Short Wave - Who Would Be Most Affected By Roe Reversal

Episode Date: May 13, 2022

If the U.S. Supreme Court rules in line with the draft decision leaked in early May, the decision to reverse Roe v. Wade affect a much broader group than people who get pregnant. But research shows abortion restrictions have a disproportionate impact on young women, poor women and especially those in communities of color. NPR health correspondent Yuki Noguchi talks to Short Wave scientist-in-residence Regina G. Barber about how this ruling would affect those women and how groups helping them get abortions are preparing.Email the show at [e-mail]. See pcm.adswizz.com for information about our collection and use of personal data for sponsorship and to manage your podcast sponsorship preferences.NPR Privacy Policy

You're listening to Shortwave from NPR. Hey there, shortwavers. Regina Barber here today with science reporter Yuki Noguchi. Hey, Yuki. Hi, Regina. So I understand you've been looking into who would feel the impact if indeed the Supreme Court overturns Roe v. Wade. Yeah, so if the court rules in line with its draft decision leaked in early May, that would disrupt abortion access across the country by turning those decisions back to the states.

That ruling would trigger state abortion ban. and restrictions in about half the states affecting anyone seeking an abortion who lives there. And that's because some state lawmakers have passed so-called trigger laws, meaning if Rose overturned in some states, a lot more abortion restrictions would go into effect soon after. That's right. So depending on your state, things might not change. But in certain states, you might be subject to those restrictions. The effect of abortion policy is, of course, something that touches everybody, a much broader group than just people who get pregnant. But research clearly shows abortion restrictions have a very disproportionate impact on young women, poor women, and especially those in communities of color.

Today on the show, we'll talk about how this ruling would affect those women and how groups helping them get abortions are preparing. You're listening to Shortwave, the Daily Science podcast from NPR. Yuki, let's start with some statistics. Who gets abortions in the U.S.? It's really common about one in four women in the U.S. get an abortion in their lifetime. More than half of them are women in their 20s and lower income people are more likely to get one. But it also varies very much by race. Black and Latino women account for more than half of abortions, according to the most recent estimates. And the reason is the same as for other racial disparities we see across health care. less access to doctors or insurance, sex education, and contraception, plus they face higher rates of poverty.

And those most likely to seek abortions are also those most likely to see impact from this ruling. Because, again, this decision will trigger state laws banning or seriously restricting abortions across the South, which, of course, is home to a very large share of the country's Black and Latino residents. Yeah, and many people are also concerned that people most likely to have complicated pregnancies, might not be able to end them, like when the mother or the baby are at risk. Yeah, in this country, black women die three times more often in childbirth than their white counterparts. And their babies are more than twice as likely to die than white babies. So people like Monica McLemore, who's a professor of nursing and an abortion researcher,

says that is the flip side of restricting abortion. For people who are going to be forced to birth or continue pregnancies to turn, we already have a black internal health crisis that's going on. And that has to do with black women overall having less access to social supports, like prenatal care, healthy food, transportation, for example. And so McLemore says if states take away the right for these women who are at risk to get abortions, then they should also provide more social support to help them raise healthier children.

But she says that isn't part of the discussion. And in fact, she points out, many clinics that serve these women will likely close. And with those closings goes away significant support for other things like contraception, testing for sexually transmitted infections, and other reproductive health care. Right. Exactly. That sort of wrap around care, you know, less contraception and less access to the kind of care that leads to better outcomes. So you can see how that would feed into this existing problem that she's talking about. And many people are talking about the knock-on effects like that. And you talked to a woman who faced that scenario, right? Yeah. Laurie Bertram Roberts wasn't. able to get an abortion several years ago, even after doctors warned her she might die.

She lives in Tuscaloosa, Alabama and was already in financial straits, and she already had three kids. She fit, you know, a pretty typical profile, actually, of many people seeking abortions who are already mothers. And despite all those risks, she felt forced to carry the baby to term. And we ended up homeless within a year. So she lived this connection between abortion access and overall health. Mississippi and Alabama are both two states that have very high black maternal mortality rates and black infant mortality rates. And what does forced birth look like for us with those being our reality? So she says not having good health care and then not having access to abortion is a vicious public health cycle.

After her experience, Robert started the Yellowhammer Fund, which funds travel and logistics. and supports people seeking abortions throughout the South. And what is she saying people in those communities are likely to do after this ruling? Yeah, Roberts and others that run similar funds say there'll be a couple of options. For those who still need a clinic, they might have to travel further, you know, to states where abortion is still legal. And that's pricey, right? I mean, gas prices. So it's more expensive and more complicated.

And Roberts thinks more people may try to use abortion. pills, which is what's been happening in Texas since more strict abortion restrictions went into place there in 2021. Yeah, let's talk about what each of those options look like. Talk us through how it would be more complicated to get to a clinic. Well, already clinics have different rules and there are different state rules, obviously. So Robert says navigating all of that is already really tricky. You know, some require parental consent for minors. Others have waiting periods, which vary. as do fees for each service. You know, some clinics are open on weekends and many aren't.

She says access to abortion comes down to these kinds of logistics. She says, you have to think, not just about the total number of miles to get to a clinic, but also how many times you might be required to go there. You have to honestly know that for the whole southeast. Currently, you have to know that for like basically your entire area of the country. It might make more sense to travel further to one that doesn't have a waiting period or is open on the weekend. to minimize how much work the person would have to miss. She has an actual rulebook to keep track of this and to find a clinic match for each patient. But of course, a ruling will create a whole new set of rules to keep track of for clinics that are way further afield. You mentioned abortion pills as an alternative. Those weren't around when Roe was decided. How big a difference does that make today? It's a major change because those pills, whether through a clinic or self-managed at home, now make up a majority of abortions. You know, it's been supercharged by the pandemic and telehealth, obviously.

But many people can't take them because they have a blood disorder or might be later in a pregnancy when they find out they have a fetal abnormality. And Terry Ann Thompson says telehealth isn't an option for everyone. She's at the research group Ibis Reproductive Health. At present, there are 19 states that actually ban telehealth for medication abortion care. And 11 of those states are actually considered part of the South. That states where black and Latinx communities are. are highly represented, then there really is no access available to those populations. Now, as a practical matter, it may still be possible to get access to those pills.

You know, there are websites like Plan C or, you know, you can get them through the mail. But that is definitely the next frontier of the battle. Specifically, a big question is, will women who use them or other means of terminating a pregnancy be prosecuted? And in fact, there's been cases of that already. Yeah, so far isolated. cases, but they get a lot of tension. And last month, a Latino woman was detained for an alleged self-induced abortion in Texas, which, as we've mentioned, passed new abortion restrictions

in September of 2021. That happened in Zana Zamora's community of the Rio Grande Valley, and she runs the Frontera Fund, which helps fund abortions for people. She says, even though she helped get that case dismissed, it had a huge chilling effect. You see someone in your community who got arrested because of their pregnancy outcome, it does create a lot of fear and anxiety and uncertainty and a lot of misinformation that gets spread out throughout communities. Samara says people will have to travel further to Minnesota or Colorado to seek abortions, but many people won't be able to afford that. So Texas is a good example because it's been living under these new restrictions known as SB8.

What else did she say has she? changed since those laws took effect there? Well, cost and complications, like I mentioned earlier, are a big issue. There are groups like Samora's around the country that have deep experience navigating people to abortions, but at the same time, these new challenges, of course, mean it's more expensive. Her group, Frontera Fund, used to spend $4,000 a year before new rules took effect in Texas. Now they have to send everyone out of state for abortions. So their expenses just exploded 60 times that, a rate of a quarter million dollars a year. To save money, these funds are sending women alone, which means they're trying to support people emotionally from far away.

They're having to travel thousands of miles, and especially in our case in the Real Grandi Valley, because we are geographically the furthest away from any state border, we're having to travel the furthest. People there regularly cross the border to Mexico to get dental care or medications because they tend to be cheaper. But Zamora says that's not an option for people without documentation. You know, they're afraid of not being able to return. So they can't get abortion pills by just going to Mexico. So are people in states where abortion will remain legal preparing for an influx of patients from other parts of the country? Yeah. And in fact, you are already seeing that from people leaving Texas. Ariabonios Perea is with Kolar, a Latina-run reproductive rights fund

based in Denver. She told me that since SB8 took effect, clinics in Colorado have seen a 500% increase in volume. And that's, you know, just from one state, Texas. So again, the ruling would restrict abortion for like another two dozen states. The members of these communities in these states are going to seek refuge somewhere else. So yes, we're going to see an impact on maybe the capacity. Our communities of color knew that Colorado would be a safe haven if they chose to come here for care. So she says they are anticipating their clinics will need additional support to try to accommodate what she assumes will be a huge influx from other states as well. That's a lot to consider. We'll be watching. Thank you so much for your reporting, Yuki. Good to talk to you, Regina.

Jane Greenhalsh and Giselle Grayson edited this story. Eva Tesfai was the producer. Margaret Serino checked the facts. The audio engineer for this episode was Quasi Lee. Beth Donovan is our Senior Director and Anya Grunman is our Senior Vice President of Programming. I'm Regina Barber. Thanks for listening to Shortwave, the Daily Science Podcast from NPR.