I recently attended DC’s inaugural Maternal and Infant Health Summit focusing on strategies to address the health challenges faced by women and families in our city. I also read the newly published Family Planning Community Needs Assessment for the DC Family Planning Project. While I applaud both Mayor Bowser for taking on the maternal health crisis and the Women’s Foundation for sponsoring the report, I am left wondering why neither of these forums seriously examined access to abortion as a contributing factor to the state of health of District women.
Why not? Unintended pregnancy and maternal mortality rates are significantly higher in Washington, DC than in the rest of the US. According to research from the Centers for Disease Control and Prevention published in 2014, maternal mortality rates in DC are nearly twice the US average, at 41 deaths per 100,000 births. This staggering number is the highest rate in the country, and concentrated in wards with high poverty.
A combination of stigma and bad national politics is to blame. In Washington, DC, any bill that our pro-reproductive health city council passes and our reproductive health champion mayor signs must pass Congressional review. Further, Congress controls and approves DC’s budget as a part of their yearly federal appropriation. Congressional representatives from outside the District determined that DC cannot use its own locally raised tax dollars for low income women to obtain abortions through their Medicaid insurance, creating for some women an insurmountable economic barrier to a safe and legal medical procedure. Until DC controls its own fate, women in the District cannot do so.
When women are able to plan their families, those families are stronger and more resilient. We need to break through the political noise, defy social stigma, and fight hard for increased access to all reproductive health services, including contraception and abortion, which DC statehood would permit. In order to improve maternal health, we need to ensure pregnant women have knowledge of and access to all possible options. This includes increased access to culturally competent and high-quality prenatal care, proximity to maternity wards to give birth, and yes, access and funds to terminate a pregnancy a woman decides she does not want or is not able to carry to term. Indeed, the majority of women seeking abortions already have children and access to abortion is a vital part of self-determination, bodily autonomy, and managing the health of oneself and one's family. It is also crucial to the health of our city.
The key is self-determination. Self-determination is vital to both the ability to make decisions about one’s own body and the ability as a city government to make decisions about its own constituents. DC statehood is requisite to both.