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Research shows that, in addition to medical necessity, people tend to seek abortions because they do not feel financially prepared or are worried about their age, health, or marital status or caring for their children (Biggs, M. A., et al., BMC Women’s Health, Vol. 13, 2013).
Most people who have abortions are not White. In 2019, the abortion rate was 23.8 per 1,000 Black women, 11.7 per 1,000 Hispanic women, 13 per 1,000 Asian American, Native American, and other women—and just 6.6 per 1,000 White women, according to data reported to the Centers for Disease Control and Prevention (CDC) (Abortion Surveillance—United States, 2019, CDC, 2021).
For people of color in this country, the denial and violation of bodily autonomy is nothing new. Enslaved Black women were raped and forced to carry children, while their descendants faced involuntary sterilization throughout the 20th century. Native American, Puerto Rican, and other women of color have endured similar horrors (Kozhimannil, K. B., et al., New England Journal of Medicine, Vol. 387, No. 17, 2022).
“To have this shadow of a reminder that we don’t have say over our bodies, it feels especially minimizing and devaluing when this right is taken away,” said Jessica Smedley, PsyD, a clinical psychologist based in Washington, D.C.
Even in 2023, people of color still get worse medical care overall, including worse reproductive health care and less access to contraception, and are more likely to be uninsured than White people. About 19% of American Indian and Alaska Native people and about 18% of Hispanic or Latino people are uninsured, compared with less than 6% of non-Hispanic White people (Health Insurance Coverage by Race and Hispanic Origin, U.S. Census Bureau, 2021 [PDF, 498KB]).
Restricted access to abortion can be particularly distressing for people of color, Smedley said, because of the unsafe conditions they may face during and after pregnancy. In addition to being three times as likely to die in childbirth as their White counterparts (Working Together to Reduce Black Maternal Mortality, CDC, 2022), Black women face much higher rates of severe maternal complications. Women living in majority Hispanic communities also face severe complications 32% more often than those living in majority White communities (Racial Disparities in Maternal Health, BlueCross BlueShield, 2021).
Because of these disparities, women of color are more likely to need lifesaving abortions, including in the event of an ectopic pregnancy, a life-threatening condition where a fertilized egg implants outside of the uterus (Stulberg, D. B., et al., Fertility and Sterility, Vol. 102, No. 6, 2014). In other cases, women who have had miscarriages may need medication or procedures that are now illegal where they live.
But because of entrenched interpersonal and medical racism, “people stereotypically associate Black women with poor sexual decision-making and childrearing, which means they are less likely to be believed when they say they need an abortion for medical reasons, especially if they are poor,” said Candice Hargons, PhD, an associate professor of counseling psychology at the University of Kentucky who studies sexual wellness and healing racial trauma.
Research suggests that due to racial bias, medical providers often fail to take Black patients’ pain seriously (Hoffman, K. M., et al., PNAS, Vol. 113, No. 16, 2016). That bias affects reproductive health care, where Black women who report pelvic pain and other symptoms are less likely than White women to receive a diagnosis of endometriosis (Bougie, O., et al., BJOG, Vol. 126, No. 9, 2019).
Recent data also indicate that some women of color may be more likely to attempt abortions at home if they face barriers to receiving care. In a recent survey of nearly 20,000 patients seeking abortion across the U.S., Hispanic women were more likely to attempt a “self-managed” abortion, or one outside the health care system through medication, herbs and botanicals, or self-harm (Aiken, A. A., et al., JAMA Network Open, Vol. 6, No. 4, 2023).
To complete this grim picture, more than 6% of women in the Turnaway Study who were forced to carry unwanted pregnancies faced serious health consequences, including eclampsia, postpartum hemorrhage, and even death (Gerdts, C., et al., Women’s Health Issues, Vol. 26, No. 1, 2016).
“When you’re told you cannot have ownership over your body, how is that affecting Black girls and women? It’s affecting every part of their lived experience,” said Jameta Nicole Barlow, PhD, MPH, a community health psychologist and an assistant professor of writing at the George Washington University in Washington, D.C.
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