Document ID: ./input/supremecourt_opinions/opinions/21pdf/19-1392_6j37.pdf/19-1392_6j37.pdf
Page Number: 186

Cite as:  597 U. S. ____ (2022) 

39 

BREYER, SOTOMAYOR, and KAGAN, JJ., dissenting 

cated pregnancy imposes significant strain on the body, un-
avoidably involving significant physiological change and ex-
cruciating  pain.    For  some  women,  pregnancy  and  child-
birth  can  mean  life-altering  physical  ailments  or  even
death.  Today, as noted earlier, the risks of carrying a preg-
nancy to term dwarf those of having an abortion.  See supra, 
at 22.  Experts estimate that a ban on abortions increases
maternal mortality by 21 percent, with white women facing
a  13  percent  increase  in  maternal  mortality  while  black 
women face a 33 percent increase.13  Pregnancy and child-
birth may also impose large-scale financial costs.  The ma-
jority briefly refers to arguments about changes in laws re-
lating  to  healthcare  coverage,  pregnancy  discrimination, 
and family leave.  See ante, at 33–34.  Many women, how-
ever, still do not have adequate healthcare coverage before
and after pregnancy; and, even when insurance coverage is
available, healthcare services may be far away.14  Women 
also continue to face pregnancy discrimination that inter-
feres with their ability to earn a living.  Paid family leave 
remains  inaccessible  to  many  who  need  it  most.  Only  20
percent of private-sector workers have access to paid family
leave, including a mere 8 percent of workers in the bottom 

—————— 

13 See L. Harris, Navigating Loss of Abortion Services—A Large Aca-
demic Medical Center Prepares for the Overturn of Roe v. Wade, 386 New 
England J. Med. 2061, 2063 (2022).  This projected racial disparity re-
flects existing differences in maternal mortality rates for black and white 
women.  Black women are now three to four times more likely to die dur-
ing or after childbirth than white women, often from preventable causes.
See Brief for Howard University School of Law Human and Civil Rights 
Clinic as Amicus Curiae 18. 

14 See  Centers  for  Medicare  and  Medicaid  Services,  Issue  Brief:  Im-
proving Access to Maternal Health Care in Rural Communities 4, 8, 11 
(Sept.  2019),  https://www.cms.gov/About-CMS/Agency-Information/
OMH/equity-initiatives/rural-health/09032019-Maternal-Health-Care-in-
Rural-Communities.pdf.    In  Mississippi,  for  instance,  19  percent  of 
women of reproductive age are uninsured and 60 percent of counties lack
a single obstetrician-gynecologist.  Brief for Lawyers’ Committee for Civil 
Rights Under Law et al. as Amici Curiae 12–13.