Reflections on the overturning of Roe v. Wade and how it impacts people experiencing homelessness

Published: July 12, 2022

As someone who has worked in health policy with a legal perspective for several years, I was unfortunately not surprised by the recent overturning of Roe v. Wade. I had been bracing myself for this for a while but am still reeling and grieving from the decision. It is difficult to grasp that I now live in a world where I have fewer reproductive rights than my mom did at my age.

While I am relieved that I live in Washington State, where abortion is legal, reproductive health is protected more than in other states, and our current governor supports protecting people seeking reproductive health care from other states, I cannot overstate how overturning Roe will impact even the most progressive states. This is a life-or-death situation for many people.

First and foremost, overturning Roe sends the message that women and people who may become pregnant do not have control of their own bodies. It robs us of our agency and autonomy, our health, and financial futures. And it disproportionately impacts Black, Indigenous, and people of color (BIPOC) and LGBTQ+ folks.

This is especially relevant to Building Changes’ work because of our focus on children, youth, and families experiencing homelessness and our commitment to ensuring they have safe, equitable access to health care that supports both their health and housing stability.

Through our maternal health work, we know that reproductive health and homelessness are deeply connected. Young women experiencing homelessness are almost five times more likely to become pregnant and far more likely to experience multiple pregnancies than young women who are housed.1 Pregnancy can increase a woman’s risk of becoming homeless, and pregnant women face significantly greater health risks while unstably housed.2 Unstable housing is considered a contributing factor to pregnancy-related deaths. At the same time, people of color are disproportionately impacted by homelessness and also have disproportionately high rates of pregnancy-related deaths.

In a recent op-ed, Linda Goler Blount, president and chief executive of the Black Women’s Health Imperative, wrote that “Women who are denied an abortion are more likely to live in poverty six months after giving birth, more likely to still be in poverty four years later, and less likely to be employed full time after the same period.” Blount goes on to state that “for many Black women, the post-Roe cost of getting an abortion will simply be too high,” concluding that “[t]he Supreme Court’s decision to overturn Roe means Black women and their families will suffer the most.”

Through our work helping to ensure health care access for unaccompanied homeless youth, we know that young people experiencing homelessness, especially LGBTQ+ youth who are overrepresented in the homeless youth population, face many barriers to accessing health care. There are already a limited number of reproductive health clinics across our state that unaccompanied youth feel comfortable going to, and we know that people from other states where abortion is illegal will come to Washington for care, putting even more pressure on clinic capacity.

Clinics across the state that provide a comprehensive range of reproductive health services must continue to be funded. It’s critically important for all our communities that these clinics continue providing a diverse range of services affordable to all patients, that all clients feel safe and heard, and that the clinics are not under threat of violence or other restrictions. Our current governor and state attorney general have expressed that Washingtonians and others who come here seeking a safe and legal abortion will be protected, but any changes to state leadership could change that.

These are the issues that I have been thinking about over the past few weeks. As upset, sad, and uncertain as I have felt, three things have been helping me process this Supreme Court decision: supporting organizations across that state that I know are doing great work in reproductive health care; reaching out to family members, colleagues, and friends to share our collective grief, as well ideas about actions we can take; and taking steps in my work and personal life to bring more awareness to how this issue impacts me and the communities I serve.

1 Smid, M., Bourgois, P., & Auerswald, C.L. (2010). The Challenge of Pregnancy among Homeless Youth: Reclaiming a Lost Opportunity. Journal of Health Care for the Poor and Underserved 21(2), 140-156.

2 Clark, R. E., Weinreb, L., Flahive, J. M., & Seifert, R. W. (2019). Homelessness Contributes to Pregnancy Complications. Health Affairs, 139-146.

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