Abortion is healthcare.
Out of 629,898 abortions reported to the CDC for 2019, Black women accounted for 38.4 percent, while White women comprised 33.4 percent of those abortions. Abortion rates were 3.6 times higher among Black women when compared to white women. Much of the disparity can be explained by inequities in rates of unintended pregnancies and other factors, including unequal access to quality family planning services, economic disadvantage, and distrust of the medical system.
Research has shown that comprehensive sex education can help young people delay the onset of sexual activity, reduce the number of partners, and increase contraceptive use. At least one study found that teens who received comprehensive sex education were 50 percent less likely to report a pregnancy than those who received abstinence-only education. Black youth, low-income youth, and youth from single-parent households were less likely to get formal sex education. Black youth were more likely to receive abstinence-only education, “which is ineffective and stigmatizing.”
Black women are more likely to live in contraceptive deserts, with higher barriers to purchasing contraceptives. Due to redlining and other intentional segregation efforts, Black women tend to live near pharmacies that “impede the purchase of contraception.” There are many obstacles: limited hours, fewer female pharmacists, fewer patient brochures on contraception, condoms that are difficult to access, and fewer self-checkout options. Even when they obtain contraception, it’s more likely to fail. Black women and women with low socioeconomic status have higher rates of contraceptive failure than white and high socioeconomic status women, even when using more effective contraception.
As a direct result, Black women ages 15 to 49 are less likely to use contraception, including prescription contraception, such as birth control pills and long-acting reversible contraceptives (like an IUD or a birth control arm implant), the most effective forms of birth control after abstinence and permanent sterilization. Those between 18 and 24 tend to prefer condoms, a less effective way to prevent pregnancy. Access to contraception like birth control and condoms also reduces the rate of unwanted pregnancies and the need to seek abortions.
Accessing prescription birth control without health insurance is complicated. Black women and girls are uninsured at nearly twice the rate of White women and girls, according to data from 2020. All of these inequities are rooted in social and structural racism and discrimination.
Black women in the South, where several abortion bans take effect following the supreme court’s recent decision related to Roe v. Wade, have the lowest health insurance coverage rate among all Black women. Southern states like Mississippi have refused to expand Medicaid coverage, preventing Black women in those states from having better health outcomes. Black women in Medicaid expansion states have experienced fewer maternal deaths than those in non-expansion states.
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