This week marks 49 years since the landmark decision in Roe v. Wade gave women the right to choose what happens in the event a person does not want to carry a pregnancy to term. The Supreme Court decision, in a ruling of 7-2, struck down a Texas abortion ban, and in a companion case, upheld the challenge to Georgia’s abortion laws. Now, nearly half a century after the decision, SCOTUS finds itself in a similar place—deciding whether or not women should have autonomy over their reproductive organs. And proponents of Roe v. Wade say the decision to not uphold could be particularly harmful to Black women.

Last month, the state of Mississippi asked the Supreme Court to overturn Roe v. Wade in the case of Dobbs v. Jackson Women’s Health Organization. The case will decide if a 2018 abortion ban in the state that prohibits nearly all abortions after 15 weeks’ gestational age, will be upheld. “If the Supreme Court rules in favor of Mississippi and Roe v. Wade falls, the consequences will be far-reaching and devastating for people across the country,” says Breana Lipscomb, Senior Advisor for Maternal Health and Rights for the Center for Reproductive Rights. 

Lipscomb asserts that states across the South and Midwest will likely eliminate abortion entirely if the conservative-leaning court empowers them to do so with their decision, leaving people in these states few options for medical care in the event a person does not want to carry a pregnancy to term. “Many states that have the most severe abortion restrictions also tend to have the fewest supportive maternal health policies in place,” says Lipscomb. “They often have persisting obstetric provider shortages—limiting access to life-saving maternity care. Many of these same states refused to expand Medicaid under the Affordable Care Act, and many have not yet agreed to extend critical Medicaid coverage to a full year after delivery.”

This is why the Center for Reproductive Rights is urging the U.S. Senate to pass the Women’s Health Protection Act (WHPA), which would protect abortion access nationwide, even if Roe falls. In a historic vote last September, the House of Representatives passed WHPA. Senator Chuck Schumer is now calling for a vote in the Senate in hopes of enacting a federal solution to protect access to abortion care. In recent months, states like New Jersey have taken matters into their own hands, making access a right per state law. 

“In the past few months, states have repealed pre-Roe abortion bans, required public and private coverage of abortion care, repealed parental involvement laws and started conversations about funding for people living in other states who are traveling to access care,” says Elisabeth Smith, Director of State Policy and Advocacy at the Center for Reproductive Rights. 

Because Black and Brown communities experience health inequities and discriminatory barriers to essential social services, the center believes that the potential harms created by denying women autonomy will fall hardest on women of color. “Black women suffer great harm when reproductive rights are restricted,” says Lipscomb. “While legality alone has never been sufficient to guarantee access, without those legal protections, pregnant Black women who have abortions will face fewer safe options and higher risks of criminalization and punishment.” Lipscomb adds that if Roe falls, “it will be another devastating attack on Black women’s bodily autonomy and their/our ability to decide for them/ourselves what is best for their/our bodies and families.”

In general, abortion bans deny people the right to make important decisions about their health. But Lipscomb points out that it’s particularly cruel to do so in a country where preventable maternal deaths have become a human rights crisis. Black women in the U.S. are four more likely to die from pregnancy complications than white women are and carrying a pregnancy to term is 14x more dangerous than having an abortion. “No matter what the outcome of the pregnancy will be,” Lipscomb says, “Black women must have access to high quality, respectful, and comprehensive health care services as they weigh these risks.”