By Judith G. Fales

Leaders from UB Jacobs School of Medicine, UB Baldy Center for Law and Social Policy, WNY Coalition for Reproductive Justice, UB Law School, UB Gender Institute, Erie County Department of Health, Buffalo Women Services, and WNY Coalition for Reproductive Justice recently discussed how laws, court decisions, and public health deficiencies result in poorer health care, especially for women of color.

According to WebMD, reproductive health justice requires the ability to control your own body, choose to have or not have children, how you will have children, and be able to care for your children in a healthy and safe community.

Loretta Ross, Smith College professor and co-creator of the theory of reproductive justice, discussed the implications of having each state make decisions regarding a woman’s reproductive choices, noting that since legislatures are 81% White and 71% male, the decisions often disproportionately harm women of color.

Dr. Sarah Berga, UB Professor and Chair of the Department of Obstetrics and Gynecology, said that allowing different states to decide women’s reproductive choices will impact physicians’ training and desire to practice in those states. For example, some state laws restrict gender-affirming care and limit prenatal genetic testing. As a result, Dr. Berga believes that OB-GYNs will be reluctant to practice in a state that restricts care, which will lead to reproductive care deserts where women will need to travel great distances to receive care. Lynn Paltrow, JD, founder of Pregnancy Justice, says some state laws will even impact women who will be subject to criminal prosecution for seeking care outside of their state.

The term reproductive justice was created in 1994 by Black women activists who felt they were not included in the reproductive rights movement. Professor Ross is committed to a 21st century of human rights, instead of war and violence, and to combatting our nation’s unequal distribution of health resources. She points out that maternal mortality has decreased 30% worldwide, but the U.S. ranks 55th worldwide. Also, Black mothers in New York state are 2.5 times more likely to die of, and less likely to be diagnosed and treated for, depression than White mothers. While New York ranks 4th best nationally for infant mortality, the U.S. ranks 50th worldwide. 5.6 deaths per 1,000 babies in WNY (higher than downstate).

The good news is that the use of midwives and doulas to perform deliveries, provide pre- and post-natal care, and emotional support has resulted in a nearly 53% decrease in caesarean sections. However, states that refuse to expand Medicaid have seen an increase in the disparity of care between the wealthy and poor, and a decrease in hospitals providing OB/GYN care.

Factors contributing to deficient care include lack of reliable public transportation, opposition to doulas, laws inhibiting free-standing birth centers, and racial inequities.

Everyone agreed that improved healthcare services for women of color requires an expansion of maternal care in primary care settings, and a well-functioning public health system to deter dependence on emergency departments.