As soon as I found out I was pregnant, I knew I wanted an abortion. The immediate decision didn’t come from fear or confusion; it came from clarity. I was too sick to work, constantly running out of my classes to throw up and juggling multiple jobs to stay afloat. Behind all of that was a mental health battle I’d been quietly fighting for years, and I didn’t have access to the support I needed. There was no way I could carry this pregnancy to term—and, more importantly, I didn’t want to. It was my body. It was my life, and I made my decision. It really should have been that simple. But almost immediately, I learned how hard it was to access abortion care.
This is America, after all — where racist, sexist policies are so deeply embedded into our institutions that they shape who gets access to essential care and who gets left behind. And for folks most impacted by systemic inequities—like disparities in income, health insurance and medical racism—no one is facing the brunt of these bans and restrictions like Black women. We’re already more likely to die from pregnancy-related causes or suffer physical and mental health complications. Forcing us to carry a pregnancy to term isn’t just a denial of our rights—it’s a direct threat to our lives.
Because of the abortion restrictions in my state at the time—and a deeply hostile access landscape—getting my abortion turned into a lengthy, complicated process. My appointments had to be split into two parts: the first was “options counseling,” and the second was the actual procedure. On top of that, there was a mandatory 24-hour waiting period between visits. I was attending school in a very rural part of Ohio, an hour and a half from the nearest abortion clinic and three hours from my hometown. I didn’t have a car and was too sick to drive anyway. I was at everyone’s mercy to get to my appointments. I felt complete desperation and helplessness.
By the time I sat down in the clinic for my abortion, it had been an entire month since I first sought care, and I was exhausted. It was thirteen weeks of vomiting, sleepless nights and the slow, glooming dread that I might not make it through this. I hadn’t kept down a full meal in weeks. I couldn’t even hold down my morning coffee, and I couldn’t imagine being pregnant for one more day. I just wanted out of my body. When the procedure was finally over, I was the most grateful I’d ever felt. I could’ve kissed the ground because my future had been returned to me.
Like so many others across the country, I was living in one of the many states actively determined to ban or restrict our reproductive rights—a human rights offense that disproportionately impacts Black women and birthing people. More than 57% of Black women—roughly 7 million of reproductive age—live in states with abortion bans or severe restrictions. Horrifically, many of these same states also report some of the highest maternal mortality rates in the country. In my home state of Ohio, a 2023 study showed that Black women are five times more likely to die from pregnancy-related causes than women in other states.
Let that sink in: Five times more likely to die.
What’s more, states with restrictive abortion laws are more likely to be maternity care deserts with fewer maternity care resources, weaker Medicaid coverage, fewer clinics and less access to OB/GYNs. These combined factors create a terrifying container for the Black maternal health crisis in America. Nationally, Black women and birthing people are three times more likely to die from pregnancy-related causes than white women, according to the CDC. Why? Not because of biology—but because of systematic racism. These outcomes are driven by income disparities, medical bias and insurance gaps. The message is devastatingly clear: Black women cannot afford to be denied abortion care.
This is America, after all — where racist, sexist policies are so deeply embedded into our institutions that they shape who gets access to essential care and who gets left behind.
These bans have immediate, deadly consequences for Black women and our families.
In August of 2022, Amber Nicole Thurman, a 28-year-old student and mother, died in Georgia after being denied a simple dilation and curettage (D&C) procedure that would have saved her life. A D&C is a routine procedure used in both abortion and miscarriage care. Doctors watched her health deteriorate for 20 hours. Twenty hours of fear and hesitation because Georgia’s new felony laws made them too afraid of being prosecuted. When they finally intervened, it was too late.
Just a few months later, another Georgia mother, Candi Miller, died in November 2022—also unable to access safe abortion care due to Georgia’s criminalization of D&Cs. She was denied abortion care and denied dignity. Denied life. Legal access to D&Cs has saved countless lives since Roe v. Wade was decided in 1973. In fact, studies show that the maternal mortality rate for women of color dropped by up to 40% in the year following legalization.
These stories have deeply impacted me because I see myself in them; I see my friends and my family. These women deserved to live, and they deserved compassion, care and agency. When we’re forced to carry pregnancies, we suffer—physically, mentally, financially. Our families suffer, too. The ripple effects are enormous. So, how can we address this? There’s no single answer, but a crucial part of addressing Black maternal health inequity is abortion justice.
“We can’t talk about improving maternal health outcomes for Black women and birthing people without confronting the relentless attacks on abortion access,” says Nourbese Flint, President of All* Above All, a policy organization advancing maternal health equity through abortion justice. “These aren’t just political tactics—they’re racist, classist policies that uphold systems of control and deny us agency over our bodies and our futures.”
Abortion justice—an approach that goes beyond legality—envisions “a world where care is there for everyone who needs it, without barriers based on who you are, where you live, or how much you earn.” That means real access, no questions asked. No traveling across state lines. No fear of prosecution. No trying to decipher legal jargon. No dying because of delayed or denied healthcare—just care.
Centering us means building systems that honor our autonomy, trust our decisions, and make space for us to lead—not just during Black Maternal Health Week, but every single day.
When we can live self-determined lives, we can truly thrive. For me, my abortions gave me the power to determine my future. They allowed me to continue my education and keep the jobs that helped me stay in school. They gave me the space and resources to heal, access mental health care, and, ultimately, escape poverty. Now, I’m in a position to support myself—and even my family when needed. I’m an awesome big sister, granddaughter and friend, and I am able to hold space for those I love. These are the titles I cherish. They’re what I need to live a meaningful, healthy life and to give life if I decide to.
In an effort to advance abortion justice as a solution, All* Above All launched the Abortion Justice Playbook—a roadmap to improving maternal health equity through the lens of abortion access. “It’s about transforming the systems that are failing Black communities,” says Flint. “The Playbook gives advocates, organizers, and policymakers the tools to connect the dots between abortion access and maternal health equity.”
And let’s be clear: Black women and birthing people must be the center of this movement—not just represented, but resourced. Not just heard but trusted. As we continue working toward equitable maternal health outcomes, we need to be at the front, the center and all sides of the discussion. The conversations must start with our voices, not just include them.
“Centering Black women and birthing people starts with power—not just presence,” Flint reminds us. “It means resourcing Black-led work, listening to our lived experiences, and ensuring that policies are shaped by our realities—not political compromise. Centering us means building systems that honor our autonomy, trust our decisions, and make space for us to lead—not just during Black Maternal Health Week, but every single day.”
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