On July 26, 2022, the PA House Democratic Policy Committee held a policy hearing to discuss how abortion access will shape the overall debate on reproductive health rights in the commonwealth and heard from different speakers. 

The hearing was presided over by Senator Katie Muth, committee chair, and included a number of Senators and representatives known for their progressive platforms, particularly on abortion access in Pennsylvania. The committee also heard from four women from different sectors of reproductive and public health, and one advocacy organization who testified before the state senators and representatives. 

“We also have to focus on not only how we sustain abortion access, but how do we expand it?” said State Rep. Morgan Cephas. 

With increasing legislative activity led by the Republican Party, state Democrats across the country grapple with upholding abortion access, fending off anti-abortion legislation, and expanding access for citizens in neighboring states who no longer enjoy that right.

In Pennsylvania, a constitutional amendment was brought before the legislature's chambers in the dead of night, when there would be little to no public scrutiny, a strategy their Democratic counterparts vehemently denounced.  

Since then, representatives at the local level have mobilized and performed outreach in an effort to promote information surrounding the medical procedure. 

Although Pennsylvania is an abortion-friendly territory, the state struggles with high pregnancy mortality rates. 

“Despite having some of the finest academic medical centers in the nation, Philadelphia’s pregnancy-related death rate is above the national average,” said Dr. Asta Mehta, Medical Officer of Women’s Health for the Philadelphia Department of Public Health, and a practicing OB/GYN in Philadelphia.

In Philadelphia alone, there were 110 infant mortality rates between 2013 and 2018, averaging 18 deaths per year, according to the Philadelphia Department of Health. The second-leading cause was natural deaths, next to accidental rates, which include drug intoxication, motor vehicle accidents, and fires.

In light of these figures, the witnesses at the hearing emphasized the importance of state-sponsored funding to have a wider reach. Many communities also face financial barriers that preclude patients from seeking care. 

“Whatever we can do in the Commonwealth to support the abortion donation fund, fund people to get abortions, and fund the transportation to the procedures is helpful,” Mehta explained. 

Said barriers create larger disparities for low-income communities that can’t afford abortions, resulting in higher mortality rates among them. In 2020, nearly half of all reproductive health procedures were received by the Black population, accounting for 14,177 abortions next to white individuals, who make up a much larger portion of the overall population. 

“Here in the Commonwealth it’s kind of a problem we’ve created for ourselves and it’s going to add to the systemic problems that we already see and something that we now just regenerated and created as opposed to something that we’re working hard to accomplish through inherent poverty that we’ve had through generations,” Mehta added in her testimony.

Ceisha Elmore, a representative for the advocacy and Human Rights Organization New Voices for Reproductive Justice, also spoke to the issue of inequity in abortion access, which disproportionately punishes low-income Black neighborhoods. 

“This attack on abortion access is just another way to continue to deny marginalized people basic human rights,” Elmore said in her opening testimony. 

Elmore went on to say that: “We know that Black birthing individuals will be the most affected... This amplifies the agenda to dismantle Black family structures, perpetuate generational poverty and cause divisions in our community.”

Racial dynamics play a punishing role in reproductive health care, especially for Black women, who are four times more likely to die from pregnancy-related causes than white women and more likely overall than other racial groups. 

Access to reproductive health services thus becomes a key factor in whether or not Black women will survive pregnancy-related medical issues. 

In Philadelphia, the data demonstrates this likelihood, whereas in the 2012-2018 report, non-Hispanic Black women accounted for 73% of pregnancy-related deaths, as opposed to white women, who made up 19% of pregnancy-related mortalities. 

“These state-sanctioned environments create a culture of criminalization for Black people and People of Color, from police, medical professionals, and even from civilians,” Elmore emphasized. 

According to a report from The National Partnership for Women and Families, Black women and families were already bearing the brunt of inaccessible care from mortality rates to lower-quality health care. The same report found that hospitals that served Black communities ranked worse in birth outcomes, including elective deliveries, non-elective cesarean births, and maternal mortality. 

“This does not demonstrate a pro-life agenda. If abortion restrictions upset you, it is the expectation that limited healthcare access, the housing crisis, and exposure to community violence also upset you because they all oppress gender minorities,” Elmore continued.

“This is [reproductive] justice,” she said. 

As the commonwealth continues to address expanding access, it becomes increasingly clear that exacerbated inequities brought about by a legacy of systemic disparities, state reps will continue to wrestle with an already unequal system of care. 

On the ground, Signe Espinoza, Executive Director at Planned Parenthood Pennsylvania Advocates, said that centers can see over 90,000 patients per year, with many of them experiencing 3-4 weeks of wait for care. 

“It’s not the time to be lukewarm on abortion,” Espinoza said while noting that the Commonwealth can assist via administrative support. 

Espinoza also noted there is a marked distrust from the Latinx community.

“There’s a huge distrust in my community around doctors. I think there’s a really dark history there, particularly about forced sterilization,” Espinoza added, while also emphasizing that she goes out of her way to seek a doctor more adequately prepared to treat her. 

As the hearing wrapped up, Dr. Sara Gutman, a Complex Family Planning Fellow at the University of Pennsylvania said: “There will always be a need for abortion.”

As state lawmakers seek to expand access, surrounding communities continue to echo this sentiment, and the need for said access to become readily available for vulnerable and low-income populations.

A multi-pronged issue, the policy hearings serve as a starting step for lawmakers to address an inequity issue amid a turbulent political climate, where the Commonwealth is also expected to treat out-of-state abortion seekers.