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reproductive healthcare
'Good Genes,' Anti-Abortion Laws, Declining Birth Rates, and What They Have in Common
Promoting good genes and limiting access to birth control and abortion are inextricably tied by two threads: white supremacy and the patriarchy. And they have been for more than 150 years.
Oct 12, 2025
From American Eagle’s campaign with Sydney Sweeney to the Trump administration’s efforts to limit access to birth control to the US birth rate hitting an all-time low, there has been a lot of noise online this summer, and every time something takes center stage, people come out of the woodwork telling us to not get distracted. To stay focused.
And I get it. I do. It’s a lot.
But we can’t just overlook one headline in favor of another, because in America, promoting good genes and limiting access to birth control and abortion are inextricably tied by two threads: white supremacy and the patriarchy. And they have been for more than 150 years—ever since the first time abortion was criminalized in America in the late 1800s.
In the words of Leslie Reagan (author of When Abortion Was a Crime): “White male patriotism demanded that maternity be enforced among Protestant women.”
When he wrote of American westward expansion, he asked: “Shall [these regions] be filled by our own children or by those of aliens? This is a question our women must answer; upon their loins depends the future destiny of the nation.”
Back in 2022, when Dobbs v. Jackson’s Women’s Health rolled back the protections granted by Roe v. Wade, the justices claimed to have reached the majority ruling, in part, because abortion rights weren’t “deeply rooted in the country’s history and traditions.” But here’s the thing: America had a long-standing tradition of abortion before it became widely outlawed in the late 1800s. In fact, for much of American history, terminating a pregnancy during the first four months wasn’t even considered abortion. It was simply an attempt to “restore menses.”
Before the end of the 19th century, a regular menstrual flow was considered essential to a woman’s health. Herbalists, midwives, and physicians recommended childbearing people sip herbal emmenagogic teas (teas that stimulate menstrual flow) in the days leading up to and throughout the course of their periods to maintain regularity and to restore menstruation if it arrived late.
It was this tradition that politicians and some doctors of the era (specifically those who were a part of the newly-created American Medical Association) wanted to eliminate.
The AMA was founded in 1847, creating a professional group for college-educated doctors (all men at the time). They were faced with a problem: The medical profession was still establishing itself, and so AMA doctors weren’t well-respected in America, but midwives, one of their primary competitors in the field, were. One of the many reasons for this was that midwives were willing to provide abortion services, something AMA-recognized physicians were unwilling to do because they claimed it violated the Hippocratic Oath.
One particular physician, Horatio Robinson Storer, saw abortion as an opportunity to help accredited physicians gain respect: If they could turn abortion into a moral issue, they could destroy public respect for midwives—allowing AMA physicians to take over the field of gynecological health and establish themselves as both the moral and scientific authority on medicine.
With the AMA at his back, in 1857 Storer started a campaign to change the way America thought about abortion—sending letters to physicians and newspapers, publishing books, and eventually working with legislatures to criminalize the practice.
What else was happening in 1857? The lead up to the American Civil War, which we all know was fueled by white supremacy. Not only was much of America fighting for the right to enslave people, they also feared being outnumbered by the very people they were trying to enslave. And with the declining birth rates among white, Protestant women, it was a well-founded fear (and one that wasn’t only limited to the South, especially with the influx of immigrants in northern cities).
Storer used this fear to his advantage.
When he wrote of American westward expansion, he asked: “Shall [these regions] be filled by our own children or by those of aliens? This is a question our women must answer; upon their loins depends the future destiny of the nation.”
The argument was a powerful one—one that changed the way America viewed abortion for 100 years. How did they do it? By destroying the concept of quickening, thereby reclassifying the restoration of menses as abortion and criminalizing those who practiced it. They stated quickening was little more than a feeling, and a feeling wasn’t medicine. This in turn discredited childbearing people as the ones who knew their own bodies best.
The AMA’s efforts culminated in the Comstock Law in 1873, which made the public discussion of birth control and abortion illegal by banning it as obscenity, and by 1880, every state had laws restricting abortion. Early-term abortion, which had once been considered an essential part of women’s healthcare, was labeled evil (and criminal) and midwives were rebranded as abortionists. These views of abortion continued for 100 years until Roe v. Wade gave people with uteruses the right to an abortion, and it’s clear they’ve persisted in the decades since.
Now, to be clear, most doctors today recognize abortion as healthcare. This isn’t meant to demonize modern-day physicians. But as we look to today’s headlines when it comes to the health of childbearing people, it’s almost impossible not to draw parallels, and keep this reality in mind as we fight to regain the rights the Supreme Court has stripped us of.
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Young Pregnant People Need Choices, Not Shame
With young people’s autonomy so limited, we must ensure young pregnant and parenting people have the support they need.
Aug 09, 2025
Access to affordable family planning and sexual health services is under attack, with the current administration threatening millions of dollars in Title X funding.
Millions of poor, uninsured, low-income individuals rely on this program not only for contraception but for cancer detection, HIV testing, and other essential services. The administration’s hostility toward proven programs like this puts young people at greater risk of pregnancy, in an environment where reproductive choices are limited. The consequences of abortion bans are clear: People are getting sick and losing their lives because access to basic reproductive healthcare is being stripped away. But what if you are young? What if you are Black? What if you live in a state restricting abortion? What if you do not get to decide?
For young pregnant people, these bans and funding cuts are even harder to navigate because of barriers to their independence. With the potential cuts to Title X programs, young people’s access to contraception will be even more limited. If they become pregnant when they don’t want to be, some states that still allow abortion have restrictions requiring consent from parents. With young people’s autonomy so limited, we must ensure young pregnant and parenting people have the support they need.
Reproductive justice is a human rights framework coined in 1994 by 12 Black women in response to the reproductive rights and health groups that excluded the lived experiences of those who have been marginalized. This concept includes the right to parent, the right not to parent, the right to parent children in safe and healthy communities, and the right to bodily autonomy. Young people, too, deserve reproductive justice.
What if young people had access to healthcare free from biases and shame?
A powerful misconception is that we are often just one decision away from shaping the course of our lives. But it isn’t the one individual decision. It’s the collective punitive reaction from society that stands in the way of young people getting the support they need. For the young pregnant person who is parenting, there is a systemic lack of support coupled with stereotypes that lead to negative outcomes.
As a child, my knowledge about the consequences resulting from decisions we make about our bodies was limited to the concrete and practical, such as skinning my knee in the neighborhood kickball tournaments when I ran around the bases too quickly. That knowledge quickly expanded when my older sister became pregnant as a teen, and I observed the organized shunning she experienced from family members to healthcare workers to teachers and friends. This was the first time I witnessed shame. I heard how family members talked about her pregnancy as a defining moment, as if any glimpse of a future was now extinguished. Those family members and friends who were “supportive” disappeared once my niece was born. It was at this moment that I decided that I wanted to offset that shame for her, for us, for every young Black girl who is navigating a pregnancy.
I did my best to be a supportive little sister as a child, standing up to all who spoke negatively about my sister and her choices. This experience stayed with me, and as a first year medical student, I founded Sisters Informing Healing Living Empowering (SIHLE) Augusta, renamed Choices Within Reach, an organization that works to support young Black mothers in Augusta, Georgia, through providing community, financial resources, and infant supplies. For the past seven years, in addition to my medical and residency training, we have worked to disempower the systems that shame and marginalize young people about their reproductive choices. Transforming that childhood rage to triumph, this ever-expanding sisterhood is my greatest accomplishment.
Now, as an OB-GYN and community organizer, I continue to hear the echoes of my sister’s story through my patients and the young people I serve in Georgia.
These stereotypes of young parenting people that go back to public condemnation of “teen moms” and “welfare queens” in the 1970s and 80s are still alive in the collective shunning of young Black pregnant people. In many schools, there is a “pregnant student” policy that states that the school won’t make accommodations for a pregnant student unless required by documented medical circumstances. High school students are not granted “maternity leave.” These policies are penal and don’t support the pregnant student’s success, especially when combined with isolation that the pregnant adolescent may be enduring within her community.
It is these punitive policies and attitudes that lead to statistics like only 50% of teen mothers receive their high school diploma by age 22, compared to 90% of teens who do not give birth in their adolescence. The lack of education and support makes it hard for them to find job opportunities, leading to a hard time making ends meet, and so on. This is a collective shunning of young motherhood.
These roots also shape our healthcare system. Just as young moms slip through the cracks of the community, they also often do in the healthcare system. Adolescent medicine providers try to close these gaps for young people. However, the gap widens when they become pregnant. Is it the OB-GYN who receives little to no training on how to specifically care for a pregnant teen or the pediatrician who has not specialized in pregnancy that is trying to care for the teen who is pregnant? When the gaps are felt by young moms, they might disengage from prenatal care, lose trust in their providers, and face poor health outcomes for the mother and baby.
This is especially true when the stereotypes of pregnant adolescents are woven into the implicit and explicit biases of the providers. These biases affect how their providers view them, the care they receive, and their outcomes. Kia, who experienced pregnancy at 16 years old, had her pregnancy confirmed by her pediatrician, who had been caring for her since she was an infant. However, once her urine pregnancy test was positive, there was an obvious disconnect. They told her she could no longer be seen in the office and was not offered any options counseling, OB-GYN references, or even an ultrasound. This experience led Kia to delay seeking prenatal care. What if the pregnancy was in the wrong location? What if there were complications? As we attempt to close the gap of maternal morbidity and mortality rates in the U.S., which are disproportionately higher in Black people, we must address the systems that increase risks faced by young Black parents.
The fight against the societal punishment of young Black parents is an issue of reproductive justice. In a nation where systemic barriers persist, the futures of young Black parents don’t come down to personal choices; they are intricately tied to the what kind of support, education, and resources they can access. It is far beyond time to restructure the narratives and fill the gaps society created for our young Black pregnant and parenting people.
What if we had culturally sound, group prenatal care that focused on and highlighted the needs of young, Black pregnant people? What if we built a community that came together to support young parents with childcare, financial resources, and school or job support? What if medically accurate, comprehensive sex education were available to all young people? What if young people had access to healthcare free from biases and shame? We can create the kind of world where we all have equitable access to the full spectrum of reproductive freedoms, no matter our age or location.
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As Medicaid Turns 60, Immigrant and BIPOC Communities Face an Uncertain Future
The Medicaid cuts passed in the recent budget bill will severely limit access to coverage for millions, particularly those already living at the margins.
Jul 30, 2025
July 30 marks the 60th anniversary of Medicaid, a program that, since 1965, has provided critical healthcare coverage to millions of people in the U.S. It was created as a promise: that no one should be denied medical care because of their income, background, or zip code. But as we mark this milestone, that promise is in jeopardy, especially for immigrant, BIPOC, and rural communities who rely on Medicaid the most.
Legislation that included deep cuts to Medicaid was signed into law by the president as part of a broader budget package. While many of these cuts won’t take effect until 2027, their impact will be devastating. These changes will severely limit access to coverage for millions, particularly those already living at the margins.
Medicaid is more than a public program. For many, it is the only way to see a doctor, receive prenatal care, or access family planning. It’s the largest payer of reproductive healthcare in the United States, covering 42% of all births and more than 75% of publicly funded family planning services. For people in rural areas or healthcare deserts, Medicaid is the last lifeline.
And yet, it’s being chipped away.
Medicaid is turning 60. Instead of weakening it, we should be strengthening its reach and renewing its purpose for the next generation.
In rural America, where nearly 50% of pregnant people rely on Medicaid and OB-GYNs are increasingly hard to find, any change in funding can be catastrophic. Patients already drive hundreds of miles for basic services—cancer screenings, contraception, abortion care. Add new hurdles to coverage, and these journeys become impossible for many.
These cuts won’t just affect undocumented immigrants. Immigrant families, including many with U.S. citizen children, will be among the hardest hit. Years of anti-immigrant policies have already led to fear and confusion about accessing public benefits. Now, eligibility restrictions and additional red tape will create further barriers for families in need of prenatal, postpartum, or emergency care.
At the Women’s Reproductive Rights Assistance Project (WRRAP), we are already seeing the strain. We work with pregnant people from across the country—many in rural or under-resourced areas who can’t afford abortion care or find it nearby.
This isn’t just policy. It’s people trying to stay healthy, raise their kids, and survive.
Black and Latina women are already more likely to rely on publicly funded clinics for reproductive care. These communities are also more likely to experience hospital closures and provider shortages. Cuts to Medicaid only deepen existing racial and economic disparities in care access.
As a nonprofit, WRRAP is nonpartisan, but we are not neutral when it comes to justice and survival. Medicaid is turning 60. Instead of weakening it, we should be strengthening its reach and renewing its purpose for the next generation.
Here’s what you can do right now:
·Learn more: Many of these changes are complex and delayed, making it easy to overlook their real impact. Follow trusted sources like WRRAP and Guttmacher Institute.
·Donate: Support abortion funds like WRRAP that help cover the gap when people are denied abortion care. Every dollar helps a real person.
·Know your elected officials: Meet with them now and learn what their commitments are to their communities.
·Register and help others register to vote in 2026: While we are nonpartisan, we strongly believe that civic participation matters.
·Talk about this: Bring it up at work, school, places of worship, and in your group chats. When we break the silence, we build momentum. History has never changed through silence, it changes when we speak up, stand up, and refuse to back down.
·Advocate locally: Your state can expand or protect Medicaid access regardless of federal changes.
When our rights are under attack, compliance is complicity. The decisions being made today will shape access for years to come. Immigrant and BIPOC communities cannot afford to lose Medicaid. They shouldn’t have to fight for the right to care.
As we celebrate 60 years of Medicaid, be loud, be unapologetic, be unrelenting. Because healthcare is not a privilege. It is a right. And it is worth fighting for.
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