California leads on reproductive care in post-Dobbs America — but we can do better | Opinion

Robin Epley
·4 min read
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Late June marked the one-year anniversary of the Supreme Court’s decision to overturn Roe vs. Wade, ending our constitutional right to an abortion, a law of the land for nearly 50 years — and for my entire life.

Californians are fortunate to have political leaders so vocally committed to ensuring reproductive health care access for girls, women and pregnant people across the country, but we can and must do better for Black and Latina mothers within our state borders.

Opinion

With the Dobbs decision, the Supreme Court “sent the decision back to the states,” a politically charged move that has put the lives of millions of women living in conservative states at risk. Liberal California has emerged as the leading opposition to that ruling, enshrining the right to an abortion in its own state constitution last November, and further moving to establish itself as a sanctuary for pregnant people.

In 2021, more than 40 sexual and reproductive health care providers, advocacy organizations and legal and policy experts established the California Future of Abortion Council to coordinate reproductive freedom and justice efforts across the state.

Now, a new report from the Gender Equity Policy Institute, a non-profit based in Los Angeles, shows that thanks to those combined efforts, California not only has the nation’s lowest maternal mortality rate, California teens are also half as likely to become mothers compared to their peers in states that have banned abortion.

“California has been a leader in advancing women’s sexual and reproductive health for decades, and the data shows that pregnant people and babies in California and other states supportive of reproductive freedom have healthier outcomes than they do in states banning abortion,” said Nancy Cohen, president of the Gender Equity Policy Institute.

Teen mothers typically experience poverty, malnutrition, pregnancy-related complications and emotional problems, such as depression and drug and alcohol use, according to the National Institutes of Health. The children of teen mothers are also at greater risk of physical, cognitive and emotional problems. Currently, one in four teens live in states that ban abortion.

“We are tracking the impacts of women losing autonomy over their bodies, and we expect the divide between states to widen as more states enact and enforce abortion bans and deny people basic reproductive healthcare,” Cohen said. “The sad reality is that the end of the constitutional right to abortion has created two very different Americas for pregnant people and their babies.”

Women in California are also less likely to lack health insurance compared to women living in banned states by about half, but serious equity concerns remain a problem for the state.

The neonatal mortality rate for Black babies in California is twice as high as the mortality rate for all babies statewide, and Latinas in California, who are more likely to give birth during their teen years, are also less likely to have health insurance, according to the Gender Equity Policy Institute.

Just 22 states support reproductive freedom, while 28 states ban or restrict abortion care in some way, as of December 2022. The 22 states that support abortion rights have expanded Medicaid under the Affordable Care Act, which the Institute found “played a critical role in expanding access to no-cost birth control as well as prenatal and postnatal care.”

Mothers living in states that ban abortion were nearly three times as likely to die during pregnancy, childbirth or soon after giving birth, and babies born in states that ban abortions were 30% more likely to die in their first month of life.

“2022 was a battleground for women, not just in protecting their bodily autonomy, but just surviving,” said Holly Martinez, the executive director of the California Commission on the Status of Women and Girls. “(It was about) surviving the height of the pandemic, when they’ve lost a record number of jobs, especially for women of color and working mothers. We know that women who had children left the workforce in droves and are still struggling to recover economically.”

California can stop the country’s war on women by continuing to provide reproductive care, but also by subsidizing child care costs and ensuring that women and mothers can remain a part of the state’s workforce. As individual Californians, we can continue to support pro-choice candidates in other states, and by volunteering or donating to help pregnant people travel from other states for reproductive care here.

We can also commit ourselves to not just providing reproductive healthcare and abortion rights for white women, but also for boosting the rates of survival and the quality of care for women of color, non-binary and transgender mothers.

Americans now live in a post-Roe America, with a Supreme Court that has shown it can and will remove long-held and cherished rights against popular opinion. Racial and ethnic disparities remain unacceptably high in every state, and even California must and can do better.