In early July 2022, a 10-year-old rape victim in Ohio crossed into Indiana, in hopes of receiving an emergency abortion. This quickly caught the attention of the news and sparked discussion among the American people about whether she should carry the pregnancy to full term. Following the overturning of Roe v. Wade, a law that recognized legal abortion as a constitutional right, cases of this nature have sparked mass upset over the lack of women’s bodily autonomy in the United States. The New York Times article, What Pregnancy and Childbirth Do to the Bodies of Young Girls, details the brutal implications of childbirth on young female bodies [1]. In the article, Dr. Ashkok Dyalchand, who works with pregnant, low-income adolescents in India, states the critical issue is that “the pelvis of a child is too small to allow passage of even a small fetus.” Here in the U.S. in 2017, 4,460 pregnancies in girls under 15 were recorded, with roughly half resulting in an abortion. When access to safe abortion is eliminated, the lives and well-being of young girls and women are put at risk. This act of control against women is a clear form of structural violence, and those of other minority racial or socioeconomic statuses will experience greater barriers.
What were the effects of Roe v. Wade being overturned:
The U.S. Supreme Court’s overturning of Roe v. Wade has made it significantly more difficult for women with few resources to access safe abortions. Since June 24, 2022, in Dobbs v. Jackson Women’s Health Organization, 14 states have near-total abortion bans at any point in pregnancy: Alabama, Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, West Virginia, and Wisconsin [2]. While all states ostensibly have exceptions when the patient’s health is in danger, the vagueness of the law’s language has caused delays in medical care, leading to near-death experiences. These abortion bans have disproportionate effects on marginalized populations with increased challenges with access. Liza Fuentes, a senior research scientist, at Guttmacher Institute, a sexual and reproductive health research organization, says that the impact of overturning Roe v. Wade “falls hardest on those who already struggle to access health care and face interlocking systems of oppression” [3]. Due to the federal Hyde Amendment, which prohibits the use of federal funding for abortion services with few exceptions, low-income people are further restricted. Millions of women enrolled in Medicaid do not receive abortion coverage and are forced to carry the pregnancy to term [2]. The intersectionality of marginalized identities compounds barriers to access, with 1 in 3 adults under age 65 on Medicaid having a disability. The Hyde restriction disproportionately prevents low-income people with disabilities from accessing abortions, a prime example of the part intersectionality of identities plays in abortion care.
What is intersectionality and why it is important:
Intersectionality occurs when race, gender, class, and socioeconomic status overlap to intensify systematic discrimination. In her article, Demarginalizing the Intersection of Race and Sex feminist advocate and scholar on critical race theory, Kimberlé Crenshaw uses the analogy of traffic through an intersection to describe how discrimination can compound in multiple identities. The intersectionality of identities increases the risk of being a target of discrimination. An accident in her metaphorical intersection can be caused by cars traveling from multiple directions. If a Black woman is injured in the intersection, “her injury could result from sex discrimination or race discrimination” [4]. This could manifest as the denial of a job or not being respected by peers. This concept applies to adolescent pregnancies, where young girls are already the victims of systemic sexism. When this identity is intertwined with a racial minority status or underprivileged socioeconomic status, it puts young women at a significant disadvantage. It has been reported that “adolescents of color and those who live in underserved communities [are] more likely to become pregnant during their teen years” [4]. They are also at a higher risk of pregnancy than more well-educated, racially privileged individuals to “experience negative health and social consequences of pregnancy” [5]. With a higher likelihood of getting pregnant, girls from a minority population are more likely to experience medical gaslighting by their doctors or be shamed into carrying the pregnancy to full term, despite the brutal effects on their bodies. A 2014 evaluation published in the Journal of Neonatal-Perinatal Medicine stated that young maternal age is associated with an “increased risk of maternal anemia, infections, eclampsia and pre-eclampsia, emergency cesarean delivery and postpartum depression” [1]. This can stem from the stigma surrounding abortions or the belief that young girls are not mature enough to have bodily autonomy. Abortion and pregnancy are already predominantly women’s issues, and the addition of further societal prejudices in the form of racial, health, and economic disparities only magnifies the struggle for women who are attempting to terminate a pregnancy.
What is structural violence:
While intersectionality refers to the struggles of the individual, structural violence relates to the individual’s struggle within a prejudiced society. Structural violence encompasses disparities in everyday life, ranging from racism and sexism to targeted homicides and community violence [6]. According to a study in South and West Chicago, girls exposed to “higher levels of community violence have an increased likelihood of experiencing [intercourse] without contraception and teenage pregnancy” [7]. In short, women in these communities are more likely to become pregnant at a young age.
What are the financial barriers:
Further, adolescent girls may face challenges accessing the financial resources necessary for abortion clinic fees or traveling to a different state for the operation. Traveling for an abortion is a privilege —these families may lack the financial means or work flexibility to do so. In New York Times’ author Allison McCann’s analysis of the costs of abortions, she breaks down the costs for 9 patients. Patient ‘A’ traveled from Idaho to Washington in her second trimester with her partner and two children for an abortion. With the procedure cost, travel, hotel, food, etc. the total came to $4,884 [8]. This exorbitant cost is unfeasible for many women, even with the lowest patient cost of Patient ‘C’ at $1,321. For young women with limited access to health care due to high costs, this can render necessary procedures unattainable. Additionally, the stark contrast in poverty rates between Black and Hispanic groups compared to white groups creates a cycle of disadvantage, adding barriers to resources and access. According to the 2019 United States Census Bureau report, the poverty rate was 18.8% for the Black demographic and 15.7% for the Hispanic demographic compared to the 8.6% poverty rate for the white demographic [9]. This pronounced disparity puts safe abortions out of reach for many low-income young women. Those without access to healthcare and a clinical provider are more likely to resort to unsafe practices to terminate their pregnancy, putting their physical well-being at risk [3].
Conclusion:
The overturning of Roe v. Wade has elucidated and underlined the marginalization and mistreatment of women in America. Revoking women’s reproductive rights not only leads to more unwanted pregnancies but also disproportionately affects those living in communities with higher rates of violence. This heightens the likelihood of adolescent pregnancies and exacerbates structural violence against women. With a legal system so blatantly skewed against women’s needs, we must reevaluate the fundamental values that form the foundation of our country.
Editors Notes:
llustration by Iris Ren ’27. Ren is a Computer Science major and is currently the Chief Content Creator of BU Graphic Medicine Club*.
*Graphic Medicine Club (GMC) as a student-led organization at Boston University has provided a dedicated platform for students, artists, authors, and healthcare professionals to connect and engage with the broader graphic medicine community. Existing pre-health-related student organizations tend to focus on providing students with medical certifications and guest speaker lectures, but it is also important for future healthcare providers to understand patient perspectives outside the scientific or medical perspective. By exposing students to the shared experiences of patients and healthcare providers who live within the medical system, GMC provides a humanistic lens that is often overlooked in healthcare training.