United States: A pressing crisis has emerged as a surge in the deaths of Black infants across the US South is linked to abortion bans and systemic healthcare shortcomings.
The recent ruling on the South Carolina abortion ban exacerbates an already critical situation, as several southern states have implemented or legalized abortion bans within their jurisdictions.
The rise in the number of deaths among Black infants and mothers in states like South Carolina and Georgia within the US Deep South has raised national alarms. Data obtained by KFF Health News from South Carolina’s state health department revealed alarming statistics from Orangeburg County, where the infant mortality rate in 2021 hit a 50-year high since 1970. Among the 17 infants who died in Orangeburg that year, one was Black, a concerning revelation reported by USA Today.
Similar distressing patterns prevail in other states. For instance, in states like Kansas, Arizona, and Wisconsin, the mortality rate among Black infants is more than double that of white infants. Shockingly, Flint, Michigan, predominantly inhabited by Black residents, recorded an infant mortality rate surpassing any Southern state in 2021.
The impact of the SC 2022 abortion ban on Black American lives has been deeply concerning. Since the Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization, allowing state legislatures to impose abortion bans, many states have enacted stringent policies. Over half of all Black Americans residing in the South face some of the nation’s strictest abortion laws, with preliminary data suggesting adverse effects on Black women and infants, as per USA Today.
KFF data highlights that 42 percent of reported abortions in the US were obtained by Black women in 2021, surpassing other racial groups. Furthermore, a KFF survey among 569 OB-GYNs this year revealed that the Dobbs decision exacerbated pregnancy-related mortality, aggravating racial and ethnic disparities in maternal health.
Reports from USA Today suggest a rise in birth rates in states with abortion bans or restrictions post the Dobbs ruling. However, these state-level bans are poised to be particularly detrimental to Black women and children, who face higher risks of mortality before, during, and after childbirth compared to their white counterparts.
Most states are yet to release infant and maternal death data reflecting the Dobbs decision’s impact. Nonetheless, maternal health experts remain pessimistic about the outlook. Kelli Parker from the Women’s Rights and Empowerment Network expressed profound concern, emphasizing the unique adverse impact of such legislation on women of color and historically marginalized groups.
State-specific mortality data underscores the grim reality. In Texas, statistics from the Department of State Health Services revealed a notable increase in infant deaths following the passing of a six-week abortion ban in 2021. Disturbingly, Black infants in Texas die at more than double the rate of white infants.
South Carolina’s Supreme Court upheld an abortion ban linked to detecting fetal cardiac activity. This ban has resulted in non-Hispanic Black infants being over twice as likely to die within their first year compared to non-Hispanic white infants. The state has seen a staggering 40 percent increase in Black infant mortality from 2017 to 2021. Additionally, non-Hispanic Black women in South Carolina experienced a 67 percent higher pregnancy-related mortality ratio compared to their white counterparts in 2018 and 2019, as reported by USA Today.
The reasons behind the elevated mortality rates in the Deep South are complex. While the Dobbs ruling plays a role, public health experts point to numerous factors, including the closure of rural hospitals, inadequate healthcare access with a scarcity of doctors and midwives, pervasive obesity and chronic diseases, and the reluctance of several states to expand Medicaid under the Affordable Care Act. The intersection of poverty and structural racism within the healthcare system is also blamed for the deaths of Black women and their infants.
Disturbingly, Black patients have consistently reported various biases in their healthcare experiences. The KFF survey this week revealed complaints from Black patients, citing assumptions made by healthcare providers without inquiry, attributing personal fault for health problems, disregarding direct requests or questions, and refusal to prescribe necessary pain medication.
Efforts to address these distressing health outcomes are underway. Researchers are striving to identify solutions to enhance health outcomes for mothers and infants in the South. The National Institutes of Health granted a $16.5 million grant to Ochsner Health and its partners to establish the Southern Center for Maternal Health Equity, focusing on Louisiana’s high maternal mortality rates. The research aims to devise ways to provide healthcare in rural areas lacking hospitals and high-risk specialists, with a focus on disproportionately affected Black pregnant women.
The Medicaid program, a critical children’s health insurance initiative, offers coverage to families with children through the US Department of Health and Human Services. Eligible women are covered for 12 months postpartum. However, many childless women in Southern states remain ineligible for this low-income health insurance program until pregnancy, as several Deep South state lawmakers have refrained from expanding access to Medicaid under the Affordable Care Act.
Healthcare policy experts stress the importance of extending Medicaid coverage to women before and between pregnancies to mitigate the burdens posed by obesity, diabetes, and hypertension, reducing risks to women and infants. John Simpkins from the nonprofit MDC in North Carolina highlighted the necessity of monitoring long-term improvements, acknowledging that achieving success will be gradual and require interventions starting with newborns, following through adulthood, and possibly their subsequent generations. While Medicaid expansion could uplift families from poverty, its full benefits might take a generation to materialize, emphasizing the need for sustained efforts to attain enduring improvements in population health.