Racial Disparities in Pregnancy Termination: Critical Race Theory Meets Abortion

Background The scientific community consistently and assiduously traces racial disparities in all areas of medical science with a view to identifying and addressing inequities. The sole notable exception is in the area of abortion. From 1968 up until 2022 the Centre for Disease Control has reported abortion statistics from the USA including data on race. No previous studies have explored the racial imparities in abortion demand and the variation of this with time. No woman aspires to have an abortion. Even where women wish abortion to be available, no woman desires to be a position where they feel they are in need of such an intervention. In this light, the incurious posture of the scientific community is difficult to reconcile with the attention given to other racial inequities in other fields of medical and social science. Methods The CDC abortion surveillance records were interrogated from 1989 to 2022. We compared the figures reported for the number of abortion per 1000 live births amongst black women with that for white women. Results Across the 34 year period the abortion rates per 1000 live births was considerably higher amongst black women compared to white women. The last third of century has observed the ratio of abortions per 1000 live births of black versus white women in the US rise from 2 in 1989 to 4 in 2022. This is driven predominantly by a consistent decline in the number of abortions per 1000 live births amongst white women from 252 abortions/1000 lives births in 1989 to 106 abortions/1000 live births in 2022. The corresponding figures have remained inveterately high amongst black women with undulations overlying a modest trend towards decline, with 469 abortions/1000 live births in black women in 1989 to 429/1000 live births in 2022. Conclusions The glaring and expanding racial disparity with regard to abortion demand remains neglected and unattended. Critical Race Theory (CRT) here is both insightful and instructive. It posits that centuries of racial injustice have left an indelible imprint in the fabric and modus operandi of almost every domain of life, especially where race is combined with other features exploited as parameters for discrimination, in this instance the fact that abortion relates to women. CRT prevents us prescinding our attention from an ineluctable question: If there were a phenomenon that disproportionately affected the reproductive system of young white men, leading them to seek invasive medical and/or surgical interventions to their reproductive system, oftentimes involving manipulation of the sex hormones, with an expanding race gap over the last three decades, leading to the termination of white foetuses at a rate of almost 500 per 1000 live births, would society and the medical community be equally taciturn and struthious about the issue. CRT would answer in the negative. Indeed the novelty of this work in 2025 shows the abject demotion of black women in the hegemony of research priorities.