On June 24, the Supreme Court overturned Roe v. Wade. In a concurring opinion, Justice Clarence Thomas stated that there also should be reconsideration of rights to contraception, among other issues. We are in a time of major challenges to reproductive rights and maternal health. I am a Professor of Nursing and someone who spent many Saturday mornings in the 80’s and 90’s volunteering to escort women past lines of anti-abortion activists into a women’s health clinic providing abortions. I am also the mother of an adult son with an intellectual disability and an activist in the disability rights movement. I am encouraged that prominent health professional organizations, such as the American Nurses Association and the American Medical Association, and disability rights organizations such as the American Association of People with Disabilities have issued statements against the Supreme Court ruling.
One in four adults in the US have disabilities. Even before the Supreme Court ruling women with disabilities faced discrimination and worsening access to reproductive health care. Pregnant women with disabilities in the US have higher rates of pregnancy-related complications and deaths than pregnant women without disabilities. It is known that people with disabilities who are also from minority, ethnic, and other marginalized communities face a “double burden” in health disparity. The United States is already one of two countries with recent increases in maternal mortality. The elimination of abortion services in many areas of the country will undoubtedly lead to higher maternal mortality among women with disabilities, as it is expected to do generally and particularly among women of color.
Unfortunately, the relationship between the disability rights movement and the reproductive rights movement is troubled. As noted in an editorial of the California Law Review, the reproductive rights movement often portrays the presence of disability status with a fetus as tragic and justifying the right to abortion, while anti-abortion advocates often use more empowering language regarding the parenting of children with disabilities, all while states with the most restrictive abortion laws also have funding and policies that make it harder to raise children in healthy environments. Further, the disability rights movement has concerns with the almost total loss of children with Down syndrome in countries such as Iceland, where almost 100% of women who receive a positive pre-natal test for Down syndrome opt for abortion. Related to these types of issues, some prominent women in the disability community have favored overturning Roe v Wade. Others note the “strange bedfellow” aspect of the intersection of the disability rights movement with the anti-abortion movement.
The health care system broadly also has its own troubled relationship with the disability rights movement. In March 2020, at the beginning of the COVID-19 pandemic, 183 disability rights and justice organizations supported a call to action to protect the lives and rights of people with disabilities, noting a year later that this had not happened. Nearly two years in, the Biden administration rightly issued an announcement on new actions to address the needs of people with disabilities in the responses to COVID-19.
Going forward, health care organizations concerned with the impact of the Supreme Court decision on the health of women and reproductive rights organizations should not wait to address disability issues and should consider the establishment of Diversity, Equity, Inclusion, and Accessibility (DEIA) Committees to ensure that their efforts to protect women’s health and reproductive rights are fully inclusive. What are these committees? Many organizations are working to improve the diversity of their workforce, clientele, and their outreach through Diversity, Inclusion, and Equity (DEI) Committees, including many health care organizations. The committees are typically made up of diverse staff members who are responsible for helping bring about cultural, policy, procedural, and needed ethical changes necessary in organizations. DEI Committees are thought to have many benefits. Forbes published 15 benefits including ensuring that employees feel safe, respected, and connected. A few years ago only about 4% of businesses had diversity initiatives around disabilities, but more recently, organizations have established DEIA Committees.
Establishing DEIA Committees is in line with President Biden’s January 25, 2021 Executive Order on Diversity, Equity, Inclusion and Accessibility in the Federal Workforce. The US Department of Labor refers to DEIA as a foundation for meaningful change as it includes ensuring that programs, services, communication and facilities are inclusive of people with disabilities and can be used by them. It’s time to ensure that people with disabilities feel safe, respected and connected going forward on protecting women’s health and reproductive rights.