Repeal of Roe risks exacerbating the US’s most shameful statistic
Roula Khalaf, Editor of the FT, selects her favourite stories in this weekly newsletter.
If the US Supreme Court goes ahead with the repeal of Roe vs Wade later this year, the fallout will be far-reaching. Abortion would almost certainly become illegal or heavily restricted in 22 states and would be under severe threat in at least four others.
As such, 27mn women of childbearing age would have their reproductive rights rolled back by 50 years. By this summer, most of them may find themselves living under broadly the same abortion rules as those in Sierra Leone, Congo-Brazzaville and just 22 other countries worldwide.
The most damning part of such an enormous backward leap is who would bear the brunt of the ban, and what this tells us about the dire state of maternal health in the world’s richest healthcare system.
In 2019, there were 23.8 abortions carried out per 1,000 non-Hispanic black women in the US, compared to 11.7 among Hispanic women and 6.6 among white women. In 1994, one in four US abortion patients had an income below the federal poverty line. By 2014, it was one in two. In other words, a ban would disproportionately affect black women and those least able to afford to cross state boundaries for the procedure.
The negative socio-economic impacts of unwanted births are well-established. A study led by Diana Greene Foster at the University of California, San Francisco found that US women denied an abortion are more likely than peers who receive one to experience long-term economic hardship.
Women’s health is also at stake. Many think abortion a much riskier procedure than birth but this is wrong. In 2020, 861 US women lost their lives during or immediately after pregnancy, for a rate of 23.8 maternal deaths per 100,000 live births. Over the past six years, there have been 0.41 abortion-related deaths per 100,000 legal abortions, an almost 60-times smaller risk.
Along with deaths from guns and opioids, maternal mortality must rank as one of the US’s most shameful statistics. Its rate of 23.8 deaths per 100,000 live births ranks 36th out of the 38 OECD countries, behind the likes of Chile, Turkey and Lithuania, and ahead of only Colombia, Latvia and Mexico.
Moreover, the maternal mortality rate for non-Hispanic black US women is more than double that, at 55.3 deaths per 100,000. So the group most likely to be directly affected by a ban would also pay a far steeper cost in terms of health. An invaluable 2021 study by sociologist Amanda Jean Stevenson at the University of Colorado, Boulder, quantified this at a 33 per cent increase in pregnancy-related deaths among black women following a ban, and a 21 per cent rise across women of all races.
As is almost invariably the case, when something bad happens in the US, it happens disproportionately to black people and those on low incomes. The repeal of Roe vs Wade is no exception, though the harms will be felt by every woman. The US may claim to be a developed nation, but when it comes to women’s health, this could not be further from the truth.
Comments