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An upcoming Supreme Court ruling may disproportionately impact on people of color

LEILA FADEL, HOST:

A recently leaked draft opinion suggests the U.S. Supreme Court will likely overturn the landmark abortion ruling Roe v. Wade. If that happens, more than two dozen states are expected to ban or seriously restrict abortions. That would affect anyone seeking abortion in those states but especially poor women and women of color. NPR's Yuki Noguchi joins us to explain why.

Good morning, Yuki.

YUKI NOGUCHI, BYLINE: Good morning, Leila.

FADEL: So, Yuki, let's start with who this ruling will impact. Who gets abortions in the U.S.?

NOGUCHI: Yeah. Well, it's estimated about 1 in 4 women will get an abortion in their lifetime. More than half the people who access abortion are women in their 20s; also low-income people are more likely to get one. And race is a factor. Black and Latino women account for more than half of abortions, according to the most recent estimates. And the reason is the same as other racial disparities across health care - you know, less access to doctors and insurance or contraception and education. Plus, they face higher rates of poverty. And the ruling itself would disproportionately affect those communities also because many Southern states with large Black and Latino populations have bans that would be triggered by this ruling.

FADEL: And so what are people in those communities likely to do?

NOGUCHI: Well, they have a couple of options. I mean, for those who still need a clinic, they might have to travel further, you know, to states where abortion will still be legal. And that's pricey, right? - I mean, gas prices. But some may try to use abortion pills.

Laurie Bertram Roberts co-founded the Yellowhammer Fund in Tuscaloosa, Ala. And that group pays for travel or child care and logistics for people seeking abortions. And she says that's gotten more expensive and complicated. And this is something she knows firsthand. She wasn't able to get an abortion several years ago, even after doctors warned her she might die. She was already in financial straits with three kids and felt forced to carry the pregnancy to term.

LAURIE BERTRAM ROBERTS: And we ended up homeless within a year.

NOGUCHI: And she sees a connection between abortion access and overall health.

ROBERTS: Mississippi and Alabama are both two states that have very high Black maternal mortality rates and Black infant mortality rates. And what does forced birth look like for us?

NOGUCHI: So she says not having good health care and then not having the access to abortion is a vicious public health cycle.

FADEL: So it becomes an equity issue. If you have money, you get to a somewhere with access; if you don't, you can't. Now, you mentioned abortion pills as an alternative. Those weren't around when Roe was decided.

NOGUCHI: Exactly.

FADEL: What about that?

NOGUCHI: Yeah. And that's a major difference. Those pills, whether through a clinic or self-managed at home, now make up a majority of abortions. But many people can't take them. You know, maybe they have a blood disorder or are later in pregnancy and find out about a fetal abnormality then.

And Terri-Ann Thompson says telehealth isn't an option for everyone. She's at the research group Ibis Reproductive Health.

TERRI-ANN THOMPSON: At present, there are 19 states that actually banned telehealth for medication abortion care. And 11 of those states are actually consider part of the South. That's states where Black and Latinx communities are highly represented. Then there really is no access available to those populations.

NOGUCHI: You know, as a practical matter, it may still be possible to get access to these pills, you know, through the mail or something. But that is definitely the next, you know, frontier of this battle. Specifically, the question will be, will women who use them or use other means of terminating a pregnancy be prosecuted?

FADEL: And that's happened, right?

NOGUCHI: Yeah. Just last month, a Latina woman was detained for an alleged self-induced abortion in Texas, which, as you know, passed new abortion restrictions last September. Zaena Zamora lives there and runs the Frontera Fund, which helps fund abortion access for people. And she says that case had a huge chilling effect.

ZAENA ZAMORA: When you see someone in your community who got arrested because of their pregnancy outcome, it does create a lot of fear and anxiety and uncertainty and a lot of misinformation that gets spread out throughout communities.

NOGUCHI: So Zamora says people will have to travel further to places like Minnesota or Colorado to seek abortions. But, you know, many people, like I said, won't be able to afford that.

FADEL: NPR's Yuki Noguchi - thank you so much for your reporting, Yuki.

NOGUCHI: Thank you. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

Leila Fadel is a national correspondent for NPR based in Los Angeles, covering issues of culture, diversity, and race.
Yuki Noguchi is a correspondent on the Science Desk based out of NPR's headquarters in Washington, D.C. She started covering consumer health in the midst of the pandemic, reporting on everything from vaccination and racial inequities in access to health, to cancer care, obesity and mental health.