Black Women Suffer Most From Restrictive Reproduction Policies, Study Shows

pregnant black woman in hospital gown

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Key Takeaways

  • Restrictive reproduction policies make it difficult for women to obtain services that are often essential.
  • Structural racism within the obstetrics and gynecology fields has lead to the biased and often inferior treatment of Black patients.
  • The U.S. has one of the worst maternal mortality rates for minority women in the industrialized world.

A recent study published in the journal Preventative Medicine revealed that women from states with more restrictive reproductive laws were more likely to give birth to low-weight babies, particularly if they were Black. This data is concerning, but is just one piece of the broader conversation surrounding the consequences of limiting access to maternal health services.

In 2016, a groundbreaking maternal mortality study funded by the Bill & Melinda Gates Foundation and published in The Lancet mirrors this danger, noting that the United States had one of the highest rates of maternal deaths compared to other developed nations. In 2017, a six-month investigation led by NPR and ProPublica confirmed that the U.S., in fact, had the worst maternal mortality rate in the industrialized world. The issue is even more prevalent in states with restrictive reproductive policies.

Minority Groups Are Disproportionately Affected

BIPOC women all too often face racial and ethnic disparities in the U.S. healthcare system, and Black women are the most disproportionately affected. The Centers for Disease Control and Prevention (CDC) indicates that Black women are three to four times more likely to die from pregnancy-related causes than White women.

The new research sheds light on the issue: “In the U.S., unacceptably high levels of racial and ethnic disparities in infant mortality and adverse birth outcomes exist. Increased exposure to structural racism results in higher levels of infant mortality rates and fetal growth restriction.”

Kimbery Langdon, MD

Premature births are the primary reason for low birth weight infants. Black and Hispanic women have higher rates of premature babies due to lack of access to care or fear of the medical establishment that is primarily White—making racial disparities in healthcare a huge issue.

— Kimbery Langdon, MD

Consider the fact that Black women living in the least restrictive states had an 8% lower risk of having a baby with low birth weight than their counterparts in the most restrictive states. It’s a statistic that speaks to the protective effect reproductive rights have for minority groups especially.

When women have access to beneficial programs like free or low-cost birth control, locally available Planned Parenthood centers, and supportive prenatal healthcare, their chances of giving birth to a premature baby are greatly reduced. 

Kimberly Langdon, MD, a retired OB/GYN in Ohio and writer for Medzino says, “Premature births are the primary reason for low birth weight infants. Black and Hispanic women have higher rates of premature babies due to lack of access to care or fear of the medical establishment that is primarily White—making racial disparities in healthcare a huge issue.”

Family Planning Clinics Are Not Abortion Clinics

In the U.S., there are several national policies aimed at protecting a woman’s right to choose how and when she gets pregnant, and whether she will carry that pregnancy to term. Despite that, each state has the power to choose how much access its residents have to those programs and can limit reproductive rights accordingly.

Unfortunately, those women's health clinics like Planned Parenthood that are dedicated to family planning, are unfairly branded as abortion clinics. In reality, they grant women access to a whole host of prenatal health services which enable them to bring a healthy baby to term. When certain states choose to close these centers, those women lose out on far more than abortions.

It's also important to note that pregnancy itself has its own set of health risks. "Any pregnancy that occurs, whether intended or not, can result in adverse outcomes—primarily as a reflection of underlying medical conditions such as obesity and high blood pressure," says Langdon.

When women don't have access to proper reproductive health care, especially in situations where the pregnant mother has preexisting health concerns, the risk for mother and baby increases.

Restricted Rights Lead to Poor Pregnancy Outcomes

These policies, like restricted access to birth control, mandatory parental consent, waiting periods for abortions, and restrictions on funding for abortions lead to higher rates of poor pregnancy outcomes such as low birth weight, higher infant and maternal mortality rates, and increased odds of preterm birth.

UPDATE, June 24

The Supreme Court passed down a decision overturning Roe v. Wade, which guaranteed access to abortion. Without this protection, it is up to the states to determine how to treat abortion. Many states will either eliminate access to legal abortion or put severe limitations in place. These will make it significantly harder for Black pregnant people to receive the reproductive healthcare they need, including abortions.

“These policies also make it difficult, if not impossible, to obtain contraception, leading to higher rates of unplanned pregnancies,” says Sarah Cross, MD, assistant professor of Obstetrics, Gynecology and Women's Health at the University of Minnesota Medical School.

Sarah Cross, MD

Comprehensive sexual health education and access to contraceptives reduce the number of women seeking an abortion. When abortion services are limited or not available, women are then forced to carry these pregnancies, sometimes even ones that threaten their health or life.

— Sarah Cross, MD

“What we know is that comprehensive sexual health education and access to contraceptives reduces the number of women seeking an abortion. When abortion services are limited or not available, women are then forced to carry these pregnancies, sometimes even ones that threaten their health or life.”

What This Means for You

Women living in states with the most restrictive reproductive rights have limited options when it comes to pregnancy and birth control. But, says Langdon, Planned Parenthood and similar resources are a good starting point in any state, and can direct women to other resources that can be helpful as well.  

9 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Sudhinaraset M, Vilda D, Gipson JD, Bornstein M, Wallace ME. Women’s reproductive rights policies and adverse birth outcomes: a state-level analysis to assess the role of race and nativity statusAm J Prev Med. doi:10.1016/j.amepre.2020.07.025

  2. Kassebaum NJ, Barber RM, Bhutta ZA, et al. Global, regional, and national levels of maternal mortality, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015The Lancet. 2016;388(10053):1775-1812. doi:10.1016/S0140-6736(16)31470-2.

  3. Centers for Disease Control and Prevention. Pregnancy-Related Deaths.

  4. Requejo J, Merialdi M, Althabe F, Keller M, Katz J, Menon R. Born too soon: care during pregnancy and childbirth to reduce preterm deliveries and improve health outcomes of the preterm babyReprod Health. 2013;10 Suppl 1:S4. doi:10.1186/1742-4755-10-S1-S4

  5. Manuck TA. Racial and ethnic differences in preterm birth: A complex, multifactorial problemSemin Perinatol. 2017;41(8):511-518. doi:10.1053/j.semperi.2017.08.010

  6. Institute for Women’s Policy Research. Status of Women in the States. Reproductive Rights.

  7. Planned Parenthood. State Attacks on Sexual and Reproductive Health.

  8. Coroyannakis C, Khalil A. Management of hypertension in the obese pregnant patientCurr Hypertens Rep. 2019;21(3):24. doi:10.1007/s11906-019-0927-x

  9. Wallace ME, Evans MG, Theall K. The status of women’s reproductive rights and adverse birth outcomesWomens Health Issues. 2017;27(2):121-128. doi:10.1016/j.whi.2016.12.013

By Christin Perry
Christin Perry is a freelance writer and editor. Her work has been published in The Bump, The Knot, Scary Mommy, LittleThings, Parents, Qeepsake, and more. She has experience writing email marketing campaigns, website copy, and SEO-optimized content. Christin is also a mom of three.