Racial Disparities in Pregnancy Termination: Critical Race Theory Meets Abortion

Racial Disparities in Pregnancy Termination: Critical Race Theory Meets Abortion | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Racial Disparities in Pregnancy Termination: Critical Race Theory Meets Abortion Chika Edward Uzoigwe This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8524612/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract 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. Health sciences/Diseases Health sciences/Health care Health sciences/Medical research Figures Figure 1 Figure 2 Introduction The disproportionate impact on black women was one of the key arguments used to challenge the restriction of abortion services following the US Supreme Court Decision of Jackson v Dobbs 1 . 2 . However this was one of the first times that racial disparities in abortion had entered socio-political and even medical debate. Even so, it did so only tangentially and was decidedly excluded from the main topic of discussion, such that in could never by the cynosure. Inequities in healthcare are well established. However in all other domains it garners significant attention, with concerted and dedicated drives to determine their aetiopathogenesis and where possible equilibrate any racial imbalance 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 . Abortion is a notable and inexplicable exception. No woman aspires to have an abortion. Even where they desire abortion as an intervention to be available, no woman wants to be in a position where she feels she needs to have recourse to such an intervention. The incurious posture of the medical profession to disparities in abortion is perplexing. If abortion is healthcare, how can one portion of the population have a disproportionate recourse to this provision and this not be subject of further enquiry and investigation? The important role of Critical Race Theory (CRT) in eradicating discrimination is being increasingly appreciated 11 , 12 . CRT posits that race is a social construct, however centuries of disenfranchisement based on race have resulted in inveterate racism interwoven into societal matrices. It counsels that discrimination is a default posture in societal paradigms and can only be eradicated by active attentiveness and surveillance against its manifestations and occurrence in all its guises 13 . Notwithstanding 52 years since Roe v Wade we report the first study reporting the variation of racial disparities in abortion with time. Methods Since 1969 the Centre for Disease Control (CDC) has continuously collated data from the US on abortion as part of its surveillance programme 14 . 50 states in addition to the District of Columbia and New York City report such data. These geographic regions are collectively designated as the 52 areas. Details on race and ethnicity are also recorded, including the number of abortions per 1000 live births by self-reported race. The hitherto annual CDC Abortion Surveillance report was suspended for the first time in 2025. One of the earliest racial categorisation recorded within the CDC report was Black, White and “Other”, from 1989. Prior to this time Black and other ethnicities were amalgamated. Up until 2006 Hispanic women were placed within the same category as white women. From 2007 ethnicities were divided into Black, White, Hispanic and Other. For each year from 1989 to 2022 (the most recently reported data) we compared the number of abortion per 1000 live births for Black and White women. The raw data is derived directly from the CDC Abortion Surveillance Reports, which is published annually and freely available (See Appendix 1). Results The number of abortions per 1000 live births from 1997 to 2022 has been consistently and considerably greater in black women compared to white women (Table 1 , Fig. 1). Further From 1997 to 2022 there has been a progressive increase in the ratio of abortions per 1000 live births between black and white women (Fig. 2). In 1997 the ratio of abortions/1000 live births for black women to white women was 2.0. In 2022 this figure was 4.0. The difference is driven predominantly by the much more rapid decline in the abortion rate amongst white women compared to black women. In 1989 there were 492 abortions per 1000 live births amongst black women but 252 amongst white women. These figures had fallen to 429 and 106/1000 live births respectively. Thus rate has over halved for white women with a much more modest decline amongst black women. Discussion Abortion rates as measured by births per 1000 live births are extremely high for both black and white women, but especially so in the former. The values have remained inveterately high from 1989 to 2022, with a decline in rates observed amongst both black and white women, with a more rapid decline in the case of the latter. The ratio of the number abortions per 1000 live births for black women to white women has doubled over the period of 34 years from 2 in 1989 to 4 in 2022. This is driven by a more concerted decline in abortion rates for white women compared to black women. Abortions per live 1000 live births more than halved in the 34-year study period for white women from 252/1000 live births in 1989 to 106 in 2022. The decline amongst black women was less pronounced from 496/1000 live births in 1989 to 429 in 2022. The divergence is difficult to explain, all the more so as medical science appears ambivalent to it. Poverty is one of the commonest reasons women seek abortions 15 , 16 . Heath et al found that male partners who accompany women to have abortions express a similar sentiment 17 . In Heath’s study, however, only 34% of men expressed the wish that their partner not continue with the pregnancy. Nonetheless, tellingly, the “poverty gap” or “affluence gap” between black and white people has remained relatively constant over the past decades 18 . It cannot therefore unequivocally account for the divarication in abortion rates between black and white women. These racial disparities, unlike in every other domain, has escaped scrutiny and evaluation. Abortion is not an anodyne intervention. No one woman ultimately wants to be in a position where she feels she is in need of this procedure. Yet there is some indifference in the face of this stark and expanding inequality in abortion between black and white women. Even the muted, mussitating and permissive response to the CDC discontinuing its annual abortion surveillance is evidence of the subordinate position of phenomena, even invasive phenomena, that relate exclusively to women and in particular black women. Critical Race Theory (CRT) is instructive. The “ Critical ” moiety of the phrase connotes the fact that the paradigm challenges fundamental norms and orthodoxies, which rather than being seemingly neutral may be imbued with racism 19 . It challenges individuals and whole disciplines to re-evaluate their own empirical praxes and belief systems. It is unpalatable for anyone to consider that some of their behaviours may be influenced by implicit and/or subconscious discriminatory reflexes 20 . Yet huge race-based disparities in abortion have existed, repeat themselves and continued to expand for over a third of a century and our profession remains reticent. Equality necessarily means equality in every domain. It is has proven important to consider the causes and address where possible racial inequalities in cardiovascular disease, cerebrovascular disease, renal disease, oncology care, peri-natal mortality. Indeed where the underlying causes have been elucidated this has benefited all 21 , 22 . This has become a mission in modern medicine; but it seems much less palatable to do so in the arena of abortion. Under the heuristic of Critical Race Theory (CRT), one must consider if the abortion rates were reversed; such that abortions were over 450/1000 live births amongst white women and was multiples of that for black women and this discrepancy had existed for over 33 years and doubled over this period, whether the phenomenon would attract such little attention. Within CRT intersectionality is a cardinal precept. This is the notion that a number of grounds of discrimination such a gender, age and sexual orientation can intersect with and thus amplify racism. With this in mind one must rebrand the aforementioned comparison to consider if young, working-age white men had recourse to a medical and/or surgical intervention related to their reproductive system with a frequency equivalent to 450 per 1000 live births leading to the termination of white foetuses at an equivalent rate, a figure four times that of black foetuses, whether there would be a nimiety of enquiry or if it would in actuality become a priory superseding all others. Significantly our findings engage young black women and their reproductive health and thus are prima facie not transferrable to young white men in any way. Abortion can be a polarising issue. However irrespective of one’s views, the figures reported herein are alarming and mandate urgent attention. If one considers abortion as healthcare, one must, as a matter of urgency, attend to why one portion of the population has recourse to this procedure at a rate four times that of another, a ratio which has doubled in the last 34 years. If one considers abortion morally prohibited, then the exceptionally high rates in a specific group that is the subject of discrimination by both gender and race is undesirable and warrants further intensive investigation. A struthious or reticent posture on either side of the debate is inexcusable. The datasets generated and/or analysed during the current study are available in the studies in the supplementary material and reported in Table 1 . Table 1 : Table 1 Variation in abortion rates measured by abortions per 1000 live birth amongst black and white women as recorded by CDC data over time. Third row shows number of US reporting arrears from which data collected. Year No of Reporting Areas Black Women White Women Ratio 1989 33 496 252 2.0 1990 32 521 258 2.0 1991 26 502 246 2.0 1992 36 518 236 2.2 1993 36 552 231 2.4 1994 37 538 217 2.5 1995 36 534 204 2.6 1996 35 555 202 2.7 1997 39 543 194 2.8 1998 39 512 189 2.7 1999 37 529 177 3.0 2000 41 503 167 3.0 2001 39 491 165 3.0 2002 37 495 164 3.0 2003 35 491 165 3.0 2004 38 472 161 2.9 2005 38 467 158 2.9 2006 39 459 162 2.8 2007 25 480 144 3.3 2008 28 472 140 3.4 2009 29 477 140 3.4 2010 28 483 141 3.4 2011 27 459 132 3.5 2012 27 435 127 3.4 2013 29 420 121 3.5 2014 30 391 121 3.2 2015 30 390 111 3.5 2016 32 401 109 3.7 2017 36 393 122 3.2 2018 31 335 110 3.0 2019 30 386 117 3.3 2020 30 426 118 3.6 2021 33 498 116 4.3 2022 32 429 106 4.0 Declarations Funding: No funding was received Author Contribution There is sole author who is wholly responsible Acknowledgement N/A Data Availability The datasets generated and/or analysed during the current study are available in the studies in the supplementary material and reported in Table 1. References Kozhimannil KB, Hassan A, Hardeman RR. Abortion Access as a Racial Justice Issue. N Engl J Med. 2022 Oct 27;387(17):1537–1539. Harvey SM, Larson AE, Warren JT. The Dobbs Decision - Exacerbating U.S. Health Inequity. N Engl J Med. 2023 Apr 20;388(16):1444–1447. Lavizzo-Mourey RJ, Besser RE, Williams DR. Understanding and Mitigating Health Inequities - Past, Current, and Future Directions. N Engl J Med. 2021 May 6;384(18):1681–1684. Jones DS, Hammonds E, Gone JP, Williams D. Explaining Health Inequities - The Enduring Legacy of Historical Biases. N Engl J Med. 2024 Feb 1;390(5):389–395. doi: 10.1056/NEJMp2307312 . Steinbrook R. Disparities in health care–from politics to policy. N Engl J Med. 2004 Apr 8;350(15):1486-8. Javed Z, Haisum Maqsood M, Yahya T, Amin Z, Acquah I, Valero-Elizondo J, Andrieni J, Dubey P, Jackson RK, Daffin MA, Cainzos-Achirica M, Hyder AA, Nasir K. Race, Racism, and Cardiovascular Health: Applying a Social Determinants of Health Framework to Racial/Ethnic Disparities in Cardiovascular Disease. Circ Cardiovasc Qual Outcomes. 2022 Jan;15(1):e007917. doi: 10.1161/CIRCOUTCOMES.121.007917 . Epub 2022 Jan 18. PMID: 35041484. Diao JA, He Y, Khazanchi R, Tiako MN, Witonsky JI, Pierson E, Rajpurkar P, Elhawary JR, Melas-Kyriazi L, Yen A, Martin AR. Implications of race adjustment in lung-function equations. The New England journal of medicine. 2024 May 19;390(22):2083. Hassan S, Gujral UP, Quarells RC, Rhodes EC, Shah MK, Obi J, Lee WH, Shamambo L, Weber MB, Narayan KMV. Disparities in diabetes prevalence and management by race and ethnicity in the USA: defining a path forward. Lancet Diabetes Endocrinol. 2023 Jul;11(7):509–524. doi: 10.1016/S2213-8587(23)00129-8 . Epub 2023 Jun 22. PMID: 37356445; PMCID: PMC11070656. Dwyer-Lindgren L, Baumann MM, Li Z, Kelly YO, Schmidt C, Searchinger C, La Motte-Kerr W, Bollyky TJ, Mokdad AH, Murray CJ. Ten Americas: a systematic analysis of life expectancy disparities in the USA. Lancet. 2024 Dec 7;404(10469):2299–2313. doi: 10.1016/S0140-6736(24)01495-8 . Bocour A, Lewis E, Lee S, Eisenstein LG. Disparities in Kidney Disease and the Race-Neutral eGFR - Research and Action in NYC's Public Hospital System. N Engl J Med. 2025 Oct 30;393(17):1657–1658. Ansell DA, James B, De Maio FG. A Call for Antiracist Action. N Engl J Med. 2022 Jul 7;387(1):e1. Givens ML, Gennuso KP, Pollock EA, Johnson SL. Deconstructing Inequities - Transparent Values in Measurement and Analytic Choices. N Engl J Med. 2021 May 13;384(19):1861–1865. Yam EA, Silva M, Ranganathan M, White J, Hope TM, Ford CL. Time to take critical race theory seriously: moving beyond a colour-blind gender lens in global health. Lancet Glob Health. 2021 Apr;9(4):e389-e390 https://www.cdc.gov/reproductive-health/data-statistics/abortion-surveillance-system.html Biggs MA, Gould H, Foster DG. Understanding why women seek abortions in the US. BMC Womens Health. 2013 Jul 5;13:29. Finer LB, Frohwirth LF, Dauphinee LA, Singh S, Moore AM. Reasons U.S. women have abortions: quantitative and qualitative perspectives. Perspect Sex Reprod Health. 2005 Sep;37(3):110-8. Heath JM, Nguyen BT. Why Men Have Abortions: Quantitative and Qualitative Perspectives From Urban Family Planning Clinics in Chicago, Illinois, USA. Am J Mens Health. 2025 Jan-Feb;19(1):15579883241307795 https://www.minneapolisfed.org/article/2022/how-the-racial-wealth-gap-has-evolved-and-why-it-persists Givens ML, Gennuso KP, Pollock EA, Johnson SL. Deconstructing Inequities - Transparent Values in Measurement and Analytic Choices. N Engl J Med. 2021 May 13;384(19):1861–1865. Sivashanker K, Gandhi TK. Advancing Safety and Equity Together. N Engl J Med. 2020 Jan 23;382(4):301–303. Selvaraj S, Claggett B, Shah SH, et al. Cardiovascular Burden of the V142I Transthyretin Variant. JAMA. 2024;331(21):1824–1833 Hopper T, Olabisi OA. APOL1-Mediated Kidney Disease. JAMA. 2024;331(19):1668–1669. doi: 10.1001/jama.2024.2667 Additional Declarations No competing interests reported. Supplementary Files Appendix1CRT.docx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8524612","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":618399534,"identity":"3f6ad4b9-9cd8-41ec-b068-fda7f443561d","order_by":0,"name":"Chika Edward Uzoigwe","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA1UlEQVRIiWNgGAWjYDACCcZmBoYKZhQxZhxqkbWcASpiI14LUAFjGyla+Gc3Nxv8nGctxz+/+djHHww2+fIOPMYGeC25c7A5sXdburHEMbbk2TwMaZYbD/AYJ+DTYiCR2HyAd9vhxA1sPMZABx02MGzgMT5ASMvBv3MgWhh/EKslmbcBooWBB6hFnoGAwyRuJDYbyxwD+SUtmZnHIM3AgJmtGK/3+WekP5Z8UwMMsebDhxl/VNgYyLc3b5bApwXdnUB0mAT1ECDfQLKWUTAKRsEoGOYAACevPmWKHISVAAAAAElFTkSuQmCC","orcid":"","institution":"Harcourt House","correspondingAuthor":true,"prefix":"","firstName":"Chika","middleName":"Edward","lastName":"Uzoigwe","suffix":""}],"badges":[],"createdAt":"2026-01-05 20:23:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8524612/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8524612/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":106636080,"identity":"8e74e939-cbe2-45b4-bfd0-5dc399d68a2c","added_by":"auto","created_at":"2026-04-10 16:52:11","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":202387,"visible":true,"origin":"","legend":"\u003cp\u003eVariation in abortion rates measured by abortions per 1000 live births amongst black (blue) and white women (green) with a trend line (red) as recorded by CDC data over time.\u003c/p\u003e","description":"","filename":"CRTvsAbortionFigure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8524612/v1/53b380c57d4bbf7f3459853e.jpg"},{"id":107479256,"identity":"f4b3b322-ff55-4cad-b339-639915794a38","added_by":"auto","created_at":"2026-04-22 01:21:20","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":245022,"visible":true,"origin":"","legend":"\u003cp\u003eRatio of abortion rates measured by abortions per 1000 live births for black women to white women over time from CDC data.\u003c/p\u003e","description":"","filename":"CRTvsAbortionFigures2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-8524612/v1/6486b6b8485cc4f4c350bdf2.jpg"},{"id":108976904,"identity":"e06e06c2-1547-41ef-96e1-acf6953f16ec","added_by":"auto","created_at":"2026-05-11 11:29:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":708138,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8524612/v1/f3292266-1a19-438f-8247-bec53c92913e.pdf"},{"id":106636082,"identity":"edbadf92-0e8e-46a6-b4ab-ea6713d0ced3","added_by":"auto","created_at":"2026-04-10 16:52:11","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":22347,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix1CRT.docx","url":"https://assets-eu.researchsquare.com/files/rs-8524612/v1/7012dc7cdef69542d0ff28eb.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Racial Disparities in Pregnancy Termination: Critical Race Theory Meets Abortion","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe disproportionate impact on black women was one of the key arguments used to challenge the restriction of abortion services following the US Supreme Court Decision of \u003cem\u003eJackson v Dobbs\u003c/em\u003e\u003csup\u003e1\u003c/sup\u003e.\u003csup\u003e2\u003c/sup\u003e. However this was one of the first times that racial disparities in abortion had entered socio-political and even medical debate. Even so, it did so only tangentially and was decidedly excluded from the main topic of discussion, such that in could never by the cynosure. Inequities in healthcare are well established. However in all other domains it garners significant attention, with concerted and dedicated drives to determine their aetiopathogenesis and where possible equilibrate any racial imbalance\u003csup\u003e3\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e4\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e5\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e6\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e7\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e8\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e9\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e10\u003c/sup\u003e. Abortion is a notable and inexplicable exception. No woman aspires to have an abortion. Even where they desire abortion as an intervention to be available, no woman wants to be in a position where she feels she needs to have recourse to such an intervention. The incurious posture of the medical profession to disparities in abortion is perplexing. If abortion is healthcare, how can one portion of the population have a disproportionate recourse to this provision and this not be subject of further enquiry and investigation? The important role of Critical Race Theory (CRT) in eradicating discrimination is being increasingly appreciated\u003csup\u003e11\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e12\u003c/sup\u003e. CRT posits that race is a social construct, however centuries of disenfranchisement based on race have resulted in inveterate racism interwoven into societal matrices. It counsels that discrimination is a default posture in societal paradigms and can only be eradicated by active attentiveness and surveillance against its manifestations and occurrence in all its guises\u003csup\u003e13\u003c/sup\u003e. Notwithstanding 52 years since \u003cem\u003eRoe v Wade\u003c/em\u003e we report the first study reporting the variation of racial disparities in abortion with time.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eSince 1969 the Centre for Disease Control (CDC) has continuously collated data from the US on abortion as part of its surveillance programme\u003csup\u003e14\u003c/sup\u003e. 50 states in addition to the District of Columbia and New York City report such data. These geographic regions are collectively designated as the 52 areas. Details on race and ethnicity are also recorded, including the number of abortions per 1000 live births by self-reported race. The hitherto annual CDC Abortion Surveillance report was suspended for the first time in 2025. One of the earliest racial categorisation recorded within the CDC report was Black, White and \u0026ldquo;Other\u0026rdquo;, from 1989. Prior to this time Black and other ethnicities were amalgamated. Up until 2006 Hispanic women were placed within the same category as white women. From 2007 ethnicities were divided into Black, White, Hispanic and Other. For each year from 1989 to 2022 (the most recently reported data) we compared the number of abortion per 1000 live births for Black and White women. The raw data is derived directly from the CDC Abortion Surveillance Reports, which is published annually and freely available (See Appendix 1).\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe number of abortions per 1000 live births from 1997 to 2022 has been consistently and considerably greater in black women compared to white women (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, Fig.\u0026nbsp;1). Further From 1997 to 2022 there has been a progressive increase in the ratio of abortions per 1000 live births between black and white women (Fig.\u0026nbsp;2). In 1997 the ratio of abortions/1000 live births for black women to white women was 2.0. In 2022 this figure was 4.0. The difference is driven predominantly by the much more rapid decline in the abortion rate amongst white women compared to black women. In 1989 there were 492 abortions per 1000 live births amongst black women but 252 amongst white women. These figures had fallen to 429 and 106/1000 live births respectively. Thus rate has over halved for white women with a much more modest decline amongst black women.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eAbortion rates as measured by births per 1000 live births are extremely high for both black and white women, but especially so in the former. The values have remained inveterately high from 1989 to 2022, with a decline in rates observed amongst both black and white women, with a more rapid decline in the case of the latter. The ratio of the number abortions per 1000 live births for black women to white women has doubled over the period of 34 years from 2 in 1989 to 4 in 2022. This is driven by a more concerted decline in abortion rates for white women compared to black women. Abortions per live 1000 live births more than halved in the 34-year study period for white women from 252/1000 live births in 1989 to 106 in 2022. The decline amongst black women was less pronounced from 496/1000 live births in 1989 to 429 in 2022.\u003c/p\u003e\n\u003cp\u003eThe divergence is difficult to explain, all the more so as medical science appears ambivalent to it. Poverty is one of the commonest reasons women seek abortions\u003csup\u003e15\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e16\u003c/sup\u003e. Heath et al found that male partners who accompany women to have abortions express a similar sentiment\u003csup\u003e17\u003c/sup\u003e. In Heath\u0026rsquo;s study, however, only 34% of men expressed the wish that their partner not continue with the pregnancy. Nonetheless, tellingly, the \u0026ldquo;poverty gap\u0026rdquo; or \u0026ldquo;affluence gap\u0026rdquo; between black and white people has remained relatively constant over the past decades\u003csup\u003e18\u003c/sup\u003e. It cannot therefore unequivocally account for the divarication in abortion rates between black and white women.\u003c/p\u003e\n\u003cp\u003eThese racial disparities, unlike in every other domain, has escaped scrutiny and evaluation. Abortion is not an anodyne intervention. No one woman ultimately wants to be in a position where she feels she is in need of this procedure. Yet there is some indifference in the face of this stark and expanding inequality in abortion between black and white women. Even the muted, mussitating and permissive response to the CDC discontinuing its annual abortion surveillance is evidence of the subordinate position of phenomena, even invasive phenomena, that relate exclusively to women and in particular black women.\u003c/p\u003e\n\u003cp\u003eCritical Race Theory (CRT) is instructive. The \u0026ldquo;\u003cem\u003eCritical\u003c/em\u003e\u0026rdquo; moiety of the phrase connotes the fact that the paradigm challenges fundamental norms and orthodoxies, which rather than being seemingly neutral may be imbued with racism\u003csup\u003e19\u003c/sup\u003e. It challenges individuals and whole disciplines to re-evaluate their own empirical praxes and belief systems. It is unpalatable for anyone to consider that some of their behaviours may be influenced by implicit and/or subconscious discriminatory reflexes\u003csup\u003e20\u003c/sup\u003e. Yet huge race-based disparities in abortion have existed, repeat themselves and continued to expand for over a third of a century and our profession remains reticent. Equality necessarily means equality in every domain. It is has proven important to consider the causes and address where possible racial inequalities in cardiovascular disease, cerebrovascular disease, renal disease, oncology care, peri-natal mortality. Indeed where the underlying causes have been elucidated this has benefited all\u003csup\u003e21\u003c/sup\u003e\u003csup\u003e,\u003c/sup\u003e\u003csup\u003e22\u003c/sup\u003e. This has become a mission in modern medicine; but it seems much less palatable to do so in the arena of abortion.\u003c/p\u003e\n\u003cp\u003eUnder the heuristic of Critical Race Theory (CRT), one must consider if the abortion rates were reversed; such that abortions were over 450/1000 live births amongst white women and was multiples of that for black women and this discrepancy had existed for over 33 years and doubled over this period, whether the phenomenon would attract such little attention. Within CRT intersectionality is a cardinal precept. This is the notion that a number of grounds of discrimination such a gender, age and sexual orientation can intersect with and thus amplify racism. With this in mind one must rebrand the aforementioned comparison to consider if young, working-age white men had recourse to a medical and/or surgical intervention related to their reproductive system with a frequency equivalent to 450 per 1000 live births leading to the termination of white foetuses at an equivalent rate, a figure four times that of black foetuses, whether there would be a nimiety of enquiry or if it would in actuality become a priory superseding all others. Significantly our findings engage young black women and their reproductive health and thus are \u003cem\u003eprima facie\u003c/em\u003e not transferrable to young white men in any way.\u003c/p\u003e\n\u003cp\u003eAbortion can be a polarising issue. However irrespective of one\u0026rsquo;s views, the figures reported herein are alarming and mandate urgent attention. If one considers abortion as healthcare, one must, as a matter of urgency, attend to why one portion of the population has recourse to this procedure at a rate four times that of another, a ratio which has doubled in the last 34 years. If one considers abortion morally prohibited, then the exceptionally high rates in a specific group that is the subject of discrimination by both gender and race is undesirable and warrants further intensive investigation. A struthious or reticent posture on either side of the debate is inexcusable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe datasets generated and/or analysed during the current study are available in the studies in the supplementary material and reported in\u003c/strong\u003e Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\n\u003cp\u003eTable\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e:\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003cdiv class=\"colspec\" align=\"char\"\u003e\u0026nbsp;\u003c/div\u003e\n\u003ctable id=\"Tab1\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eVariation in abortion rates measured by abortions per 1000 live birth amongst black and white women as recorded by CDC data over time. Third row shows number of US reporting arrears from which data collected.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eYear\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eNo of Reporting Areas\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eBlack Women\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eWhite Women\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eRatio\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e1989\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e33\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e496\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e252\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e1990\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e521\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e258\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e1991\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e26\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e502\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e246\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e1992\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e518\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e236\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e1993\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e552\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e231\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e1994\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e538\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e217\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e1995\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e534\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e204\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e1996\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e555\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e202\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.7\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e1997\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e39\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e543\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e194\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e1998\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e39\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e512\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e189\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.7\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e1999\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e529\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e177\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2000\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e41\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e503\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e167\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2001\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e39\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e491\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e165\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2002\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e37\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e495\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e164\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2003\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e35\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e491\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e165\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2004\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e38\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e472\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e161\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.9\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2005\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e38\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e467\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e158\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.9\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2006\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e39\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e459\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e162\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e2.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2007\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e25\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e480\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e144\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2008\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e472\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e140\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2009\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e29\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e477\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e140\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2010\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e28\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e483\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e141\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2011\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e459\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e132\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2012\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e27\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e435\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e127\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.4\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2013\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e29\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e420\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e121\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2014\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e391\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e121\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2015\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e390\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e111\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2016\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e401\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e109\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.7\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2017\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e36\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e393\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e122\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2018\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e31\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e335\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e110\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2019\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e386\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e117\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2020\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e30\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e426\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e118\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3.6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2021\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e33\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e498\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e116\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.3\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u003cstrong\u003e2022\u003c/strong\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e32\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e429\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e106\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e4.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eFunding:\u003c/h2\u003e\u003cp\u003e\u003cstrong\u003eNo funding was received\u003c/strong\u003e\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eThere is sole author who is wholly responsible\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eN/A\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets generated and/or analysed during the current study are available in the studies in the supplementary material and reported in Table 1.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003e Kozhimannil KB, Hassan A, Hardeman RR. Abortion Access as a Racial Justice Issue. N Engl J Med. 2022 Oct 27;387(17):1537\u0026ndash;1539.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Harvey SM, Larson AE, Warren JT. The Dobbs Decision - Exacerbating U.S. Health Inequity. N Engl J Med. 2023 Apr 20;388(16):1444\u0026ndash;1447.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Lavizzo-Mourey RJ, Besser RE, Williams DR. Understanding and Mitigating Health Inequities - Past, Current, and Future Directions. N Engl J Med. 2021 May 6;384(18):1681\u0026ndash;1684.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Jones DS, Hammonds E, Gone JP, Williams D. Explaining Health Inequities - The Enduring Legacy of Historical Biases. N Engl J Med. 2024 Feb 1;390(5):389\u0026ndash;395. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1056/NEJMp2307312\u003c/span\u003e\u003cspan address=\"10.1056/NEJMp2307312\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Steinbrook R. Disparities in health care\u0026ndash;from politics to policy. N Engl J Med. 2004 Apr 8;350(15):1486-8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Javed Z, Haisum Maqsood M, Yahya T, Amin Z, Acquah I, Valero-Elizondo J, Andrieni J, Dubey P, Jackson RK, Daffin MA, Cainzos-Achirica M, Hyder AA, Nasir K. Race, Racism, and Cardiovascular Health: Applying a Social Determinants of Health Framework to Racial/Ethnic Disparities in Cardiovascular Disease. Circ Cardiovasc Qual Outcomes. 2022 Jan;15(1):e007917. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1161/CIRCOUTCOMES.121.007917\u003c/span\u003e\u003cspan address=\"10.1161/CIRCOUTCOMES.121.007917\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2022 Jan 18. PMID: 35041484.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Diao JA, He Y, Khazanchi R, Tiako MN, Witonsky JI, Pierson E, Rajpurkar P, Elhawary JR, Melas-Kyriazi L, Yen A, Martin AR. Implications of race adjustment in lung-function equations. The New England journal of medicine. 2024 May 19;390(22):2083.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Hassan S, Gujral UP, Quarells RC, Rhodes EC, Shah MK, Obi J, Lee WH, Shamambo L, Weber MB, Narayan KMV. Disparities in diabetes prevalence and management by race and ethnicity in the USA: defining a path forward. Lancet Diabetes Endocrinol. 2023 Jul;11(7):509\u0026ndash;524. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/S2213-8587(23)00129-8\u003c/span\u003e\u003cspan address=\"10.1016/S2213-8587(23)00129-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2023 Jun 22. PMID: 37356445; PMCID: PMC11070656.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Dwyer-Lindgren L, Baumann MM, Li Z, Kelly YO, Schmidt C, Searchinger C, La Motte-Kerr W, Bollyky TJ, Mokdad AH, Murray CJ. Ten Americas: a systematic analysis of life expectancy disparities in the USA. Lancet. 2024 Dec 7;404(10469):2299\u0026ndash;2313. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/S0140-6736(24)01495-8\u003c/span\u003e\u003cspan address=\"10.1016/S0140-6736(24)01495-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Bocour A, Lewis E, Lee S, Eisenstein LG. Disparities in Kidney Disease and the Race-Neutral eGFR - Research and Action in NYC's Public Hospital System. N Engl J Med. 2025 Oct 30;393(17):1657\u0026ndash;1658.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Ansell DA, James B, De Maio FG. A Call for Antiracist Action. N Engl J Med. 2022 Jul 7;387(1):e1.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Givens ML, Gennuso KP, Pollock EA, Johnson SL. Deconstructing Inequities - Transparent Values in Measurement and Analytic Choices. N Engl J Med. 2021 May 13;384(19):1861\u0026ndash;1865.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Yam EA, Silva M, Ranganathan M, White J, Hope TM, Ford CL. Time to take critical race theory seriously: moving beyond a colour-blind gender lens in global health. Lancet Glob Health. 2021 Apr;9(4):e389-e390\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.cdc.gov/reproductive-health/data-statistics/abortion-surveillance-system.html\u003c/span\u003e\u003cspan address=\"https://www.cdc.gov/reproductive-health/data-statistics/abortion-surveillance-system.html\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Biggs MA, Gould H, Foster DG. Understanding why women seek abortions in the US. BMC Womens Health. 2013 Jul 5;13:29.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Finer LB, Frohwirth LF, Dauphinee LA, Singh S, Moore AM. Reasons U.S. women have abortions: quantitative and qualitative perspectives. Perspect Sex Reprod Health. 2005 Sep;37(3):110-8.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHeath JM, Nguyen BT. Why Men Have Abortions: Quantitative and Qualitative Perspectives From Urban Family Planning Clinics in Chicago, Illinois, USA. Am J Mens Health. 2025 Jan-Feb;19(1):15579883241307795\u003c/span\u003e \u003c/li\u003e\u003cli\u003e\u003cspan\u003e \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.minneapolisfed.org/article/2022/how-the-racial-wealth-gap-has-evolved-and-why-it-persists\u003c/span\u003e\u003cspan address=\"https://www.minneapolisfed.org/article/2022/how-the-racial-wealth-gap-has-evolved-and-why-it-persists\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Givens ML, Gennuso KP, Pollock EA, Johnson SL. Deconstructing Inequities - Transparent Values in Measurement and Analytic Choices. N Engl J Med. 2021 May 13;384(19):1861\u0026ndash;1865.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Sivashanker K, Gandhi TK. Advancing Safety and Equity Together. N Engl J Med. 2020 Jan 23;382(4):301\u0026ndash;303.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Selvaraj S, Claggett B, Shah SH, et al. Cardiovascular Burden of the V142I Transthyretin Variant. JAMA. 2024;331(21):1824\u0026ndash;1833\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e Hopper T, Olabisi OA. APOL1-Mediated Kidney Disease. JAMA. 2024;331(19):1668\u0026ndash;1669. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1001/jama.2024.2667\u003c/span\u003e\u003cspan address=\"10.1001/jama.2024.2667\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8524612/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8524612/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e \u003cp\u003eThe 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.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe 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.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eAcross 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.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eThe 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 \u003cem\u003emodus operandi\u003c/em\u003e 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.\u003c/p\u003e","manuscriptTitle":"Racial Disparities in Pregnancy Termination: Critical Race Theory Meets Abortion","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-04-10 16:52:07","doi":"10.21203/rs.3.rs-8524612/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"f8a42196-629a-47b4-9bb1-a1ac98209af9","owner":[],"postedDate":"April 10th, 2026","published":true,"recentEditorialEvents":[{"type":"decision","content":"Rejected","date":"2026-05-08T10:01:17+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-05T14:21:37+00:00","index":131,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-04T20:12:48+00:00","index":130,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2026-05-03T19:24:48+00:00","index":129,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":65803856,"name":"Health sciences/Diseases"},{"id":65803857,"name":"Health sciences/Health care"},{"id":65803858,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2026-05-08T10:12:35+00:00","versionOfRecord":[],"versionCreatedAt":"2026-04-10 16:52:07","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8524612","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8524612","identity":"rs-8524612","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}