This essay holds an accumulation of pages that all aim to describe the significance of reproductive justice and why it remains an important and controversial issue today. This essay attempts to acknowledge the unequal access to reproductive healthcare, by describing the history of abortion, the access to abortion as it remains for minority women, eugenics, as well as a look into the structural racism that has plagued the healthcare system for decades disproportionately affecting Black women. 

In the United States Abortion has historically been illegal.  From the 1880s up until the decision of Roe. VS Wade, it was simply impossible for a woman to obtain a safe and legal abortion. Because of this, thousands of women wanting an abortion had no choice but to look to the underground abortion networks in an effort to get an illegal and often unsafe abortion.  Abortion access became even more strict in the early 1940s when many states chose to be in cooperation with the medical establishment, rapidly enforcing even harsher abortion laws and legislation across the country. Once again with many women having to seek illegal abortion, this movement only increased the amount of “back alley” abortions that were performed. Criminalization of abortion came in the early 1870s, when laws made it a federal crime for any doctor to perform an abortion. The effects of this criminalization and strict legislature can be seen in the literature writing in the National Library of Medicine:

 Abortion became criminalized in the US around 1870, yet many abortions were performed. While estimates for the yearly number of pre-Roe illegal abortions roughly resemble today's number of legal abortions, the difference between legal and illegal abortion rests in the difference between the large number of women who died or were injured then, and the very few women who now die from illegal abortions. Along with the self-induced abortion, different categories of providers performed illegal abortions: physicians, nonphysicians, nurses, midwives, and lay people; all with varying skill, experience, and motives (Joffe, 1991). 

With abortion now criminalized and underground abortion becoming even harder to access around the 1960s, the women's rights movement gained its support by millions of US women. movement one of the most powerful women's rights movements in our country's history. This movement spread fast throughout the country, making it one of the most powerful women's rights movements in our country's history.  Although these women were fighting against the restrictions they faced surrounding abortion,  their fight went beyond their rejection of these laws and the restrictions. Women marched the streets of cities across the country fueled by the idea that a woman's right to choose becomes a constitutional right when threatened. It was this movement that would eventually lead to the case of Roe vs. Wade officially legalized abortions in 1973, and federally protected a woman's right to choose. The sad fact remains, that with the recent overturning of Roe vs. Wade women's rights are once again vulnerable and jeopardized.   With the Supreme Court's recent overturning of Roe Vs. Wade, a woman living in an abortion-banned state, is now forced to either travel across the country to the nearest legal abortion state or is left with no other option than to risk her health to obtain an illegal abortion or carry out the pregnancy. With many states having such broad bans, their laws do not even account for extreme cases. Cases such as rape, incest, and medically needed abortions. These harsh restrictions will and have already led to a drastic increase in women seeking unsafe illegal abortions and carrying out pregnancies that can lead to fatal pregnancy-related complications. This overturning also means that our country is heading in the direction of a pre-Roe environment. This means states with decade-old abortion laws could seek to reinstate them, stripping away not only a woman's right to choose but also criminalizing women who seek to resolve unwanted pregnancies. Michigan, a state with many decades-old anti-abortion laws, could proceed to revert to laws dating back to 1931, making abortions a felony. Unfortunately, the effects of this recent overturning become increasingly dangerous for minority women living in some US States. 

Black women, in particular, have historically been mistreated when it comes to their reproductive health. As a result of the dangerous conditions they face during and after pregnancy, the banning of abortions can disproportionately impact Black women compared to their counterparts. Therefore showcasing the intersections between these topics. Maternal health disparities among Black women can be traced back to slavery, where Black women's reproductive health was used for economic gains and where they faced experimentation amongst many other harsh conditions. The first women's hospital was established on a slave farm, showcasing a disturbing history where Black women endured medical experimentation without consent stripping them away from their bodily autonomy. This historical context underscores systemic and institutional racism, which ultimately contributes to the excessively high rates of both maternal and child mortality rates as well as the life-threatening complications experienced by Black women today. 

A recent analysis conducted by the United Nations sheds light on the misperceptions surrounding the Black female body within medical education. The study reveals misconceptions such as claims that Black women’s nerve endings are less sensitive and require less anesthesia and that Black women’s blood coagulates faster than that of white women (Baumgaertner & Fassihi, 2023). These notions result in a disparity in reproductive care for Black women because their physical pain is not perceived as a significant complaint, therefore delaying life-saving interventions. The Centers for Disease Control and Prevention's (CDC) most recent report emphasizes a spike in maternal deaths in 2021. The report revealed 1,205 maternal deaths in the United States in 2021, with 69.9 deaths per 100,000 live births among Black mothers, a rate 2.6 times higher than the rate for White women (Hoyert, 2023). This trend in maternal deaths extends to infant mortality rates, CDC research in 2021 underscores that infants of Black women faced a mortality rate of 10.55, the highest mortality rate of that year compared to other racial groups (Ely & Driscoll, 2023). Furthermore, socioeconomic factors like education and wealth do not appear to be significant contributors. Data reveals evident disparity, even among the most affluent black mothers, infant mortality rates are higher at 437 slightly surpassing those of the poorest white women, which stand at 350 (Kliff et al., 2023).  

In conclusion, the intersections of historical injustices, systemic racism, and misconceptions have resulted in disproportionate reproductive care for Black women. The ramifications of slavery can still be found in deeply ingrained biases within medical education and institutions, illustrating a cycle of mistreatment and neglect. The devastating data on maternal and infant mortality rates highlights the immediate need for systemic reform, as well as culturally competent training for healthcare providers. To foster an inclusive and informed healthcare system it is crucial to challenge these differences and prioritize the well-being of every woman and child regardless of race or socioeconomic background. 

            The intersection of systemic racism and misogyny is deeply embedded within the structure and society of the United States. The healthcare system is no exception to this. Throughout history, Black and Indigenous women of color and disabled people have been abused and exploited by the medical field, particularly in the form of reproductive control. This continues to affect the way that the healthcare system operates, and is made evident by the laws and practices that are still in effect in the present day.  According to the National Women’s Law Center (2023), performing involuntary sterilization procedures on disabled individuals is legal in the majority of states. The only two states that have completely banned the practice are North Carolina and Alaska. In addition to that, many illegal sterilizations are done to the most marginalized members of society, an example being the women who were given hysterectomies in detention centers at the U.S. border (Medosch, 2022). The forced sterilizations happening in the twenty-first century are closely connected to the eugenics movement, which began during the start of the twentieth century. It's important to note that the white supremacist ideology this movement was based on has long been intertwined with the United States, due to its history of colonization. 

.           Rooted in anti-blackness and ableism, the goal of the eugenics movement was to improve society by getting rid of traits that eugenicists considered “undesirable” or “defective”.  Eugenics theory relies on a misunderstanding of genetics, that traits such as intelligence and social skills are a result of biology, not socialization or culture. Mental illness and disabilities were also believed to be caused by genetic inheritance As a result of scientific racism and prejudice against disabled people, anyone who was not white, upper class, and able bodied was viewed as unworthy of having the right to reproduce. Therefore, it is unsurprising that this movement had the most support from upper class white people. 

          One of the main ways that this movement was carried out was through the forced sterilization of Black and Indigenous women and disabled people. This was made legal in 1927 with the Supreme Court ruling of Buck vs. Bell, which authorized the state to enforce sterilizations on people deemed “feebleminded” (Grenon and Merrick, 2014). This disproportionately affected women of color. About 60% of tubal sterilizations done 

in the U.S. were on Black women.  Indigenous women were also heavily impacted. “Over the six-year period that had followed the passage of the Family Planning Services and Population Research Act of 1970, physicians sterilized perhaps 25% of Native American women of childbearing age, and there is evidence suggesting that the numbers were actually even higher” (Theobald, 2019) . At medical schools, women of color were used as test subjects for students to practice on (Ko, 2016). Often, these procedures were given to patients without their knowledge or consent. Even when patients signed papers agreeing to them, tactics such as deceit and coercion were often used to manipulate them into doing so. 

          Eugenics impacted healthcare in the U.S. on a systemic and institutional level, and it also influenced the way that reproductive rights issues and bodily autonomy are viewed by mainstream society today.  According to the National Women’s Law Center (2023), performing involuntary sterilization procedures on disabled individuals is still legal in the majority of states. The only two states that have completely banned the practice are North Carolina and Alaska. In addition to that, many illegal sterilizations are done to the most marginalized members of society, an example being the women who were given hysterectomies in detention centers at the U.S. border (Medosch, 2022). Using a reproductive justice lens to look at the  history of eugenics helps provide a better understanding of why the ability to view sterilization and abortions as a “choice” may be a privilege in itself.  

For reproductive care to be truly equitable, it's essential for it to be centered around reproductive justice. Understanding the history of abortion rights and access to reproductive care, the connection between slavery and Black maternal health disparities, and how eugenics has been used as a tool for white supremacy and ableism, are a few examples of ways that U.S. history has impacted reproductive care in the present day. To provide equitable reproductive care to all women regardless of race, or socioeconomic status, these historical events must be viewed through the lens of reproductive justice. 

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