women holding protest signs in front of Georgia capital; one is a drawing of a uterus that says mine
Nichelle Rick-Lewis, center, of Brooklyn, N.Y., holds a sign joining hundreds of people around the Georgia Capitol protesting against two pieces of legislation they say are unfair to women Monday, March 12, 2012, in Atlanta. The rally Monday comes after the Senate last week passed measures banning abortion coverage under state employees' health care plans and exempting religious health care providers from having to cover birth control. (AP Photo/David Goldman)

Georgia is a maternity care desert in a maternal mortality crisis. Georgia voters will determine if Biden has a cooperative Senate to help reverse this tragic course.

After four years with an administration that consistently worked to roll back access to health care, including attacking Americans’ right to plan their own families, President-elect Joe Biden has a lot of work ahead of him. Although the president-elect can reverse many of President Donald Trump’s executive orders regarding abortion and contraception, Biden will also need Congress’s help to expand maternal and reproductive healthcare access.

“It’s not just about bringing the US and the world back to where we were in 2016,” Zarah Ahmed, associate director of federal issues at the Guttmacher Institute, told Vox. “Things weren’t great in 2016—a lot of people didn’t have access to care they needed and wanted and deserved. Yes, we have to undo this damage, but we also have to get to a far more equitable place.”

To do that, Democrats have to win the two Senate seats in Georgia, which would allow them to take up issues that matter to Americans but were too often ignored by Senate Majority Leader Mitch McConnell. The runoff elections will occur on Jan. 5, with incumbent senators Kelly Loeffler and David Perdue facing off against Rev. Raphael Warnock and Jon Ossoff, respectively.

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As Oshuteiya Campbell, the policy and advocacy program manager at SisterLove told COURIER: “The success of the Biden/Harris administration is at stake in the upcoming runoff elections. Georgia voters will determine whether or not the Senate will be collaborative with the incoming president.”

In Georgia, reproductive health care is a particularly salient issue. Half of the state’s 159 counties are without a healthcare provider who specializes in gynecology or obstetrics. The March of Dimes declared 37 counties in Georgia maternity care deserts for their lack of obstetric providers or hospitals.

Meanwhile, the advocacy organization NARAL Pro-Choice America has classified access to reproductive rights in the state as “severely restricted.” Fifty-five percent of Georgia women live in counties with no abortion clinics. State lawmakers have the power to adopt laws to expand or limit access to abortion—as they did with 2019’s House Bill 481, which banned the procedure after a heartbeat is detected or as early as six weeks gestation. However, Congress can do a number of things in this arena, including help low-income Americans obtain abortion care by repealing the Hyde Amendment. The long-standing amendment prohibits federal Medicaid funding from being used for abortion services outside of extenuating circumstances.

A recent Change Research poll found that 78% of suburban women in Georgia oppose banning abortion care. Yet, during her first week in office in January, Loeffler—appointed by Gov. Brian Kemp in late 2019 after Sen. Johnny Isakson resigned—co-sponsored three anti-abortion measures. One of those bills would have made the Hyde Amendment permanent; another aimed to ban most abortions after 20 weeks. 

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Perdue, for his part, has also repeatedly supported legislation to ban abortion, despite it being constitutionally protected by Roe v. Wade. In 2018, he voted to confirm conservative Brett Kavanaugh to the US Supreme Court, and days before the November election, he voted (as did Loeffler) in support of Amy Coney Barrett to the bench. Both justices are viewed as being hostile to reproductive freedom. 

The right to abortion care, said Campbell, “should not be prohibited based on someone else’s political or religious beliefs. The procedure should be between the person and their healthcare provider in a safe and legal environment.”

Reproductive rights are not just about family planning and access to abortion and contraceptives. Advocates are also pushing for more support around related issues such as uterine fibroids. Thousands of Georgia women and 11 million people across the country have been diagnosed with this often painful condition that causes heavy bleeding and other symptoms.

Amber English Coleman, the director of advocacy for The White Dress Project, a Georgia-based uterine fibroid awareness organization, told COURIER that “there are real policy solutions that exist that would improve health care, expand reproductive rights, even fund research into health disparities like uterine fibroids.” 

For example, earlier this year, Sen. Kamala Harris introduced the Uterine Fibroid Research and Education Act to support research and public education on uterine fibroids. It’s an issue that disproportionately affects Black women, who are two to three times more likely to have recurring fibroids or suffer related complications.

“Millions depend on contraceptive access as a part of their treatment path,” Coleman explained. “Many of us use sick days each month when our cycles come, and the pain is too much to bear. Many more can’t even get the care they need because they are uninsured.” 

If Ossoff and Warnock—both of whom are considered champions for reproductive rights—win the Senate, the Helping MOMS Act, which passed the House in October, could finally see some movement. If passed by the Senate, the legislation would give states the option to provide Medicaid coverage to pregnant women that extends one year after delivery.

Currently, pregnancy-related Medicaid coverage ends 60 days postpartum, though, according to the Centers for Disease Control, one third of maternal deaths occur up to one year after childbirth. Black women in the state are six times more likely to die because of pregnancy or childbirth-related complications than white women are, on average, across the U.S. With one of the highest rates of pregnancy- and childbirth-related death in the nation, Georgia is in a maternal mortality crisis in dire need of being addressed. 

“We often think of reproductive justice as a finite issue and really it’s not,” Coleman said. “It’s health care. It’s workplace policies. It’s economic justice. Reproductive justice is an umbrella that truly touches everyone.”