The recent Supreme Court decision in Dobbs v. Jackson erased the constitutional right to an abortion, immediately putting reproductive freedom in jeopardy for millions across the country. This unprecedented stripping of a legal and human right that people have relied on for 50 years intensified what was already a burgeoning reality on the ground for many. Now, as we approach midterm elections, with many local and state offices up for grabs, most abortions are banned in at least 14 states, and many more are likely to follow. This decision does not merely send the issue back to states; overturning Roe was a significant step in the antiabortion movement toward instituting a national ban on this procedure while instilling fetal personhood.

Unburdened access to safe abortion is an essential part of people retaining their ability to exercise their reproductive freedom and autonomy. These abortion restrictions violate autonomy in choosing if, when and how someone engages in one of the most fundamental human experiences of reproduction. For centuries, the power to exercise reproductive freedom and to reproduce (or not) in a safe and dignified context has not been equitably distributed for marginalized communities and particularly for communities of color. Restrictions stemming from the Dobbs decision will undoubtedly bring further disparities of autonomy in communities of color, which will lead to a widening of the health and mortality disparities we currently see.

Black and Latinx communities proportionally have higher rates of abortion than white people, a consequence of structural and systemic barriers in health care and society more broadly. People of color are making decisions about the future of their families without equitable access to living wages, jobs, and reliable food and housing. Their families face the living legacy of redlining and housing segregation, along with inequities in education access, all of which limit their movement and upward mobility. Mass incarceration and our flawed justice system disrupt families, their participation in the workforce and their contributions to society and voting. Widespread police violence destroys families, and Black parents fear police brutality before their children are even born.

Communities of color deal with barriers to health care and insurance and face racism and discrimination when they seek care, including narratives that blame people for social conditions that were created by the system. Worse yet, Black pregnant people face alarmingly high rates of pregnancy-related deaths in the hands of our health care system. Voter suppression and widespread attempts to disenfranchise communities prevent them from having a voice in transforming these structures that unjustly constrain them. This will beget further laws and restrictions that limit their rights and freedom—a modern manifestation of the separate-but-not-equal ideology of the Jim Crow era.

With these structures in mind—structures that primarily work to perpetuate barriers and poor outcomes for people of color—one thing about the Dobbs decision and the antiabortion movement becomes quite clear: this orchestrated attack on abortion rights sits within the grand plan that this country was built upon—the violent and oppressive maintenance of white supremacy.

As a Black cisgender woman and an abortion provider, I deeply fear what the unfolding of this very calculated move will do to my patients who look like me, to their families and to others from marginalized communities. As a physician who is committed to serving communities of color and helping them achieve the reproductive autonomy and well-being they deserve, I feel powerless seeing how the racist history of controlling our reproduction and freedom continues to be codified.

Throughout our country’s history, people of color’s fertility and reproduction have always been unjustly manipulated to benefit a white, misogynistic, xenophobic, homophobic nationalist system. From forced reproduction that maintained slavery as an industry to forced sterilization and contraceptive abuses that limited mobility and growth and now to sweeping abortion restrictions that will disproportionately impact people of color, we continue to directly experience how white supremacy expertly sustains itself.

When people lose the right to exercise their bodily autonomy, we see significant effects on their own personal well-being and that of their communities. Denying someone the right to an abortion can lead to increased rates of infant and maternal mortality, poverty or lasting financial hardships, reduced ability to achieve aspirational goals and worse mental health. For communities of color, this will have devastating impacts. Our country has pregnancy-related mortality rates far above those of other countries of similar economic development, and this is disproportionately shouldered by Black people who give birth. It is no coincidence that sweeping abortion restrictions are being imposed when our country is experiencing high rates of pregnancy-related mortality for people of color.

As people of color will now be forced to give birth, they will also be forced to experience an increased risk of dying from pregnancy. The lawmakers passing draconian abortion bans do nothing to avert this crisis by improving pregnancy or postpartum care and support for communities. With blood on the hands of those working to restrict abortion access, people of color will be further oppressed in our society, perpetuating the cycle of unjust and deadly social conditions.

This is not to say that if these social conditions didn’t exist, people wouldn’t seek abortion. Abortion is normal and necessary and should always be an unburdened option for people to choose for themselves. Rather it’s reckoning with the reality that reproductive decisions do not occur in isolation of the structural injustices that significantly influence people’s health and livelihood. They are making these decisions while gripped by the stranglehold of white supremacy. Burdening communities of color with being unable to vote freely, move freely, express their gender and sexuality freely, work and thrive and keep their families safe—and now with not being able to make their reproductive decisions freely—reinforces these intentional injustices.

Marginalized communities, and particularly communities of color, have proved time and again that they will overcome and achieve their liberation in all ways necessary, even in the face of deadly injustices. They are wholly capable of realizing their power to create change, as they have for centuries. Marginalized communities have led the way in the most preeminent social movements in this country and will continue to do so with courage and conviction.

A real commitment to fighting these injustices and saving lives means that white people in particular must shift power and resources to those communities and follow their leadership toward achieving self-determination and liberation. We need to move people of color into positions of power and protect their constitutional right to exercise their voices so they can make necessary changes.

We need to provide avenues for communities of color to thrive and have the same freedoms without burden or harm as white people have had for centuries. In order to realize reproductive justice and allow people to live their life with dignity and safety, we need to work to protect those who are directly in harm’s way from this restrictive landscape of abortion access.

This is an opinion and analysis article, and the views expressed by the author or authors are not necessarily those of Scientific American.