In honor of Disability Pride Month – July – and in the wake of the Supreme Court overturning Roe v. Wade, it’s important to acknowledge and appreciate the ways that abortion access and safe reproductive healthcare is fundamentally a disability rights issue. When we discuss disabled people and abortion access, the most typical context is when a pregnant person chooses to have an abortion after the fetus has tested positive for genetic markers of disability (most often Down syndrome or spina bifida). However, these conversations fundamentally ignore that disabled people are completely capable – and, depending on the person – eager to become pregnant and raise a child. The underlying ableism inherent to this rhetoric – that disabled people can’t or shouldn’t become pregnant – negates the fact that actual, living disabled people are most likely to be affected by abortion restrictions, not disabled fetuses.1 It is also an extension of the US’s long history of denying disabled people bodily and reproductive autonomy. Overturning Roe v. Wade and the wave of anti-abortion legislation that has already been passed around the country is a part of this history.
The attack on abortion rights reflects the legacy and continuation of a history in which reproduction has been weaponized to subjugate disabled people and other historically marginalized communities. Indeed, people with disabilities have faced a lengthy history of threats to bodily autonomy, including forced sterilization. Forced sterilization gained the Supreme Court’s blessing in the infamous 1927 Buck v. Bell decision, in which the Supreme Court upheld Virginia’s law that to be released from institutionalization, a patient must be sterilized (forcibly, if need be).2 Although it’s not the main subject of this blog post, it’s worth noting that forced sterilization is still very much a tactic used to oppress disabled people today. A National Women’s Law Center report published in January found that 30 states and the District of Columbia still have involuntary sterilization laws. In these states, guardians appointed by courts to make decisions on behalf of disabled people can choose whether a person is sterilized, even if it’s against that person’s wishes.3 Thus, forced sterilization is certainly not a relic of the past, and it evidences how abortion bans are just one piece of the puzzle that denies disabled peoples’ reproductive and bodily autonomy.
Disabled people are disproportionately more likely to be impacted by abortion bans for several reasons. The first is that a person’s disabilities (or the medications they take to manage their disability/disabilities) may increase the risks associated with pregnancy, giving birth, parenthood, or all three. Indeed, people with disabilities have higher rates of maternal mortality and morbidity than people without disabilities. Moreover, some disabled people take medications that must be stopped prior to pregnancy. Without abortion services, disabled people who have unintended pregnancies will be put in an impossible situation: Having to choose between suddenly ending medication and risking harmful side effects or continuing medication that could harm them and their children.4
A person with a cardiac condition could be told that pregnancy would be “tantamount to suicide” and still not necessarily qualify for an abortion because the language of these laws is so vague that doctors will undoubtedly avoid abortions that are not “immediate” emergencies out of fear of lawsuits or prosecution.5 The fact that the physical stress of a pregnancy could take years off a chronically ill person’s life would be of little to no consequence under Mississippi’s abortion law, for example, which contains a “life of the mother” exception only in the case of a “medical emergency” that “necessitate[s] the immediate performance or inducement of an abortion.”6 Additionally, many abortion activists have been highlighting that, while it isn’t easy, it’s still possible to get a hold of medication abortion even within states with abortion bans. While they’re right, not everyone can take these pills; they are contraindicated for people with certain liver, kidney, and inflammatory conditions, and due to the need for self-monitoring and adherence to care instructions they are not recommended for some people with comprehension barriers.7
The second reason that disabled people are far more likely to be negatively impacted by the end of Roe v. Wade than non-disabled people is that the other ways disabled people are systemically oppressed intersect with the issue of abortion. For example, according to the National Council on Disability, “people with disabilities live in poverty at more than twice the rate of people without disabilities.”8 They also have considerably lower employment rates. These inequities are heightened for disabled people who are further marginalized. For example, Black people with disabilities are nearly 55% more likely than white people with disabilities to live in poverty.9 LGBTQ disabled people also experience substantial economic disadvantages, and according to the Center for American Progress, disabled women have a poverty rate of 22.9%, compared with 17.9% of men with disabilities and 11.4% of nondisabled women.10
Furthermore, researchers estimate that depending on the gestation of the fetus at the time of the abortion, the average cost of an abortion is between $500 and $1,000, which is often paid out of pocket. These high costs can be prohibitive for disabled people.11 Moreover, a 2018 study found that 27 U.S. cities are “abortion deserts” – cities where people must travel at least 100 miles to reach an abortion provider. In addition to the high costs of abortions, which many disabled people cannot afford, some are unable to travel to an abortion provider because of a lack of accessible transportation, especially in areas with limited to no abortion providers.12
Another issue facing disabled people who may need access to abortion is that disabled people have higher rates of unintended pregnancies than non-disabled people.13 This phenomenon is in part because, according to a survey conducted by the Bureau of Justice Statistics, disabled people are more than three times more likely than non-disabled people to experience sexual assault. The likelihood increases for people with multiple disabilities.14 Another study found that people with intellectual disabilities are seven times more likely than others to experience sexual violence.15 Disabled people also contend with increased rates of intimate partner violence, which increases their need for abortions. People with disabilities are also at heightened risk of reproductive coercion.16
What does all of this mean for the future of disability rights advocacy and the pro-choice movement? Disability rights advocates worry that Dobbs v. Jackson Women’s Health Organization may signal just the beginning of the loss of disabled people’s rights. Robin Wilson-Beatie, a disability, sexuality, and reproductive health educator said, disabled people are still fighting for full, equal, and equitable access to the broader community. “It frightens me to think that as we swing further to the right, we can continue to revisit cases that were already decided.”17 Also, Julia Bascom, the executive director of the Autistic Self Advocacy Network said this “decision attacks the fundamental right to privacy and substantive due process, disregards precedent, and drastically narrows the scope of rights protected by the Fourteenth Amendment. In doing so, it threatens disabled people’s personal rights surrounding marriage, intimacy, sterilization, medical care, housing, speech, and more.”18 In short, pro-choice activists must do more to ensure that we are in solidarity with disabled people who can get pregnant and disability justice advocacy around the country. The loss of abortion access is fundamentally an issue of bodily and reproductive autonomy, which are intrinsically important to the disability rights movement.
Authored by NOW PAC Intern, Olivia Murray
- Bowen, Liz. “The End of Roe v. Wade Will Be a Nightmare for Disabled Americans.” The Hastings Center. Last modified June 24, 2022. Accessed July 11, 2022. https://www.thehastingscenter.org/the-end-of-roe-v-wade-will-be-a-nightmare-for-disabled-americans/.
- Powell, Robyn. “Abortion Is a Disability Issuse.” Rewire News Group. Last modified May 10, 2022. Accessed July 11, 2022. https://rewirenewsgroup.com/article/2022/05/10/abortion-is-a-disability-issue/.
- Forced Sterilization of Disabled People in the United States. National Women’s Law Center, January 2022. Accessed July 11, 2022. https://nwlc.org/wp-content/uploads/2022/01/%C6%92.NWLC_SterilizationReport_2021.pdf.
- Powell, “Abortion Is a Disability Issue.”
- Demarco, Michelle. “The New Abortion Restriction No One Is Talking about.” Politico. Last modified April 28, 2022. Accessed July 11, 2022. https://www.politico.com/news/magazine/2022/04/28/the-new-abortion-restriction-no-one-is-talking-about-00028171.
- Bowen, “The End of Roe v. Wade.”
- “Highlighting Disability / Poverty Connection, NCD Urges Congress to Alter Federal Policies That Disadvantage People with Disabilities.” National Council on Disability. Last modified October 26, 2017. Accessed July 11, 2022.
- Medina, Caroline, Lindsay Mahowald, Thee Santos, and Mia Ives-Rublee. “The United States Must Advance Economic Security for Disabled LGBTQI+ Workers.” Center for American Progress. Last modified November 2021. Accessed July 11, 2022. https://www.americanprogress.org/article/united-states-must-advance-economic-security-disabled-lgbtqi-workers/.
- “Medicaid Coverage of Abortion.” Guttmacher Institute. Last modified February 2021. Accessed July 11, 2022. https://www.guttmacher.org/evidence-you-can-use/medicaid-coverage-abortion#.
- Cartwright, Alice F., Mihiri Karunaratne, Jill Barr-Walker, Nicole E. Johns, and Ushma D. Upadhyay. “Identifying National Availability of Abortion Care and Distance from Major US Cities: Systematic Online Search.” J Med Interent Res 20, no. 5 (May 2018). Accessed July 11, 2022. https://pubmed.ncbi.nlm.nih.gov/29759954/.
- Horner-Johnson, Willi, Mekhala Dissanayake, Justine P. Wu, Aaron B. Caughey, and Blair G. Darney. “Pregnancy Intendedness by Maternal Disability Status and Type in the United States.” Perspect Sex Reprod Health 52, no. 1 (March 2020). Accessed July 11, 2022. https://pubmed.ncbi.nlm.nih.gov/32096336/.
- Harrell, Erika. Crime against Persons with Disabilities, 2009-2014 – Statistical Tables. Report no. 250200. Department of Justice, 2016. Accessed July 11, 2022. https://bjs.ojp.gov/content/pub/pdf/capd0914st.pdf.
- Shapiro, Joseph. “The Sexual Assault Epidemic No One Talks about.” National Public Radio. Last modified January 8, 2018. Accessed July 15, 2022. https://www.npr.org/2018/01/08/570224090/the-sexual-assault-epidemic-no-one-talks-about.
- Rajkumar, Shruti. “With Roe v. Wade Overturned, Disabled People Reflect on How It Will Impact Them.” National Public Radio. Last modified June 25, 2022. Accessed July 11, 2022. https://www.npr.org/2022/06/25/1107151162/abortion-roe-v-wade-overturned-disabled-people-reflect-how-it-will-impact-them.
- Diament, Michelle. “With Roe Overturned, Advocates Fear Disability Rights May Be Next.” Disability Scoop. Last modified June 27, 2022. Accessed July 11, 2022. https://www.disabilityscoop.com/2022/06/27/with-roe-overturned-advocates-fear-disability-rights-may-be-next/29921/.