As nationwide access to the vital abortion pill mifepristone hangs in the balance of federal courts, it's clear that abortion care is not just in the hands of state governments. And Black women will be the first to feel the consequences of further restrictions.
According to the CDC, Black women are three times more likely to die from childbirth than white women. Notably, the U.S. is infamous for having the highest maternal and infant mortality rates among high-income countries, despite spending the most on
"Health inequities are driven by social and economic factors all rooted in structural and systemic racism," says Childs. "This can look like Black women receiving poorer quality of care than white women. It can look like having less access to care as a whole due to insurance coverage gaps or medical deserts. It can even look like the denial of care due to medical racism. The list goes on."
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Black women put their lives on the line when they are pregnant; if abortion is banned in their state or if the Supreme Court takes the abortion pill mifepristone off the market, then Black women will have even less agency over their lives, says Childs. Eighteen states have already banned or severely restricted
"What does it mean when we take a marginalized group and further restrict access to care?" says Childs. "The reality is that these limitations on abortions won't be felt in great ways by those who are well-resourced and have white privilege in this country."
Childs says she believes that ending abortion care has less to do with familial and religious values, than it does with power and control over anyone who isn't cis, straight, white and male. She points to the anti-trans legislation that bans children from seeking gender-affirming care and criminalizes parents who try to help their children — it comes back to bodily autonomy.
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"It's about continuing to limit people's autonomy over their bodies because that gets to the core of people's identity," says Childs. "And that's a very scary thing."
However, that fear shouldn't stop employers, policymakers and voters from propelling into action. On the employer end, Childs believes that benefits leaders have a vital role to play in expanding maternal healthcare access. But they need to build benefits with Black women in mind.
"The best advice I could give is to design policies from the margins," says Childs. "Who is it hardest for to access these services? Every workplace policy, procedure and protocol should make sure that person can get the care they need."
For Childs, this means considering the PTO and finances a worker may need to receive an abortion out-of-state, not just for the treatment and travel but for child care arrangements as well, as — 60% of the women who seek abortions are already mothers.
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Childs notes that mental health care access and parental leave are also vital to ensuring families are prepared to welcome a new child to their family, if they choose to.
"Think holistically and comprehensively about maternal health," she says. "You'll lift up the entire employee community."
Makeeba McCreary is the president of the New Commonwealth Racial Equity and Social Justice Fund or NCF, which provides funding to nonprofits working to address systemic racism in healthcare, like Vital CxNs. On a policy level, McCreary encourages millennials and Gen Z to not only vote but consider running for office at the local, state and national levels.
"It's frankly disturbing to look at the white men legislating, when their decisions have nothing to do with my experience," says McCreary. The path forward is replacing those white bodies with Black, Brown and female bodies so you can vote for somebody who will actually represent the needs of your community."
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In the meantime, McCreary advises those with privilege and finances to offer their resources to community-focused organizations. While health equity cannot happen overnight, organizations like Vital CxNs are fighting to make it happen at the local level — and that's a start.
Between having little control over the decisions that come from the Supreme Court and feeling at a loss with state government leaders, Childs urges Americans not to lose hope. With lives at stake, she doesn't believe anyone can afford to give up.
"If you're losing that belief, then we're losing our footing," she says. "I operate from the firm belief that all inequities are the products of processes and system designs. They can be redesigned to create a different output."
