RALEIGH, N.C. – Abortion in North Carolina overall is on the decline, but the decrease has been more pronounced among white women than black women, according to a study of abortion trends in the state between 1980 and 2013. One factor could be that lack of access to health care makes it harder for women of color to get contraceptives.
For many women, said Dr. Rathika Nimalendran, a fellow with Physicians for Reproductive Health, it’s prohibitively expensive to get any form of contraception without health insurance. She said North Carolina’s decision not to expand Medicaid has diminished access to reproductive care overall – including contraception and prenatal care.
“I see this daily as a family physician,” she said. “More than 50% of women who are obtaining abortions already have one child. And often, the reason for an abortion is because they want to be able to care for the children they have.”
A report this month by the Georgetown University Center for Children and Families found the number of women of child-bearing age in North Carolina without health insurance is among the highest in the country. Among African-American women in the United States, those in the South have the lowest rates of health coverage, according to the National Partnership for Women and Families.
In 2014, 90% of counties in North Carolina had no clinics that provided abortions, according to the Guttmacher Institute. Pointing out that abortion is a legal medical procedure, Nimalendran said laws aimed at restricting it obstruct the relationship she has with her patients.
“North Carolina already has fairly restrictive policies,” she said. “We have one of the longest waiting periods in the country, that’s 72 hours. If North Carolina were to restrict abortion, this would, I think, really be a terrible outcome for women and for families.”
Last month, Gov. Roy Cooper vetoed Senate Bill 359, which would have meant criminal charges for doctors for failing to care for an infant that survived an abortion procedure. Earlier this year, a federal judge ruled that North Carolina’s 1973 law banning abortions after 20 weeks of pregnancy was unconstitutional.
The Georgetown report is online at ccf.georgetown.edu, and the North Carolina abortion-trends study is at ncbi.nlm.nih.gov.