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Weronika Malinowska

HED 220

Mr. Mitra

December 18 2018

The Abortion Plague

“​In 2008, the abortion rate for non-Hispanic White women was 12 abortions per 1000

reproductive-age women, compared with 29 per 1000 for Hispanic women, and 40 per 1000 for

non-Hispanic Black women​” (Beckman). Unfortunately, this is not where the disparities end.

Discrepancies in abortion rates also exist by socioeconomic status, with “women with incomes

less than 100% of the federal poverty level having an abortion rate of 52 abortions per 1000

reproductive-age women, compared with a rate of 9 per 1000 among those with incomes greater

than 200% FPL” (Disparities in Abortion Rates).

This paper will focus on Black, Hispanic, and low-income women, as these groups have

been studied more in-depth and for said groups the data on abortion rates are readily available.

Moreover, “In discussing these issues, it is essential to consider that abortion is not in and of

itself an adverse outcome” (Disparities in Abortion Rates).​ ​Abortions are stigmatized, often

referred to in public discourse as something that is “rare,” and viewed as an undesirable

outcome. However, for a woman with an unintended pregnancy, obtaining an abortion in a safe

and timely manner is a desirable outcome. Because abortions are framed as something that is

rare, it leads to the stigmatization of this procedure and of women who seek abortions, which in

turn can lead to unsafe and delayed procedure. Although abortions are a legal procedure in the
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United States, There are not enough conversations centered about abortions— it is more of a

taboo topic in this country. There are many myths and misconceptions, even though so many

women decide to terminate pregnancies each year.

Historically, non-white and lower-income women have been negatively stereotyped about

their sexual and reproductive behavior. Similarly, there is also a cultural propensity for

discussion of abortion in a manner to provoke judgment of individual women’s behavior.

Sexism, classism, and racism contribute to the structural inequity. Correspondingly, it is said

structural determinants, such as issues related to economic reasons, racism, differences in social

and historical context, as well as differences in opportunities that will determine the

discrepancies many women will endure (Dutton). The statistics of discrepancies in abortion rates

mirror other basic inequalities people of color and people from disadvantaged communities

experience. These disparities are associated with systemic hardships experienced by minorities

and people lower socioeconomic backgrounds with lower income and less education, including

“​decreased access to health care, higher levels of stress, exposure to racial discrimination, and

poorer living and working conditions” (Beckman). For the context of this paper, it is essential to

take into account the systemic nature of these disparities and their relationship to health

outcomes in all disadvantaged groups. The ultimate goal of this paper is to create a greater

understanding of the pervasive economic and social forces that fuel the disparities in abortion

rates among non-white and lower-income women. Although seemingly simple and superficial,

the high abortion rates are a result of plethora of factors. ​Abortion disparities in the United states

are a result of poverty, racism along with stigma in health care, lack of education, and access to

quality care.
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There are substantial disparities in the United States among women from different

socioeconomic backgrounds. Both ​women of lower socioeconomic status and women of color in

the United States have higher rates of abortion than ​richer​ women and White women. Disparities

in abortion rates occur by socioeconomic status, which will be referred to as SES, “with women

with incomes less than 100% of the federal poverty level (FPL) having an abortion rate of 52

abortions per 1000 reproductive-age women, compared with a rate of 9 per 1000 among those

with incomes greater than 200% FPL” (Disparities in Abortion Rates). This is the case, because

reproductive decisions made for economic reasons might be reinforced by social networks and

group behavior, according to Ushma Upadhyay, a public-health professor at University of

California, San Francisco. Similarly, because of economic reasons, African-American women

have a preference for condoms (Dutton). Even though condoms are known to be not as effective

as other, more expensive methods of protection. When it comes to contraceptive methods, money

is often a decisive factor; “the median wealth of white households is 18 times that of Hispanic

households and 20 times that of black households, according to the ​Pew Research Center

(Dutton). Nonetheless, low-income women possess a higher rate of unintended pregnancy and

abortion in spite of race. Those women are less likely to have health insurance or even consistent

access to healthcare, and therefore birth control, which has been proven by a study done by the

Kaiser Family Foundation​. With the increase in popularity of intrauterine devices—commonly

known as IUDs—abortion rates have declined, since IUDs are one of the durable and most

effective methods of birth control on the market. However, the only downside of those devices is

how expensive they are: they can cost as much as thirteen hundred dollars without insurance,
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which is not an option for many lower-income women (Dutton). “Poor and low-income women

also experienced some of the greatest increases and highest rates of unintended pregnancy”

(Finer). ​The upward trend in unintended pregnancies in women from lower SES has continued

for over a decade. These findings explain the disparities in abortion rates among women from

different socioeconomic backgrounds. ​Disadvantaged communities experience hardships, such as

poorer living and working conditions, and increased levels of stress which are related to health

outcomes. ​Income, however, is not equal to socioeconomic status. Many additional factors, such

as: wealth, history, culture, family education, as well as race all contribute to this. Next

paragraph will focus on the latter.

Race or ethnicity are independently associated with high abortion rates. They have to be

taken into account not because they show meaningful differences at the biological and behavioral

level, ​but rather because they “reflect larger systems of structural inequality, including racism

and systemic inequalities in both opportunities and power (Disparities in Abortion Rates).

Although unintended pregnancy rates have dropped over the recent years, an African-American

woman is almost five times more likely to have an abortion than a white woman, and a Latina

more than twice as likely (Dutton). Recent drop in abortion rates in the United States has been

celebrated and believed to be a major victory. Overall, according to Guttmacher Institute, the rate

of abortions in the United States is currently at its lowest point since the court case of Roe v.

Wade in 1973. To illustrate this point, the statistics speak for themselves: “about 1.1 million

abortions were performed in 2011, at a rate of 16.9 abortions for every 1,000 women of

childbearing age, down from a peak of 29.3 per 1,000 in 1981” (Dutton). However, abortion’s

racial disparities are largely excluded from the debate. Even though the rates have decreased
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among Hispanic and African-American women as well, the drop is not as significant and their

rates still tower above those of the rest of the country. This is alarming. If the whole country’s

abortion rates are dropping, why are two groups excluded and why do their rates remain

significantly higher than the American average? According to Christine Dehlendorf, who

specializes in reproductive health research and is a professor of family and community medicine

at the University of California in San Francisco, this discrepancy exists because of the greater

inequities said groups face in every aspect of their lives (Dutton). Even when money is excluded

from the equation, Black women at every income level hold the place for higher abortion rates -

higher than Hispanics or whites. “In 2000 Black women had a rate of 49 per 1000, Hispanic

women 33 per 1000 women of reproductive age, and women with an income of <100% of the

FPL 44 per 1000. In contrast, the rate for both white women and women earning >200% of the

FPL was only 13 per 1000” (Disparities in Family Planning)​. ​Women of color, and Black

women in particular are often stereotyped as promiscuous and that they just have babies. Many

minorities when faced with the decision to get an abortion do not want to be just a statistic.

Although it is not fully understood what is the cause, structural racism can be partly blamed.

Inequity and oppression are not problems that can be eradicated by getting more education or

starting a healthy diet; these problems are deep rooted in our society and are created and

maintained by societal institutions. Similarly, in order to see equality and equity that are

profound and long lasting in women’s reproductive health, institutions must change and create

new practices in how they care for and address women of color. Race and ethnicity intersect to

influent, amongst other things, where people live, the level of quality of education they obtain,

and access to health care and health insurance.

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In discussing these issues, it is essential to consider that the way the current educational

system works is ineffective and further structures inequity among lower income and/or women

of color. There are countless statistics that show relatively consistent, long-term declines in

abortion rates across the country. However, what most statistics ignore are geographic,

socioeconomic, and ethnic disparities which have been continuing to deepen and intensify,

while, at the same time, abortion rates have been falling. Two factors that have to be emphasized

when it comes to high unintended pregnancy rates and abortion rates amongst certain

communities are the difficulty of access to affordable health care and proper education. It is

important to note the systemic nature of these disparities and take into account the fact that they

are related to health outcomes. Because of limited insurance and lack of economic resources, it

might be difficult for some women to obtain contraceptives. In addition, it also might be difficult

to obtain proper sexual education. A study co-authored by Dehlendorf and published in the

American Journal of Public Health f​ ound that “Black and Hispanic adolescents receive less

thorough educations on reproductive health and birth control than their white counterparts within

the same income bracket.” The same study also observed that some minority women

experiencing pressure from their doctors to use contraceptive methods and limit their family size.

Because of this discrimination, women of color, as speculated by the study, may be discouraged

from seeking oral contraceptives such as birth control and reproductive counseling altogether

(Dutton). Education also plays an important factor in preventing unwanted child births.

“Contraceptive safety concerns, as well as apprehension about ​side effects​, appear to be more

prevalent in minority communities” (Disparities in Family Planning). Many Black women are

also concerned about the safety of birth control which stems from conspiracy beliefs about the
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use of contraceptives arising to “control the fertility of vulnerable populations” (Disparities in

Family Planning). Differences in knowledge may be a result of a plethora of societal factors,

including culturally based myths, lower levels of education, and differences in family discourse

about public health. These differences can fuel false beliefs about abortions, which will be talked

about in the next paragraph.

There are many opponents of abortion who use statistics showing disparities in abortion

rates among women of color and women from lower SES to prove their claim that abortion

providers are exploiting minority women and of ​poorer​ backgrounds. They argue that

regulations are needed to protect women and that more restrictive abortion regulations will result

in less abortions. Over the years, the differences in abortion rates have received an increasing

amount of political and media awareness, ​with “those opposed to abortion rights citing

differences in abortion rates as evidence of the diabolical nature of the “abortion industry”

(Beckman)

However, these arguments completely disregard the underlying causes of the disparities.

Efforts to restrict abortions will not influence any of the underlying factors, nor will they

contribute to the fall in abortions. Instead, as a result, more women would experience later

abortions or have unintended childbirths, which would contribute to worsening health disparities.

Opponents of abortion rights also cite differences in abortion rates as proof of racism. They try to

coerce those who are in favor of the right to obtain abortions by using these statistics. These

particular false claims blame abortion providers for targeting communities of color, and

exploiting minorities by “profiting from public funding of abortion for low-income women,”

even though there is no evidence that proves racial targeting or routine profiteering by abortion
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providers. In addition, abortion opponents also guilt minority women who choose to have

abortions by letting them believe that they are falling victim to a racist system. Those who hold

these views believe that inequities in abortion rates can be easily solved by limiting access to and

utilization of all abortion services. They view it as a threat not only to motherhood and American

values, but also to morality and social cohesion, while in fact, abortion is a “right required for

social equity for all women” (Beckman). A shift in focus has to be made from abortions to the

issue of how to improve women’s health outcomes, and women’s ability to make their own

decision about their own bodies, their reproductive health, as well as life trajectories.

To have the procedure itself is a difficult decision. Unfortunately, in addition to that,

many women often has to face society’s and others’ judgements. In public discourse, more often

than not you are damned if you get an abortion, and you are damned if you do not; there is no

golden mean. This has to change. Abortion should be the woman’s decision and she herself

should be the only person allowed to judge whether it was right or wrong. Women and all

people must make reproductive rights issues a priority. Most importantly, the focus should be on

the underlying social and structural inequalities. Ideally, a social justice perspective should be

adopted which would require that everyone works to “​promote broader social and structural

reforms that reduce poverty and the oppression of women, further their education and provide a

context in which women’s aspirations for themselves and their families can be fulfilled”

(Disparities in Family Planning). Instead of fueling the heated abortion debate, the United States

should focus on increasing access to effective contraceptives, particularly among groups who are

at greatest risk for unintended pregnancies (Finer). ​Similarly, “only through changing the social

context of women’s lives, while recognizing the diversity of their lived experiences, can
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women’s reproductive health be maximized” (Abortion Rates in The United States). Finally,

consideration of disparities in abortion rates should facilitate not only political, but also policy

efforts to increase help for groups at utmost risk. Specifically, Universal Health Care has the

ability to help reduce the rates of abortions among women of color and women of limited

economic means by making all contraceptive methods more affordable. Extended access to

contraceptives would make abortion less necessary. Universal Health Care can greatly improve

women’s health. However, as long as access to abortions is impeded and limited by government

and state policies that do not meet the needs of the diverse economic and cultural population of

women, abortion services in the United States will continue to be plagued by not only economic,

but also social disparities (Abortion Rates in the United States). ​Although the focus of this paper

were Black and Hispanic women of lower socioeconomic backgrounds, many of the issues

discussed are likely also relevant to other disadvantaged racial/ethnic groups, such as American

Indians, Alaska Natives, Asians, and Pacific Islanders. However, there is not much data on those

minorities.
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Works Cited

Beckman, Linda J. “Abortion in the United States: The Continuing Controversy.”

Feminism & Psychology,​ vol. 27, no. 1, 1 Feb. 2017, pp. 101–113.,

doi:10.1177/0959353516685345.

Dehlendorf, Christine, et al. “Disparities in Abortion Rates: A Public Health Approach.” ​Am J

Public Health​, Oct. 2013, doi:10.3897/bdj.4.e7720.figure2f.

Dehlendorf, Christine, et al. “Disparities in Family Planning.” ​American Journal of

Obstetrics and Gynecology,​ vol. 202, no. 3, 3 Mar. 2010, pp. 214–220.,

doi:10.1016/j.ajog.2009.08.022.

Dutton, Zoe. “Abortion's Racial Gap.” ​The Atlantic​, Atlantic Media Company, 23 Sept.

2014, www.theatlantic.com/health/archive/2014/09/abortions-racial-gap/380251/.

Finer, Lawrence B., and Mia R. Zolna. “Unintended Pregnancy in the United States: Incidence

and Disparities, 2006.” ​Contraception​, vol. 84, no. 5, Nov. 2011, pp. 478–485.,

doi:10.1016/j.contraception.2011.07.013.
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