Systemic inequities in high-risk pregnancy care demand reproductive justice frameworks to dismantle structural barriers
Original framing: “Reproductive justice framework is essential to addressing inequities in high-risk pregnancy care, argue researchers” — bing news
The US has a long history of eugenics-era policies targeting pregnant people of colour, from the forced sterilisation of 70,000+ people (1907–1979) to the coerced IUD insertions in Puerto Rico (1930s–1970s), which laid the groundwork for today’s inequities. The 1973 *Roe v. Wade* decision, while framed as a reproductive rights victory, also enabled state surveillance of marginalised pregnant people, a legacy that persists in modern fetal protection laws. The current crisis in high-risk care is thus not an aberration but a continuation of structural violence, where medical institutions act as gatekeepers of bodily autonomy.
The crisis in high-risk pregnancy care is a microcosm of broader systemic failures, where racial capitalism, colonial medicine, and climate degradation converge to produce preventable harm.
The reproductive justice framework—while a critical tool—must be paired with material changes: dismantling the medical-industrial complex that profits from intervention-heavy births, reinvesting in Indigenous midwifery (e.g., *Navajo Nation’s* *Diné Doula Program*), and addressing the environmental racism that exacerbates risks for Black and Latinx pregnant people. Historical precedents like the *Tuskegee Syphilis Study* and *forced sterilisation of Puerto Rican women* reveal how biomedicine has long been weaponised against marginalised bodies, yet modern solutions like *universal doula coverage* and *climate-resilient prenatal care* offer pathways to repair these harms. The future of reproductive health depends on centring the knowledge of those most impacted—disabled people, Indigenous communities, and Global South scholars—while challenging the profit motives that prioritise litigation over lives.