Reproductive Justice: A Legacy of Control and the Fight for Maternal Equity
"Deeply rooted within our nation's history and traditions." These words, penned by Justice Samuel Alito in overturning Roe v. Wade, challenge us to examine the foundation of rights in America. The 14th Amendment, a cornerstone of Reconstruction, prohibits states from depriving "any person of life, liberty, or property without due process of law." This amendment has served as the legal basis for fundamental rights including voting, contraception, and marriage equality. It defines the scope of liberty protected by our Constitution.
But what does it mean for a right to exist only if "deeply rooted within our nation's history and traditions"? This standard poses an existential challenge to our democracy, particularly for those historically denied these freedoms. The rights "deeply rooted" in our traditions have predominantly belonged to landowning white men—a historical reality that shapes our present. As society evolves, so too must our understanding of rights, exemplified by shifting attitudes toward same-sex marriage, which saw public support rise from 35% in 2001 to 61% in 2019 according to Pew Research.
The erosion of reproductive rights didn't happen overnight. In John Green's words, it occurred "Slowly, and then all at once." The fall of Roe represents the culmination of a decades-long conservative project to roll back civil rights gains. Black women, having long recognized the precariousness of these rights, were least surprised by this development.
Personal Journey and Professional Insight
My path into reproductive justice began in medical school. Despite degrees from MIT and Harvard culminating in an MD-PhD, my choice to specialize in obstetrics was met with skepticism—reflecting broader societal undervaluation of women's health, particularly Black women's health. During my residency, I witnessed firsthand the disparities in maternal healthcare. As a Black physician, I experienced institutional discrimination that deepened my commitment to addressing these systemic failures.
The birth of my twins, Yonas and Yohanna, transformed my professional mission into a personal crusade. Despite the joy of their impending arrival, I felt a profound dread during their ultrasound, knowing the stark statistics: Black women face maternal mortality rates 3-4 times higher than white women, according to CDC data. Even more troubling, educated Black women face mortality rates 5.2 times higher than their white counterparts.
Historical Context and Systemic Control
The history of reproductive rights in America is inextricably linked to the control of Black women's bodies. American slavery uniquely commodified Black women's reproductive capacity, particularly after the 1808 ban on international slave trade. The concept of "natal alienation," coined by Orlando Patterson, describes the brutal severing of familial and cultural ties that enabled the transformation of humans into commodities.
The exploitation of enslaved women took many forms, from forced labor during pregnancy to sexual abuse. The legal system codified this abuse; the 1859 Georgia v. State case exemplified how rape laws excluded Black women from protection. These historical injustices laid the groundwork for enduring inequalities in reproductive healthcare and societal attitudes toward Black motherhood.
Modern Implications and the Path Forward
Today's maternal health crisis reflects this historical legacy. The United States maintains the highest maternal mortality rates in the developed world, with Black women bearing a disproportionate burden. The COVID-19 pandemic exacerbated these disparities, leading to a 33% increase in maternal mortality rates.
The Reproductive Justice Framework offers a comprehensive approach to addressing these challenges through four key tenets:
The right not to have children
The right to have children
The right to parent in safe, healthy environments
The right to sexual autonomy and gender freedom
Contemporary challenges—including debates over medication abortion access, fetal personhood amendments, and restrictive legislation—require urgent action. The fight for reproductive justice demands a maternal equity framework that acknowledges historical context while pursuing innovative solutions.
Conclusion
The struggle for reproductive rights and maternal equity continues, illuminated by both historical injustices and ongoing disparities. Success requires understanding the complex interplay of medical racism, economic inequality, and systemic discrimination. As we face new challenges in reproductive healthcare access, the resilience and advocacy of Black women light the path forward. Their historical role as democracy's defenders, coupled with their achievements in education and entrepreneurship, offers hope for transformative change.
The fight for reproductive justice is not merely about preserving rights—it's about creating a future where all women, particularly Black women, can access the care they need to not just survive pregnancy and childbirth, but to thrive as mothers and individuals. This mission requires collective action, informed advocacy, and unwavering commitment to addressing the systemic barriers that have for too long determined health outcomes based on race and class.