NPWF President: "Robust interventions to address the substantial racial inequities in maternal health in the United States are long overdue and require immediate action." WASHINGTON, D.C. – September 19, 2023 – Today, the National Partnership for Women...
Dobbs Impact Felt Nationwide
By Katherine Gallagher Robbins, Shaina Goodman and Josia Klein
The decision to become a parent is deeply personal and profound. It has implications for a person’s health and well-being, and is one of the most economically consequential choices of a person’s life. Having a child impacts one’s education, earnings and economic security – and being able to plan if and when to have a child is an essential aspect of planning for one’s economic security and future.Frye, J. (2022, July 1). “The Overturning of ‘Roe’ Ignores Economic Realities for Pregnant people.” Fast Company. Retrieved 6 July 2022, from https://www.fastcompany.com/90765813/pov-the-overturning-of-roe-ignores-economic-realities-for-pregnant-people. Yet one year after Dobbs v. Jackson Women’s Health Organization, millions of people in the United States no longer have full control over their futures.
One year after Dobbs, 26 states have already banned or are soon likely to ban abortion.We classify a state as having banned or being likely to ban abortion if they meet at least one of the following criteria: (1) there is “trigger” ban that took effect post-Dobbs; (2) they have gestational limits banning abortion between six and twenty weeks; (3) there is an abortion ban with legal challenges pending in state courts; and (4) there have been significant legislative attempts to ban abortion, even if such attempts have not yet resulted in a ban or a state court has overturned a ban. As of the publication date of this analysis, these states are Alabama, Arizona, Arkansas, Florida, Georgia, Idaho, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, North Carolina, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, and Wyoming. See Nash, E. & Guarnieri, I. (2023, January 10). Six Months Post-Roe, 24 States Have Banned Abortion or Are Likely to Do So: A Roundup. Retrieved 2 June, 2023, from Guttmacher Institute website: https://www.guttmacher.org/2023/01/six-months-post-roe-24-us-states-have-banned-abortion-or-are-likely-do-so-roundup; The New York Times (2023, May 26). Tracking the States Where Abortion Is Now Banned. Retrieved 2 June 2023, from New York Times website: https://www.nytimes.com/interactive/2022/us/abortion-laws-roe-v-wade.html for additional details regarding specific states. Important work by In Our Own Voice and Planned Parenthood on the eve of Dobbs showed half of women of reproductive age,While people of many ages can become pregnant, in this analysis we use ages 15-49 to align with the Guttmacher Institute (see Guttmacher Institute. (2020, July). Investing in Sexual and Reproductive Health in Low- and Middle-Income Countries. Retrieved 29 June 2022, from Guttmacher Institute website: https://www.guttmacher.org/fact-sheet/investing-sexual-and-reproductive-health-low-and-middle-income-countries), the World Health Organization (see World Health Organization. (n.d.). Maternal, Newborn, Child and Adolescent Health and Ageing Data Portal. Retrieved 29 June, 2022 from World Health Organization website: https://www.who.int/data/maternal-newborn-child-adolescent-ageing/indicator-explorer-new/mca/women-of-reproductive-age-(15-49-years)-population-(thousands)), and others. including millions of women of color, lived in such states.In Our Own Voice and Planned Parenthood. (2021, October 1). Red Alert: Abortion Access is at Stake for Nearly Half of U.S. Women and People Who Can Become Pregnant. Retrieved 27 June 2022, from Planned Parenthood website: https://www.plannedparenthood.org/uploads/filer_public/8e/24/8e241a38-af52-4c89-b299-5a02c0453adf/210927-2021-red-alert-report-english-v4.pdf. Due to data limitations, the data in this paper only analyze people who identify as women, though people who do not identify as women may also become pregnant. Now National Partnership for Women & Families analysis shows that one year after Dobbs more than 36 million women of reproductive age live in states that have or are likely to ban abortion. Of these women:
- 2.9 million are disabled women;People are identified as having a disability in this analysis if they responded that they have difficulty in one or more of the following realms: vision, hearing, cognitive, ambulatory, self-care and independent living. This is a limited definition of disability that excludes a portion of disabled people. For more information on how disability is measured in the American Community Survey please see, U.S. Census Bureau. (2021, November 2). How Disability Data are Collected from The American Community Survey. Retrieved 29 June 2022 from U.S. Census Bureau website: https://www.census.gov/topics/health/disability/guidance/data-collection-acs.html.
- 12.5 million are women who are economically insecure;While people across the income spectrum may have difficulty making ends meet, in this analysis we define “economically insecure” as living in a family below 200 percent of the federal poverty line.
- 15.8 million are mothers with children under 18 at home;This analysis defines “mother” as having at least one own child (including step, adopted, or biological) under the age of 18 in the household. Due to data limitations, there are mothers who are not included in this definition, including those who have non-resident or older children or those whose children have passed away. and
- 400,100 are veterans.
We find that 15.4 million reproductive-age women of color live in these 26 statesWhite, non-Hispanic women are also impacted by the Dobbs decision; more than 20.8 million white, non-Hispanic women of reproductive age live in states that have or are very likely to ban abortions – 50.8 percent of all white, non-Hispanic women ages 15-49. and provide state-by-state breakdowns for these women, who include:
- 6.7 million Latinas;
- 6.0 million Black women;
- 283,700 Native American women;
- 1.3 million Asian women;
- 37,300 Pacific Islander women; and
- 1.1 million multiracial women.
While people from all communities are harmed by these abortion bans, we find that women veterans, disabled women and women who are economically insecure are disproportionately likely to live in these states. We also find that Black and Native American women are the most likely to live in these 26 states, while Latinas are the largest group of women of color harmed by bans.
For people in these states who become pregnant, the stakes have become dramatically higher. In the last year, thousands of women and pregnant people have not been able to have the abortions they sought, with significant negative consequences for their lives, plans, health and economic security.Advancing New Standards in Reproductive Health, University of California San Francisco. (n.d.). The Harms of Denying a Pregnant Woman a Wanted Abortion: Findings from the Turnaway Study. Retrieved 7 June 2023, from https://www.ansirh.org/sites/default/files/publications/files/the_harms_of_denying_a_woman_a_wanted_abortion_4-16-2020.pdf Layered onto the confusion about the legality of care and logistical barriers to access, pregnant people are more anxious than ever about the privacy of their personal health information and face heightened risks of criminalization.Pregnancy Justice. (2022, July). Confronting Pregnancy Criminalization: A Practical Guide for Healthcare Providers, Lawyers, Medical Examiners, Child Welfare Workers, and Policymakers. Retrieved 7 June 2023, from https://www.pregnancyjusticeus.org/wp-content/uploads/2022/12/202211-PJ-Toolkit-Update-2.pdf This is especially true for Black women and other women of color, who were already more likely to be subject to disturbing levels of surveillance and overcriminalization.
Providers, too, fear running afoul of abortion bans, and have been placed in the untenable position of having to provide less than the standard of careGrossman D, Joffe C, Kaller S, Kimport K, Kinsey E, Lerma K, Morris N, White K. (2023). Care Post-Roe: documenting cases of poor-quality care since the Dobbs decision. Retrieved 7 June 2023 from Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco website: https://www.ansirh.org/sites/default/files/2023-05/Care%20Post-Roe%20Preliminary%20Findings.pdf – or stop providing pregnancy care altogether.Musa, A., & Bonifield, J. (2023, April 7). Maternity Units are Closing Across America, Forcing Expectant Mothers to Hit the Road. CNN. Retrieved 7 June 2023, from https://www.cnn.com/2023/04/07/health/maternity-units-closing/index.html People with desired pregnancies are also harmed by abortion bans due to delayed or denied necessary care for significant pregnancy complications.Grossman D, Joffe C, Kaller S, Kimport K, Kinsey E, Lerma K, Morris N, White K. (2023). Care Post-Roe: documenting cases of poor-quality care since the Dobbs decision. Retrieved 7 June 2023 from Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco website: https://www.ansirh.org/sites/default/files/2023-05/Care%20Post-Roe%20Preliminary%20Findings.pdf This is especially egregious in light of this country’s worsening maternal mortality and morbidity crisis.Hoyert, D.L. (2023) Maternal Mortality Rates in the United States, 2021. Retrieved 7 June 2023, from Centers for Disease Control and Prevention website https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm The consequences are especially devastating for Black, Indigenous and disabled women, who are significantly more likely to die from pregnancy-related causes.National Institutes of Health. (2021).NIH Study suggests women with disabilities have higher risk of birth complications and death. [Press release]. Retrieved 7 June 2023, from, https://www.nih.gov/news-events/news-releases/nih-study-suggests-women-disabilities-have-higher-risk-birth-complications-death; Hoyert, D.L. (2023) Maternal Mortality Rates in the United States, 2021. Retrieved 7 June 2023, from Centers for Disease Control and Prevention website https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2021/maternal-mortality-rates-2021.htm.
Dobbs is a decision about access to essential healthcare, but it is also about much more than that. It is, at its core, a decision deeply rooted in sexism, racism,Mhatre, N. (2019, April 25). Abortion Restrictions Hurt Women of Color. Retrieved 27 June 2022 from National Partnership for Women & Families website https://nationalpartnership.org/abortion-restrictions-hurt-women-of-color/. For a detailed discussion of the racist roots of reproductive restrictions, see Ross, L.J. The Color of Choice: White Supremacy and Reproductive Justice. SisterSong Publication. Retrieved 29 June 2022 from https://www.law.berkeley.edu/php-programs/centers/crrj/zotero/loadfile.php?entity_key=2K2QA27B ableism and eugenics;National Public Radio. (2016, March 7). The Supreme Court Ruling that Led to 70,000 Forced Sterilizations. Retrieved 7 June 2023, from https://www.npr.org/sections/health-shots/2016/03/07/469478098/the-supreme-court-ruling-that-led-to-70-000-forced-sterilizations it is about autonomy and the role that women and people who can become pregnant play in our society. It is a decision about their futures and possibilities, their opportunities and dreams. It has already had an enormous impact on every aspect of their lives, health and well-being. And it will continue to have especially significant effects on pregnant people, especially those in marginalized communities, including women of color, disabled women, transgender and nonbinary people and people living at the intersection of these identities.
In the year since Dobbs, some policymakers have taken important steps to protect people who can become pregnant. For example, the state of Michigan repealed its “extreme 1931 abortion ban”State of Michigan. (2023). Governor Whitmer Repeals Michigan’s Extreme 1931 Abortion Ban. [Press release]. Retrieved 7 June 2023, from, https://www.michigan.gov/whitmer/news/press-releases/2023/04/05/governor-whitmer-repeals-michigans-extreme-1931-abortion-ban#:~:text=Governor%20Whitmer%20Repeals%20Michigan’s%20Extreme%201931%20Abortion%20Ban,-News&text=LANSING%2C%20Mich.,doctors%20for%20doing%20their%20jobs and the Department of Veterans’ Affairs announced access to abortion counseling and in some cases abortion for veterans and their beneficiaries.Department of Veterans Affairs. (2022). VA will offer abortion counseling and – in certain cases – abortions to pregnant Veterans and VA beneficiaries. [Press release]. Retrieved 7 June 2023, from, https://news.va.gov/press-room/va-will-offer-abortion-counseling-and-in-certain-cases-abortions-to-pregnant-veterans-and-va-beneficiaries/ But much work remains. We call on state and federal policymakers to do everything in their power to protect and expand abortion access. Doing so requires fixing the parts of our systems that are currently broken and reimagining new policies that center the people who are most affected by abortion restrictions and reproductive oppression.
Methodological note: This analysis uses the 2017-2021 American Community Survey accessed via IPUMS USA, University of Minnesota, www.ipums.org. We use a five-year dataset to have a sufficient sample size to analyze state-level data. Racial categories in this analysis exclude women who identify as Latina and/or Hispanic, who are analyzed separately. Not all women of reproductive age have the potential to become pregnant – many of them may not be able to for medical reasons or they may not participate in sexual activities that could result in pregnancy. Additionally, due to data limitations, this analysis does not include people who do not identify as women but may become pregnant, including transgender men and nonbinary people.
*For conservative estimates of the transgender and nonbinary populations see Herman, J. L., Flores, A. R., & O’Neill, K. K. (2022, June). How Many Adults and Youth Identify as Transgender in the United States? Retrieved 6 July, 2022 from Williams Institute, UCLA School of Law website: https://williamsinstitute.law.ucla.edu/publications/trans-adults-united-states/; Wilson, B., A., M., & Meyer, I. H. (2021, June). Nonbinary LGBTQ Adults in the United States. Retrieved 6 July 2022 from Williams Institute, UCLA School of Law website: https://williamsinstitute.law.ucla.edu/press/lgbtq-nonbinary-press-release/. Figures for LGBTQ nonbinary adults are for people ages 18-60. The transgender and nonbinary communities are not mutually exclusive. For example, the Williams Institute finds that 42 percent of LGBTQ nonbinary adults identify as transgender. Additionally, the transgender community includes people who identify as men and women, as well as nonbinary. There are also additional nonbinary people who do not identify as LGBTQ, as well as those under the age of 18 and over 60.
The authors are grateful to Jaclyn Dean, Marissa Ditkowsky, Llenda Jackson-Leslie and Mettabel Law for their review and thoughtful comments.
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