June 22, 2023

This month marked the first full year after Dobbs v. Jackson Women’s Health Organization, the Supreme Court decision that eliminated federal protections for abortion and allowed states to determine when — or if — people can access care. New research from the UHC's Alina Schnake-Mahl, ScD, MPH and Jackie Jahn, PhD, MPH finds that none of the states that now ban or restrict abortion offer paid family leave, effectively forcing people to give birth and then return to work.

As Schnake-Mahl and Jahn describe in the Philadelphia Inquirer, “This double whammy of mandated birth and state neglect has severe consequences. In states limiting abortion access, maternal mortality rates are higher and birthing people are more likely to have children who are born too early or who die within their first year of life.” Paid family leave gives birthing people the ability to care for themselves and their infants without losing income or employment. Both parents and infants have better health outcomes as a result. Similarly, access to abortion care lets people control when or if they want to become parents. This autonomy allows parents to raise their children in health and safety, a cornerstone of reproductive justice.

Dr. Jahn explains this concept and how it connects the two policies at the core of their research in an interview with New America: “When we start to think about abortion access, not only as a policy debate or healthcare service, but instead fundamentally shift the focus to center women and birthing people’s reproductive rights and dignity, then the connections between supportive policies become clearer.”

Interactive Map: Abortion and Paid Family Leave Policies by state

Maternal mortality rates have reached a crisis level in the United States, but this burden is unequally distributed geographically and demographically, the result of “historical and contemporary patterns of institutionalizing racism through policy.”

“With Dobbs being pulled back, we're creating conditions for more states' rights, and we are seeing disproportionate harm from this decision on Black birthing people because there are larger Black populations in these states and low-income populations,” Dr. Schnake-Mahl tells New America. “In many places, these populations will be least likely to be able to access these services because of the larger structural factors that create economic conditions.”

Effective advocacy will depend on a combined effort by public health advocates, researchers, and practitioners, their original article concludes. These coalitions can work to expand access to abortion care and paid family leave at all levels of government: federal, state, and local, particularly if states preempt local governments from enacting paid leave policies. Advocates should also use a reproductive justice lens when considering the full range of policies that can support reproductive health.