It may take months or years before we grasp the health-related ramifications of the Supreme Court ruling that makes it legal for states to ban and restrict abortion. But the existing health equity data about key reproductive health measures — including maternal mortality, birth control use, and abortion — offer clues and raise questions about the short- and long-term effects the decision will have on the quality of health of females from the country’s largest race and ethnic groups.

With those health topics in mind, we’re offering a new tip sheet with resources about unintended pregnancy, birth control use and abortion. These materials may help explain why trends aren’t solely the result of personal choices or cultural practices but also related to lingering distrust of a medical system rife with racist policies, socioeconomic bias among medical providers, availability of medical facilities, and other social and structural determinants of wellbeing. The reports, studies, and data we’re sharing will help you add more depth to stories about the implications of the Supreme Court ruling on a procedure that is an integral part of reproductive health care.

Disparities in reproductive health measures

In the process of gathering information to explain why non-Hispanic Black and Hispanic women may be most affected by the decision, all roads lead to birth control data. The CDC authors of this 2021 report on abortion trends connect the dots between birth control use and unintended pregnancy and abortion patterns. More specifically, the report’s authors suggest that differences in quality family planning services, among other reasons, could explain why non-Hispanic Black and Hispanic women of reproductive age are more likely than their non-Hispanic white counterparts to have unintended pregnancies and abortions. (see Figure 1)

The demographic abortion trends in the CDC’s 2021 abortion rate analysis raise questions about the reasons why, in some states, a high proportion of women of reproductive age who get an abortion have it later in their gestational period. In Alabama, Arkansas, and Mississippi, for example, women are more likely than their peers in other states to have the procedure when they’re seven to nine weeks pregnant.

According to a 2016 analysis of federal data by the Guttmacher Institute, 45% of pregnancies in the U.S. are unintended — a proportion higher than that of peer industrialized countries. The data show that while the rate of unwanted or mistimed pregnancies had dropped for the years they studied, it was notably high among non-Hispanic Black women. (We asked the CDC for its most recent data on unintended pregnancies and were pointed to that report.)

Implications of abortion bans and restrictions

The U.S. unintended pregnancy rate is reportedly the lowest it’s been in at least 30 years, but the higher trends in unwanted or mistimed pregnancies seen among certain demographic groups have been worrying health experts before several states passed regulations that many medical professionals argue will have detrimental health consequences on women. That’s because research going back at least 20 years in the U.S. suggests that women of reproductive age who have unintended pregnancies that result in births are more likely than those who wanted to get pregnant to smoke and drink during pregnancy and have infants who are premature or have low birth weight.

Physician groups addressed the health consequences of the restrictions in amicus briefs they filed with the Supreme Court in the Texas and Mississippi cases. In expressing its opposition to the limitations in place in the Lone Star State, the American College of Obstetricians, the American Medical Association and the American Academy of Pediatrics, were among those who stated that forcing women to travel long distances to have an abortion or to give birth as harmful to their health. The American Public Health Association, the Guttmacher Institute and other parties, which filed a brief in support of the abortion clinic suing the government of Mississippi, stated that “women who carry unintended, and especially unwanted, pregnancies to term are more likely to experience a wide range of adverse health outcomes including depression, poor birth outcomes, interpersonal violence, and psychological distress.”

Recent news stories have been addressing some of these issues, including this one published by ABC News. In this story published recently by Axios that addressed health disparities among women, the reporter shared that an advocate for Black women’s health explained that “Black women also face everyday discrimination in medical settings, such as dismissal of symptoms and false beliefs about racial differences, which can negatively impact their birthing process.”

Margarita Birnbaum (@mbirnbaumnews) is AHCJ's Health Equity Core Topic Leader. An independent journalist who has covered health disparities. Birnbaum’s stories have been published by WebMD, American Heart Association News, and American Indian, the magazine of the Smithsonian’s National Museum of the American Indian.