rates are already disproportionately higher in those states that appear certain or likely to ban abortion—47% higher than the national rate, according to a CNN analysis of data from the Centers for Disease Control and Prevention. And states with the most restrictive abortion laws of all had a 7% higher maternal mortality rate as compared to those states with fewer restrictions, the American Journal of Public Health reported in a 2021 study.

"People of all races, classes, religions, political parties, regions get abortions. Abortion is freedom, so we all have a lot to lose," Kate Kelly, a human rights attorney and host of the Ordinary Equality podcast, told Health.

Broader Ramifications of Losing Reproductive Rights

It goes without saying that if Roe is overturned and certain states proceed with severe abortion restrictions or all-out bans, many will lose their right to choose or to have autonomy over their bodies. This could cause such individuals to be subject to undue hardships, SiuButt said.

Many people will be forced to seek alternative—and even unsafe—options for abortions, or carry on with unwanted pregnancies. A ban on abortion care can also force people to travel out of state to receive an abortion. Though low-income individuals (who are disproportionately people of color, said SiuButt) may not be able to afford to travel or take time off of work.

Traveling elsewhere to obtain an abortion is also problematic at a time when states are increasingly criminalizing people for seeking abortion care and state legislators are trying to make crossing state lines to get an abortion a crime. Experts said these types of measures are likely to proliferate rapidly across the nation if Roe v. Wade is struck down.

"The costs and risks to individuals seeking an abortion will continue to escalate...and will start to include everyone who tries to help them," Kelly said, adding that: "We must all aid and abet abortion, despite the risks, because it is a human right."

Abortion will become a community responsibility, Kelly added. Communities will need to become active participants in facilitating abortion access by sharing information about the safety and availability of abortion options like abortion pills, finding and supporting local abortion funds, and saving independent abortion clinics that may be overrun with people seeking care, Kelly said.

And finally, it will become crucial moving forward for individuals living in states without protected abortion rights to become educated about safe abortions and how to access them, SiuButt said.

"In the absence of any federal or state protection," SiuButt said. "We will see a rise of private companies working with providers, partners, and individuals to truly make birth control, reproductive care and education accessible for all."

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