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Women who do not have health insurance are more likely to delay prenatal care, contributing to maternal mortality rates. (Photo: Getty)

Women who do not have health insurance are more likely to delay prenatal care, contributing to maternal mortality rates. (Photo: Getty)

The High Price of Abortion Restrictions

States with more restrictions on reproductive health care have higher maternal and infant mortality rates.

Julie A. Burkhart

 by The Hill

Abortion access is a crucial component of women’s health care. Without the ability to choose if, when, and how to give birth, women face obstacles to economic success, educational achievement, and overall health and well-being. 

Restricting access to reproductive health care — including safe and legal abortion — comes at the price of high maternal and infant mortality rates, a price that anti-choice organizations ignore when they push for the ever more punitive abortion restrictions. 

According to the Guttmacher Institute, between Jan. 1, 2011, and May 31, 2019, 479 restrictions on abortion were enacted in 33 states — accounting for more than a third of the 1,271 restrictions enacted in the 46 years since Roe v. Wade was decided in 1973. 

Anti-choice policymakers say they act in the name of women’s safety, but rarely pursue policies that improve health care. They ignore the disproportionate impact their laws have on women of color and people of low income, as well as single mothers, formerly incarcerated women and non-binary and transwomen. 

States with more restrictions on reproductive health care have higher maternal and infant mortality rates. Louisiana, Georgia, and Missouri recently proposed bans limiting abortions; they rank among the 10 states with the highest maternal and/or infant mortality rates according to 2017 data from the Centers for Disease Control and Protection (CDC). 

In 2017, Ibis Reproductive Health and the Center for Reproductive Rights published a report that featured a state-level scoring system in which policies on reproductive health vs. socioeconomic outcomes were reviewed. Researchers found an inverse relationship between abortion restrictions and women's and children’s health outcomes – as restrictions increased, health outcomes worsened. 

If anti-choice politicians and organizations care about improving health outcomes, as they claim, they would invest in and prioritize access to health care more broadly by expanding Medicaid, making childcare more affordable, and improving paid family leave for medical reasons. 

Instead, abortion opponents create more restrictions that punish, criminalize, and endanger women’s lives. The Ibis report found that when policymakers focus on restricting abortion access, they fail to address issues of maternal and infant mortality rates. In other words, by overlooking the death of women and infants, they show that their real goal is policing women’s bodies. 

Various factors influence health outcomes for mothers and infants. Access to affordable and quality health care during pregnancy ranks high among them. One in six women of reproductive age is uninsured. One in four women below the poverty level has no insurance.

Women who do not have health insurance are more likely to delay prenatal care, contributing to maternal mortality rates. In 2017, the CDC reported that African-American babies were twice as likely to die before their first birthday than white babies, regardless of the mother’s income or educational level. It illustrates not only the racial disparities in health care but also the lack of reproductive health care access. 

Health systems based on societal bias contribute to high rates of poor health outcomes and maternal mortality for black women, who are more likely to experience barriers to quality care and who often face racial discrimination within health care systems. 

Take Serena Williams’ experience, for example. Williams knew that her medical history with blood clots could affect her pregnancy

When she experienced shortness of breath after giving birth via Caesarean section, she alerted the nurses. However, the nurses dismissed her concerns, and Williams had to demand treatment repeatedly, and her condition worsened because of the delay.

After multiple tests, the doctors found that she had developed a pulmonary embolism. If it wasn’t for William’s knowing her body and standing firm with the nurses and doctors, she could have died.

Sadly, her experience is all too common and illustrates that regardless of someone’s ability to pay for quality care, racism, and other systematic barriers can affect the health treatment they receive. Black women are also three to four times more likely to die in childbirth in America than white women.  

Sadly, these preventable deaths among women of color are usually overlooked by policymakers who care more about controlling women’s bodies than improving health care for infants and their mothers.

As we prepare for the 2020 legislative session, I call on state legislatures to stop passing abortion restrictions. Stop wasting taxpayer dollars. Instead, start improving maternal and infant mortality rates. Let’s tackle the real reproductive health care crisis. 


© 2021 The Hill
Julie A. Burkhart

Julie A. Burkhart

Julie A. Burkhart is the founder and CEO of the Trust Women Foundation. Trust Women opens clinics that provide abortion care in underserved communities so that all women can make their own decisions about their health care. Follow her on Twitter @julieburkhart

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