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racial inequity
A Public Health Emergency: How Abortion Bans Are Fueling Maternal Deaths in America
People living in states that have banned abortion are nearly twice as likely to die during pregnancy, childbirth, or soon after compared with those in states where abortion remains legal and accessible.
Apr 10, 2026
The maternal mortality crisis in the United States is a national embarrassment, and it’s unfolding in real time. The US continues to have one of the highest maternal death rates among high-income countries, and the situation is getting worse, not better. Behind this trend is a growing body of research showing that state abortion bans directly contribute to increased maternal mortality, especially in communities already burdened by systemic inequities.
Maternal mortality has traditionally reflected deep structural problems in a healthcare system that fails to serve all people equally. In 2024, the US maternal mortality rate ticked upward again, reversing a brief decline and demonstrating that the crisis is far from over. Experts point to a range of causes, including reduced access to prenatal care, maternity care deserts, and strained hospital systems, all problems intensified in states with abortion restrictions and in states with increased Immigration and Customs Enforcement (ICE) agents.
A comprehensive analysis from the most recent Centers for Disease Control and Prevention (CDC) mortality figures shows that people living in states that have banned abortion are nearly twice as likely to die during pregnancy, childbirth, or soon after compared with those in states where abortion remains legal and accessible. What’s more, in supportive states where abortion has remained legal, maternal mortality has declined by about 21% since 2022, suggesting that access to comprehensive reproductive care saves lives.
Restricting abortion does more than eliminate a medical procedure; it forces people to carry pregnancies that pose very real health risks. Childbirth has inherent dangers from hemorrhage and infection to hypertensive disorders and cardiac events, and the risk of death from pregnancy is at least 44 times higher than from abortion. When abortion is inaccessible, people are compelled to continue unwanted or medically unsafe pregnancies. That dynamic alone drives increased deaths that could otherwise have been prevented.
Bans do not reduce the prevalence of abortion; they reduce its safety, push people into riskier medical scenarios, and leave pregnant people with fewer options even when their health is at stake.
Racial and socioeconomic disparities in maternal mortality did not begin with the reversal of Roe v. Wade. Black birthing people in the US have long faced significantly higher death rates than white birthing people, a symptom of deep structural racism in healthcare, poverty, and chronic stress. But abortion bans have exacerbated these inequities.
In states with abortion bans, Black birthing people are more than three times as likely as white birthing people in those same states to die from pregnancy-related causes. Those figures make crystal clear that when we talk about maternal mortality, we are talking about a crisis of racial inequity, class inequity, and political neglect. States with the worst maternal health outcomes, including Louisiana, Mississippi, and Texas, are predominantly in the South and have enacted some of the most restrictive reproductive laws.
These disparities compound with other conditions such as limited access to early prenatal care—which the CDC reports has declined across the country, with the steepest drops among Black mothers. Delays in early care are associated with worse outcomes for both mother and baby and are worsened by the closure of maternity care facilities in rural and under-resourced areas.
For undocumented and immigrant communities, the maternal mortality crisis is layered with additional barriers. Fear of immigration enforcement, including ICE, deters people from seeking care, even in emergencies. Clinics in border states with large immigrant populations were already medically underserved before Dobbs, and abortion bans have deepened that inaccessibility. Many undocumented people lack insurance, fear reporting, or face economic barriers that make traveling for care impossible. These structural obstacles do not just delay care, they can literally cost lives.
Immigrant and mixed-status families are disproportionately concentrated in states with abortion bans, like Texas, Arizona, and Florida, meaning that people who already face the greatest systemic barriers to healthcare are also the most likely to lack access to safe abortion or comprehensive maternal services. This intersection of racist policy, reproductive restriction, and anti-immigrant enforcement creates a perfect storm that pushes already vulnerable people further to the margins and deeper toward harm.
Critics of abortion argue from moral or ideological positions, but the evidence shows that access to abortion care is fundamentally a matter of public health. Bans do not reduce the prevalence of abortion; they reduce its safety, push people into riskier medical scenarios, and leave pregnant people with fewer options even when their health is at stake.
We are now witnessing a preventable loss of life, and the window to act is closing.
We know how to prevent many maternal deaths: Expand access to comprehensive reproductive care (including abortion), strengthen prenatal and postpartum support, increase Medicaid coverage, invest in maternity care infrastructure, and dismantle the historic and systemic inequities that predict who lives and who dies. We know these interventions work because states that have protected reproductive rights are already seeing declines in maternal mortality.
To ignore this crisis is to ignore evidence, dignity, and the lives of pregnant people, especially those in Black, Indigenous, immigrant, and economically disadvantaged communities.
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'License to Kill': New Report Finds Higher Homicide Rates in 'Stand Your Ground' States
"These laws change the nature of self-defense, turning everyday disputes into deadly confrontations," the report, compiled by Everytown for Gun Safety, says.
Jul 21, 2025
A new report has found that "Stand Your Ground" laws have led to an increased rate of gun homicides in the United States.
These laws allow anyone who believes they are facing the threat of death or bodily harm to use deadly force without the requirement to first retreat to safety. But according to a report released Monday by the gun control advocacy group Everytown for Gun Safety, they have become a "license to kill."
Data compiled by the group shows that these laws have led to around 700 additional gun deaths each year, increasing the number of gun deaths nationally by 8% to 11%. That estimate came from a 2022 study published by the medical journal JAMA Network Open, which looked at data from 1999 to 2017.
Following aggressive lobbying by the National Rifle Association and the firearms industry, the first Stand Your Ground laws were introduced in Florida in 2005. Since then, 29 states have adopted them.
Over that time, those states have seen especially high increases in violence, with Alabama, Missouri, and Florida all having 30% or greater increases to their homicide rates.
Everytown's report details one particularly harrowing story from Florida in which Stand Your Ground laws contributed to the shooting of two children:
In October 2022, William Hale and Frank Allison drove alongside each other on US Highway 1 in Hialeah, Florida. A traffic dispute grew more dangerous as both men began driving erratically. When Hale threw a water bottle at the other car, Allison retaliated with a gun, firing a shot that hit Hale's 5-year-old daughter. In response, Hale fired all of the bullets in his handgun, striking Allison's 14-year-old daughter.
Though both men were initially charged with attempted murder, prosecutors dropped the charges against the man who fired first. Under Florida's so-called "Stand Your Ground" legal defense law, the thrown water bottle justified responding with deadly force, leading to a child being shot. In the end, with two girls wounded in a road rage tragedy, the man who started the shootout was protected by a distortion of self-defense that allows people to shoot first and ask questions later.
"These laws change the nature of self-defense, turning everyday disputes into deadly confrontations," the report says. "Far from empowering victims, Shoot First laws lower the threshold for justifiable homicide, encouraging the escalation of petty arguments and armed vigilantism."
These laws attracted national scrutiny in 2012 following the shooting of 17-year-old Trayvon Martin in Florida by a neighborhood watchman, George Zimmerman, who was acquitted under the state's Stand Your Ground law.
The 2020 shooting of another young Black man, Ahmaud Arbery, in Georgia, is likewise believed to have been exacerbated by Georgia's Stand Your Ground law, though the three men who killed him were ultimately found guilty.
Stand Your Ground laws also contribute to heightened racial disparities for shooting victims, according to FBI data from 2019-23.
Justifiable homicide rates increased by 55% in states with Stand Your Ground laws, the report found. In those same states, the shootings of Black victims by white shooters are four times as likely to be deemed justified than they would be if the roles were reversed, a higher rate than in states without these laws.
In some Stand Your Ground states like Michigan, Indiana, Louisiana, Pennsylvania, and Kansas, the disparity was more than seven times greater for Black victims than white ones.
And contrary to claims that loose gun restrictions protect women, the report found multiple studies concluding that domestic violence cases in which a woman claimed self-defense were less likely to be deemed justifiable, while women convicted were more likely to serve longer sentences.
"In addition to increased risk of victimization in Shoot First states, convictions are unfairly skewed against people of color and women," the report concludes. "In the decades since the first Shoot First law was enacted, no research shows that these laws lead to better outcomes for anyone. Shoot First was created to solve a problem that does not exist—and Americans are paying the price."
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A Juneteenth Reflection on America’s Unfinished Business
This year, as we celebrate the end of chattel slavery in the United States, we must remember the work that Frederick Douglass called upon us all to do remains unfinished.
Jun 18, 2024
“What, to the American slave, is your 4th of July?” asked Frederick Douglass in his Fourth of July Oration in 1852. “I answer: a day that reveals to him, more than all other days in the year, the gross injustice and cruelty” of America.
Douglass’s speech remains among the most powerful and poignant in United States history more than a century and a half later. With the Civil War nearly a decade away, and the system of chattel slavery still going strong throughout the South and powering the economy throughout the country, Douglass pointed with undeniable clarity at the “venomous creature [that] is nursing at the tender breast of your youthful republic.”
As we celebrate Juneteenth in 2024, the work that Douglass called upon us all to do remains unfinished. The Civil War, the Emancipation Proclamation, and the Reconstruction Amendments formally put an end to the widespread practice of enslavement of Black people in this country. But the work of reconstructing our society and creating the truly equitable and free society promised in our founding documents has a long way to go.
Today we have the job of coming to grips with our history and charting a new path for those who come after us.
That is why on this Juneteenth, we should all ask: What, to us, is Juneteenth? For all of us, and especially for the Black community, it is a day of joyful celebration, marking the anniversary of the Emancipation Proclamation, as it has been for a century and a half. It marks the end of that “venomous creature” in the republic. To be sure, each one of us should celebrate that important day in 1865, as the Black community did so memorably in Texas that year.
But on Juneteenth, we should also remember that while the snake may have been slain, too much of its venom remains in our system. The venom still takes the form of racism, racial inequity, and the enduring power of white supremacy.
What, to each of us today, is Juneteenth? For those of us in the white community of the United States, I see it as a call to action to do our part to continue the work of reconstruction. We can and should imagine a truly equitable, multiracial America—one we have never before encountered but one which remains a real possibility. There is a fierce pushback against this work today, but this is a pushback we must resist as we continue the unfinished work of Reconstruction.
Like many white Americans whose families have been in the United States for a long time, and in fact came to these shores before the nation even existed, my family has both been involved in the business of enslaving others and has fought for the end of slavery. As Douglass pointed out in his soaring Fourth of July oration, ancestors of mine have done terrible things to others in the name of Christianity, in pursuit of money, and out of ignorance and hate. Others have valiantly fought against friends and families to create a better, fairer society.
Today we have the job of coming to grips with our history and charting a new path for those who come after us. That is why white people must join with others in the work of making our communities and institutions more diverse. Those of us who identify as white and male have a particular obligation to reflect on Juneteenth and consider how we can use what we have to be part of overcoming in the name of a brighter, more sustainable future. We have power to wield, and should wield it, in making our economies more equitable and inclusive.
In Chicago, where I live, there is a fact that I cannot shake. I can’t get it out of my head that a baby born in the predominantly Black neighborhood of Englewood is expected to live 30 years less than a baby born on the same day in the predominantly white, and more wealthy, neighborhood of Streeterville downtown. That is a difference of six miles—and 30 years.
The promise of abolition, a healed and equal society, has not yet been realized. And we can only get there by working together with friends, community, and in solidarity.
This disparity of life expectancy is a combination of a multitude of factors of which racial identity is one, but it boils down to this: a Black baby born in one part of our nation’s third largest city is less likely to enjoy as long and healthy a life as a white baby born a few miles away. There is no way to imagine that this marks an equal society. Health disparities such as this one affect Native American communities and Latin communities across America, too.
Alongside health, consider gaps in education, earnings, and wealth between racial groups in the United States, in state after state. These, in the words of Douglass, remain among our “national inconsistencies.” Black Americans consistently enjoy fewer of the fruits of the republic than those of other racial and ethnic groups. To achieve true racial healing in America, to get the venom truly out of our system, requires us to keep at the work of racial equity.
The promise of abolition, a healed and equal society, has not yet been realized. And we can only get there by working together with friends, community, and in solidarity. At the MacArthur Foundation, we put this approach into practice each day as we collectively strive to lead with a commitment to justice. The progress we have made in the past, and any progress in the future, requires collaboration between people from all kinds of backgrounds.
Juneteenth is a call to do better as a nation, to create an America in which every child born today—no matter their race, their ethnicity, their gender, their neighborhood—has an equal chance to thrive. We remain a long way from that reality. No matter our race, we should do our part on the unfinished work of creating a free and equal society.
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