Maternal and reproductive health are dominant topics on the minds of experts and women’s advocates across the United States, especially in the months following the U.S. Supreme Court's Dobbs v. Jackson decision.
Concerns over how the health care system in the U.S. cares for women, systemic racial inequalities, political effects on reproductive healthcare access and the quality of sex education have only deepened since the court ruled that abortion is not a constitutional right.
Maternal mortality
For example, the Centers for Disease Control and Prevention has said that maternal mortality — the death of a woman while pregnant or within 42 days of termination of pregnancy — is one of its leading health concerns.
Between 2018 and 2021, maternal mortality nearly doubled, according to a report fromGender Equity Policy Institute.
The University of Texas Rio Grande Valley was recently awarded a $2.3 million grant for a maternal health research center. The UTRGV School of Medicine will be among 16 institutions serving minority populations to research maternal health.
Dr. Candance Robledo, associate professor and principal investigator, said there is a need for maternal health research in her region, particularly when it can improve the health of Latinas, Black women and other people of color.
“When you look at, you know, who is most impacted and what communities are most impacted by high maternal mortality, morbidity rates they tend to be communities of color,” she said.
Red flags in the RGV and surrounding areas, which the Texas Department of State Health Services refers to as Texas Public Health Region 11, include the teen birth rates, the lack of access for women to receive maternal health care and the rates of postpartum depression, Robledo explained.
The project is planned for five years, and this first year is focused on connecting with organizations.
Racial inequality
Racial disparities in the quality of maternal and reproductive health care are top of mind for leading activists and health experts. Part of that awareness is an appreciation of the historical legacy they have inherited.
Christian F. Nunes, the president of theNational Organization for Women (NOW), is the youngest president in the organization's history and the second Black president. The first was Eileen Hernandez, one of the group's co-founders, who served in the 1970s.
Nunes said that recognizing the contribution women of color had on the feminist movement, as well as understanding their struggles in healthcare, were her goals when she became president.
“I feel like there’s racial inequality, there is discrimination. There is lack of access,” Nunes said. “We always talk about equality, equality, equality, but you cannot have equality if you do not have equity.”
Policy effects
The Supreme Court decision has cast a long shadow over physicians too.
According to a national survey conducted by KFF in 2023, one in five office-based OBGYN’s said they felt constraints on providing care for pregnancy related care since abortion bans or restrictions went into effect.
Political decisions and court rulings can resonate deeply and widely throughout personal health care experiences. When combined with systemic racial inequities, those effects are intensified.
Resound Research for Reproductive Health brought researchers together to study impacts policy and legislation has on reproductive health.
Kari White, executive and scientific director at Resound Research for Reproductive Health, looked at the different impacts policies have on access to reproductive healthcare, including abortion, contraception and pregnancy related care.
“It’s important that people are able to make a decision that is consistent with their values,” she said. "But I think it’s important to know that abortion care is very safe.”
Structural racism and interpersonal racial bias play a part in high maternal mortality in Black women, White added. Lower income communities in Texas who are disproportionately Black and Latina women, struggle with access to maternal healthcare, she added.
In 2023, the Texas Legislature passed House Bill 12, which expanded Medicaid healthcare coverage to 12 months following pregnancy. White said she was hopeful to see improvements in both maternal mortality and morbidity in the Latina and Black communities because of the expanded coverage.
“We’ve yet to see any results in the state from that expansion, but evidence from other places that have made that policy change — there is some evidence that will improve maternal health outcomes,” she added.
Young women of San Antonio
But despite the challenges, many women have taken the initiative in preparing themselves and each other for the post-Dobbs world and the challenges it may pose to the quality of their maternal and reproductive health care. They're also aware of how these political and legal decisions may impact the quality of sex education their peers may receive in school.
For example, Breanna Jimenez, a senior at East Central High School, is a part ofGirls Inc. of San Antonio, a non-profit organization aimed to educate young women about health, well-being, and development. Jimenez has attended Girls Inc. since sixth grade, and she has become focused on sexual education advocacy, especially since the Dobbs decision.
“It’s hard as both a woman and then just in like, my high school environment, it’s a far more prevalent issue than you would think,” Jimenez explained. “I don’t want to say scary, but it is disheartening to see that at the state level, women are not being taken care of.”
Audrie Torres, a junior at Centers for Applied Science and Technology Med High School (CAST Med), is an intern at UT Health Science Center, and she advocates for minority populations involving health. Recently, Torres has become more educated on health-related policy issues.
“From a state-level, it’s like we are being stripped of these things, having access to abortion and sexual health and comprehensive sex education,” she explained. “It really is important for us young girls to learn about this but it’s also for us to learn about it in a way of where it’s not discouraging us.”
Torres and Jimenez said they feel there is a gap in sex education, and their peers aren’t as knowledgeable on issues that affect them. Torres said she is realizing how the lack of access is causing lack of education among her peers.
“That just starts a slew of problems because at the foundation level you’re lacking the education on your own autonomy, contraception methods, what healthy relationships look like,” Jimenez said. “Sex is going to happen regardless, but it’s knowing what, like clinics are available to you, what birth control options are available, contraception methods, and it starts at this level.”
Gabriella Alcorta-Solorio is a health reporting intern for Texas Public Radio in collaboration with Texas Community Health News through Texas State University's School of Journalism and Mass Communication and the university’s Translational Health Research Center.
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