Introduction
Making pregnancy termination decisions is a challenging life experience that stems from large-scale socioeconomic factors and health-related risks aside from a pregnant patient’s unwillingness to raise a child. The question of race is also crucial in the discussions of abortion services in the U.S. This essay demonstrates that abortion-related racial disparities and discrimination between white and black Americans exist in different forms, including the demand for the procedure, impacts of restrictive policies, and minority women’s individual experiences.
Structural Discrimination Pertaining to Abortions
Racial Disparities in the Demand for Induced Abortions
In spite of being a numerical minority, Black women in the U.S. resort to abortion services rather often compared to the White population. According to national statistics, as of 2016, the incidence of abortion among non-Hispanic black women was more than 3.5 times higher than the abortion rate among non-Hispanic White citizens (Studnicki et al. 1). For black and white Americans, the rate was 25 and 6 abortions per 1000 women of the reproductive age, respectively (Studnicki et al. 1). Based on new abortion restrictions and the general audience’s greater awareness of pregnancy prevention methods, it would be reasonable to expect reductions in abortion rates to promote more equality between the groups. Nevertheless, in the nine years before 2016, abortion rates among black and white Americans decreased to a similar extent, producing no meaningful impact on the pre-existing disparity (Studnicki et al. 1). Therefore, black women’s demand for abortion services remains elevated compared to the situation for White healthcare consumers.
The causes of such demand-related disparities are inextricably connected with the distribution of wealth and access to the right strategies for preventing unintended pregnancies. Black women account for about 28% of all abortions performed in the U.S., which could be correlated with the social determinants of health (Howell et al. 3). Specifically, Howell et al. link the elevated abortion rate to a larger proportion of economically and professionally vulnerable individuals with no insurance among the black population (3). In other words, without stable employment, guaranteed access to medical care in case of concerns, and decent income levels, many women in the subgroup might be urged to give preference to pregnancy termination. Additionally, low earnings are positively correlated with limited access to contraception, which could explain higher rates of unintended pregnancies among black women (Howell et al. 3). Overall, the roots of African Americans’ greater need for induced abortions are multidimensional.
Abortion Restrictions: Influences on White and Black Americans
Considering the nation’s mixed attitudes to elective abortions, state-level restrictions on accessing the procedure are widely present, which is supposed to hinder black women’s reproductive decision-making even more. In 2019, eight U.S. states limited the acceptable time for abortion to eighteen or fewer weeks since gestation, so twenty-nine states are currently “hostile to abortion rights” (Howell et al. 1). The Targeted Regulation of Abortion Provider (TRAP) laws further complicate licensing processes for abortion providers at the state level, whereas provider refusal and mandatory parental consent regulations limit patients’ decision-making (Howell et al. 1). Of course, since race is a protected characteristic, no laws can officially list African-American women as the subgroup to receive fewer abortion services than Caucasian Americans. Nevertheless, the restrictions above reduce the number of abortion clinics in close proximity to women that need prompt assistance, thus necessitating traveling for abortions. Having higher poverty rates compared to their White counterparts, black American women can simply lack personal funds to afford inter-state trips in case of unplanned pregnancies (Howell et al. 2). This intuitive conclusion, however, stems from generalizations and omits White low-income women’s experiences.
Federal-level restrictions, including the so-called Hyde Amendment, can also place Black women at a disadvantage when it comes to accessing abortions. The amendment named after Henry Hyde prohibits the utilization of Medicaid to fund abortion care aside from rape, incest, and emergency cases (Howell et al. 2). While creating severe barriers to abortion care for low-income Americans, the said amendment affects non-White women disproportionately. Specifically, as per Howell et al., almost 58% of patients affected by the restriction are women of color, and white women are the remaining 42% (2). Black women account for 31% of those affected, which is not aligned with the fact that Black people make up less than 14% of the country’s population (Howell et al. 2). Therefore, federal barriers to getting voluntary abortions influence Black women disproportionately, exemplifying structural racism.
Individual-Level Perceived Discrimination and Abortions
Any explicit racial discrimination is strictly prohibited in the healthcare field, but Black women seeking abortions sometimes report encounters with disrespectful White providers that do not fully understand their personal circumstances. In a qualitative study of black women’s experiences with reproductive and abortion care in North Carolina and Georgia, Thompson et al. reveal that the group is increasingly concerned with the scarcity of Black providers (199). Black women’s descriptions of their experiences with predominantly white professionals incorporate various negative themes, such as “the lack of empathy” and “feeling undervalued/unwelcome” (Thompson et al. 200). The thematic analysis of focus group transcripts suggests that many participants would prefer to go to reproductive care clinics with Black professionals as the majority of the workforce (Thompson et al. 199). However, finding a black doctor to get reproductive services and abortions often requires Black women to engage in additional research, search for providers online, or seek external advice (Thompson et al. 199). Therefore, in the context of reproductive services, including safe abortions, Black women feel the unmet need to refer to professionals of the same race, which creates differences in white and black patients’ experiences.
It is possible that the information on discrimination against non-white pregnant and parturient women might contribute to black women’s increased use of abortions. As reported by patients, non-black providers’ prevailing contempt for minority women’s pregnancy-related needs and preferred delivery options, including Black doulas’ participation, is problematic (Thompson et al. 199). Hypothetically, the fear of being neglected in case of complications during pregnancy and delivery might make Black women see pregnancy termination as the least risky choice. For instance, in the aforementioned research, Black women express a collective concern that the issue of reproductive care is “two-sided” for them, including no support for carrying pregnancies safely (Thompson et al. 198). In the case of seeking surgical abortions in the U.S., black women are also more likely to report perceived discrimination compared to their White counterparts (Aguilar et al. 452). However, the consequences of high-risk pregnancies might have more impact on the family’s health and life.
Conclusion
Finally, statistical findings and black patients’ subjective reports of their experiences with reproductive and abortion care suggest that black Americans are in a disadvantaged position compared to their white peers when it comes to abortions. black women request more abortions, thus being more influenced by discriminatory abortion restrictions. At the individual level, the reports of imperfect experiences with service providers and perceived discrimination are also higher in black women. However, these claims might require subsequent investigation due to being based on subjective interpretations.
Works Cited
Aguilar, Gabriela A., et al. “Oral Abstracts: O9 Exploring Perceived Race/Ethnicity-Based Discrimination Among People Receiving Abortion Care.”Contraception, vol. 104, no. 4, 2021, p. 452.
Howell, Marcela, et al. Ensuring Access to Safe Abortion Care for Black Women. Black Reproductive Justice, 2020.
Studnicki, James, et al. “Perceiving and Addressing the Pervasive Racial Disparity in Abortion.”Health Services Research and Managerial Epidemiology, vol. 7, 2020, pp. 1-4.
Thompson, Terri-Ann Monique, et al. “Racism Runs Through It: Examining the Sexual and Reproductive Health Experience of Black Women in the South: Study Examines the Sexual and Reproductive Health Experiences of Black Women in the South.”Health Affairs, vol. 41, no. 2, 2022, pp. 195-202.