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For many people of color, Roe v. Wade was always in jeopardy.

Fresno resident Amalia Moreno wasn’t surprised when she heard last week that the Supreme Court had prepared a ruling that would overturn the landmark court case guaranteeing abortion rights. She obtained an abortion when she was 18, but worried that others wouldn’t have that choice whenever she saw anti-abortion protestors show up outside a women’s clinic in Fresno.

“It was a reminder to me that there were forces out there, working and chipping away, waiting for the right moment. And now that moment is here,” says Moreno, an office administrator for a legal firm.

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The leaked draft of the Supreme Court ruling, written by Justice Samuel Alito, finds that: “the Constitution makes no reference to abortion, and no such right is implicitly protected by any constitutional provision.”

The document takes on complex issues of constitutional law, pores over historical antecedents and considers the point at which a fetus could survive outside the womb. What the analysis does not do is consider the sanctity of life of the impregnated person.

“Women have always been second-class citizens and more so if you’re a Latina or a Black woman, then you’re probably a third-class citizen,” says Moreno, whose parents were Mexican immigrants.

Abortion has always been an emotionally charged topic, but it is intrinsically a health care issue and should be discussed as such. Statistics show that gender health disparities exist, with inequities being particularly pronounced among Black women and in geographic areas where health care options are limited. For example, women are more likely than men to suffer from arthritis, asthma, respiratory disease and kidney disease. Those disparities are widest in Southern states (where abortions are more restricted) and lowest in Northeastern states, according to a 2017 study by the Milken Institute.

It’s not difficult to see how health inequities would worsen if abortions are banned.

Before Roe v. Wade, women died from illegal abortions. In New York City in the early 1960s, one in four childbirth-related deaths among white women were due to illegal abortions, while the rate was one in two for Puerto Rican and nonwhite women, according to the Guttmacher Institute.

“Maternal mortality rates are a key indicator of the health and well-being of a society,” The Commonwealth Fund states in its report on maternal mortality and morbidity.

If that’s the case, then U.S. society is in peril. The United States has the highest maternal mortality rate among high-income countries in the world. Health outcomes are particularly disastrous for Black women, whose rates of maternal mortality are three times as high as those for white women. These deaths are primarily the result of hemorrhage, hypertension and infections — deaths that are often preventable. Several health organizations say systemic racism is a key reason for Black maternal mortality.

Though Latinas fare much better when it comes to maternal mortality, they face many hurdles in obtaining affordable, accessible health care, even in California.

In March, Planned Parenthood lost a bid to move into a bigger facility in Visalia, a city in the agricultural heart of the San Joaquin Valley where more than half the population is Latino. Community health advocates said such a facility is needed because a Planned Parenthood in Visalia is always crowded with patients, but anti-abortion protestors fought the expansion even though abortions are not offered at the Visalia offices.

The current health center “has one exam room that’s very tiny. It’s open three days a week, so we’re not really able to see the patient volume that the area needs,” said Lauren Babb, public relations vice president of Planned Parenthood Mar Monte, the largest affiliate in the country.

Expanded medical offices would have allowed Planned Parenthood to offer primary care services in an area that has approximately one doctor per every 2,000 residents, Babb said.

Planned Parenthood Affiliates of California plans to launch a “Powered by Pink” bus tour to educate communities in California about reproductive rights. The tour starts from a rally in Sacramento on May 14, one of more than three dozen rallies taking place statewide as part of a nationwide day of action to protest abortion bans.

Early this year, state Attorney General Rob Bonta issued a statewide alert clarifying that a pregnant person cannot be prosecuted in California for causing a miscarriage or stillbirth of that fetus.

“It would subject all women who suffer a pregnancy loss to the threat of criminal investigation and possible prosecution for murders,” wrote Bonta in an amicus curiae brief in support of a woman serving 11 years in prison for the stillborn death of her baby, allegedly caused by her use of methamphetamine. She was one of two Kings County women facing charges.

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Less than 1% of infant deaths in the United States during 2015-2017 were drug-related, according to a study by the National Center for Health Statistics. In contrast, about 10 out of 100 pregnancies result in a miscarriage.

On Tuesday, the attorney general was the lone man in a press conference where female legislators of color pledged to push forth legislation ensuring that California guarantees affordable access to abortion and other reproductive health services to residents and nonresidents. His wife, Assemblymember Mia Bonta, disclosed that she had an abortion upon graduating from Yale University when she was 21 and about to start her first job.

“I chose to get an abortion. I chose to own my body. I chose to make a decision to end the cycle of poverty in my family,” said Bonta, a Black Latina woman who met her husband at Yale.

Likewise, Moreno says she probably wouldn’t have been able to offer her daughter a healthy middle-class life if she hadn’t had an abortion when she was 18. She hoped her daughter wouldn’t be faced with the same decision if she obtained proper medical care.

“Mija, we cannot take our rights for granted. I’m not going to put my head in the sand and pretend that young people don’t have sex. All I ask is that you do so responsibly because the stakes are higher for us,” Moreno recalls telling her daughter. She advised her daughter to research all her options for birth control as soon as she became an adult.

At Tuesday’s event, Assemblymember Lori Wilson spoke about choosing to become a mom when she became pregnant as a teenager.

“Planned Parenthood afforded me the options, the opportunity to discuss all the different choices that were available to me,” Wilson said. “I felt great strength in knowing that I had the choice to decide what my future would look like. I know that I was a better mother, a stronger parent, because it was my choice and no one else’s, to have my baby.”

The female legislators of color at Tuesday’s event stood in stark contrast to most U.S. legislative bodies, representing a truer spectrum of California’s diverse population.

“Such a decision will have far-reaching and devastating consequences for our communities as it would deepen the already staggering inequities that persist,” said Onyenma Obiekea, a policy analyst at Black Women for Wellness.

Gov. Gavin Newsom promises to make California a sanctuary for anyone seeking an abortion and to fight to safeguard abortion rights in a revised state Constitution that would require voter approval. This week, he proposed a $125 million reproductive health package to expand access to abortion and other reproductive health care services. Thirteen bills are moving through the Legislature to advance reproductive health care in California, based on recommendations made by the California Future of Abortion Council, a coalition of more than 40 reproductive rights groups and advocates. Legislators say they will seek to add an urgency clause to some of those bills to ensure the state is ready if the Supreme Court does overturn Roe v. Wade.

Justice Alito complains in his decision that Roe abruptly ended the political process of allowing each state to craft its own abortion laws and “imposed the same highly restrictive regime on the entire Nation.”

However, such a regime doesn’t exist. Access to reproductive health care is spotty across the United States, often dependent on geography, even within states.

The results of limited health care access are revealing. Mississippi, the state that asked the Supreme Court to overturn Roe v. Wade, has the highest infant mortality rate in the country, according to the Centers for Disease Control and Prevention. California, which is seeking to become an abortion rights sanctuary, has the lowest infant mortality rate.

Tellingly, Alito cites a 1732 English case from a publication called Gentleman’s Magazine to establish what he states is the courts’ long tradition of treating abortion as a crime.

“In 1732, for example, Eleanor Beare was convicted of ‘destroying the Foetus in the Womb’ of another woman and ‘there-by causing her to miscarry.’ For that crime and another ‘misdemeanor’ Beare was sentenced to two days in the pillory and three year’s imprisonment.”

The Newgate Calendar publication describes Beare’s pillory punishment: “a shower of eggs, potatoes, turnips, &c. assailed her from every direction; and it was thought she would not be taken down alive. Having expended all the ammunition of the above description, stones were thrown, which wounded her to such a degree, that her blood streamed down the pillory.”

Despite tectonic advancement in scientific knowledge, the fate of women’s reproductive rights nearly 300 years later is dependent upon a case that ended in torture dating from the medieval ages.

We need to stay vigilant,” says Moreno, who said she has attended women’s marches and donated to Planned Parenthood. “We cannot go back in time. Too many lives are at stake.”

Crossposted from Capital & Main