We can’t talk abortion rights and ignore maternal mortality

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When Jamila Perritt stepped in front of a microphone and told the sign-wielding crowd in front of the Supreme Court she was an OB/GYN, they cheered. And when she told them she was an abortion provider in the city where they stood, they cheered louder.

“Thank you!” one person shouted.

Perritt, who became the president of Physicians for Reproductive Health in 2020, is just one of the many people who has spoken in front of that sacred building in the days since a leaked draft opinion let the country know that abortion rights are at risk. But as a Black woman who grew up in DC and now serves on its Maternal Mortality Review Committee, Perritt carried with her that day an intimate knowledge of the city where the Supreme Court will ultimately decide whether to overturn Roe v. Wade.

“Although I was not surprised,” Perritt told the crowd of the draft opinion, “as a provider of abortion care in the city that I grew up in, in the place that I love, I know that this ruling, should it move forward , will deeply impact the community that I was raised in and the people that I care for.”

For Perritt, the issue is about people, not politics, and that’s what she most wanted to convey to demonstrators, she told me afterward.

“We’re not talking about legal theory and political theater,” she said. “We’re talking about real people who are making decisions about if, when and how to build their families, who deserve an opportunity to do so without political interference. It’s liberty. It’s justice. That’s what’s at stake here.”

It is not lost on Perritt that the country’s abortion rights will be decided in a city that has one of the most troubling maternal mortality rates for Black people — and why that matters.

The city’s Maternal Mortality Review Committee was created in 2018 after DC Council member Charles Allen (D-Ward 6) wrote a bill aimed at examining what he and others described as the city’s “maternal health crisis.” At the time, the nation had the highest maternal mortality rate of any wealthy country, and the District’s maternal mortality rate was more than double the nation’s. Both sets of data also reflected wide gaps between the deaths of White and Black people. In the District, among the maternal deaths recorded between 2014 and 2016, 75 percent were of Black women.

At that time, I wrote a column under the headline, “Why Washington is one of the worst places to be Black and pregnant.” In it, I shared the stories of Black women who had devastating birth experiences and explained why racial disparities in maternal health couldn’t simply be dismissed as an issue of economics or education: Studies have found that lifelong exposure to racism places Black women at a health disadvantage even before they become pregnant, and it can contribute later to pregnancy complications and premature births.

Why Washington is one of the worst places to be black and pregnant

In another column, I wrote about a 15-year-old girl in DC who hid her pregnancy and then ended up at a Washington hospital with a severe case of strep throat. Doctors couldn’t stop the infection. When the baby was born at 31 weeks, the teenager was brain dead and then taken off life support.

Pregnancy does not come without risks, which is why we cannot talk about forcing people to remain pregnant without also talking about the country’s abysmal record on maternal mortality.

We cannot pretend that Black people and other people of color who become pregnant — and then are forced to remain so — aren’t more likely to die than White people who become pregnant.

We cannot pretend that we’re only talking about a fetus when we’re discussing access, or lack of, to reproductive health care.

The stakes are not evenly spread across people who become pregnant, and if the Supreme Court justices need a reminder of that, they don’t have to look far. in to recent reportthe District’s Maternal Mortality Review Committee shared these findings: “While Black birthing people constitute roughly half of all births in DC, they account for 90% of all pregnancy-related deaths and 93% of pregnancy-associated, non-related deaths.”

The report went on to describe that number as existing in “stark contrast” with White people “who comprise about 30% of births but experienced no pregnancy-related deaths, and one pregnancy-associated, non-related death during 2014-2018.”

Let’s consider those findings for a moment. They tell us that in the city where the Supreme Court justices are going about their days, mulling over what protections pregnant people deserve, almost all the pregnant people dying are Black.

“When we look at the inequitable outcomes for Black women specifically, but lots of other communities as well, certainly Indigenous women, we see that the folks who are more likely to have complications around morbidity and mortality during a pregnancy and immediately in the postpartum period are also the same communities who are more likely to need access to abortion care,” Perritt said. “What that means is that these laws restricting access to abortions will disproportionately impact those communities. It’s the same folks. It’s people of color. It’s those living on low income. It’s undocumented communities, LGBTQ folks, young people.”

Perritt also expressed concern about how DC could be left uniquely vulnerable if the Supreme Court overturns Roe v. Wade, which the draft opinion authored by Justice Samuel A. Alito Jr. suggested was likely to occur. Because DC is not a state, it remains subject to oversight by Congress.

Officials worry about legal abortion in DC if GOP takes Congress

In recent days, Del. Eleanor Holmes Norton (DD.C.) and DC Mayor Muriel E. Bowser, along with other lawmakers and community members, have expressed concern that a Republican-controlled Congress could try to restrict or ban abortion in the nation’s capital as they renewed calls for DC to be granted statehood.

“I think folks believe we are a liberal city and that we will be able to be a bastion for our communities. But we have no home rule,” Perritt said. “Without the ability to make decisions about our budget, without the ability to make decisions about the health and well-being of our communities, we will fail. Access to abortion will fall in the District.”

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