The loss of Roe complicates Biden’s plan for safer pregnancies

Climate change, deficit reduction and Medicare reform were the headline achievements of President Biden’s landmark Inflation Reduction Act which the president has called “one of the most significant laws in our history.” Many experts say it will play a significant role in addressing a number of important health and environmental matters facing the nation that have been neglected for far too long. 

Passage of this law now brings renewed hope to Biden’s broader legislative agenda, especially in the field of public health. Part of that push involves an effort by the administration to tackle an issue that for years has disproportionately affected women, especially those of color: maternal mortality. Biden should be commended for focusing energy and federal resources to address it — but timing is everything, as they say, and Biden’s attempt to improve maternal health in America could not have come at a worse moment.

The Biden administration recently released a 70-page plan to improve access to health care and address the health disparities of women of color across the country.  Among its many provisions, the plan seeks to expand the number of health care providers, improve coverage of high-quality care and provide greater social service support for women. 

“We imagine a future where every person in this country can have a safe, dignified pregnancy and birth,” the report states, “and where equitable access to health care before, during and after pregnancy is assured.”

If you thought maternal mortality has declined in recent years thanks to advancements in modern medicine, think again. A Century Foundation analysis of 2020 data from the U.S. Centers for Disease Control and Prevention (CDC) found that maternal mortality is climbing in the United States, outpacing our closest industrialized nation (France) by nearly threefold. Black women are three times as likely to die from maternal-related issues as white women, and Hispanic women experienced a 44 percent spike in maternal mortality from 2019-2020.  

It’s a growing crisis that has demanded attention for decades. But because of the Supreme Court’s decision to overturn Roe vs Wade, the problem is all but certain to continue despite Biden’s ambition to fix it. 

That’s because the availability of women’s health care professionals, which is already declining across the country, is expected to drop significantly in states that have enacted laws to ban abortion in the wake of the court’s decision. Nearly half of the OBGYN workforce resides in states that are restricting abortion, and many young OBGYNs are considering leaving to practice in states where abortion rights remain. This will only amplify the current shortage of women’s health care providers and hinder access to family planning, prenatal and postpartum health services and care for women in half the states across America — the very people Biden’s maternal health initiative seeks to help.  

There is a sad irony to it all; just when we finally see leadership from the White House confront a climbing public health threat that has disproportionately impacted women of color for years, the fallout from a politicized Supreme Court decision will make it infinitely more difficult to accomplish. What’s more, any future court action that seeks to advance Supreme Court Justice Clarence Thomas’ desire to overturn contraceptive access would make the current problem even worse.  

If the White House is committed to reversing the widening maternal mortality rate, it must first lead a federal legislative effort to protect contraceptive access and abortion rights. The U.S. House has moved to codify both rights — now the U.S. Senate must act and do the same. Biden must also designate funding and develop an operational plan to execute his 70-page initiative. Unless these things happen, Biden’s goal of having a positive and lasting impact on improving the health of women across the country has little hope of succeeding.  

Doing so will not only preserve a women’s right to choose. It will balance the availability of women’s healthcare professionals and services in states around the country. It will reduce the number of unwanted pregnancies — including those that present complications and end in fatality for the mother. It will pave the way for more equitable access to healthcare services for pregnant women of all races.   

And it will help improve public health for women everywhere by giving Biden’s plan to save lives a chance to work.  

Lyndon Haviland, DrPH, MPH, is a distinguished scholar at the CUNY School of Public Health and Health Policy.