Fighting for AAPI abortion care means disaggregating data

Fighting for AAPI abortion care means disaggregating data

by Jenn Fang

This article was originally published at Prism.

Based on the recent leak of Supreme Court Justice Samuel Alito’s majority opinion draft, the U.S. Supreme Court is expected to strike down Roe v. Wade this year and eliminate constitutional protections for abortion access. The effects will be catastrophic for many marginalized communities, including Asian Americans, whom public health and political opinion data often overlook and treat as a monolith. At this critical point in the fight for reproductive justice, advocates need to understand key differences among Asian Americans and Pacific Islanders (AAPI) that span geography, immigration status, and racial and ethnic identity to craft successful responses, resources, and outreach to counteract misinformation. AAPI communities are key stakeholders in full access to reproductive rights and health care, and like most Americans, many already support accessible abortion care.

“Most [Asian Americans and Pacific Islanders] support abortion because we have either experienced having an abortion or we know people who do,” said Seri Lee, the National Asian Pacific American Women’s Forum’s (NAPAWF) national campaign and membership director.

In fact, 74% of Asian American respondents favor abortion access—the highest of any racial group in the country. However, the full picture of how AAPI communities view abortion is more complex: Disaggregation of Asian American survey data reveals striking ethnic differences in attitudes different communities hold about abortion. For example, one 2018 study found that only 22% of Japanese Americans oppose legal abortion access compared to 69% of Vietnamese Americans, a gap that may reflect ethnic nuances in political affiliation and religious background. At the very least, abortion advocates won’t succeed by using the same messaging for both groups.

While AAPI communities differ in how they view abortion, AAPI people of virtually all ethnic backgrounds rely on abortion access as part of reproductive health care. The Guttmacher Institute found that 6% of patients who seek abortion care nationwide are Asian American, which is proportional to the 5.9% of Asian Americans in the general population. Of abortion patients born outside of the U.S., Asian Americans make up 20%. While abortion rates fell in the 1990s for patients of almost all racial groups, they remained steady among AAPI people. When disaggregated by ethnicity, studies suggest relatively strong usage of abortion care among many Asian American ethnic groups, including Chinese Americans, Korean Americans, and Thai Americans. A report published by NAPAWF suggests that due to relatively low rates of hormonal contraceptive use, nearly one-third of pregnancies in the Asian American community end in abortion. Furthermore, disaggregated data also shows that teen pregnancy rates vary widely within AAPI communities.

Asian Americans are also frequently overlooked by reproductive rights advocates because they are assumed to live in liberal states such as California, which is currently exploring ways to become an abortion sanctuary in the event that Roe is overturned. Lee points out, however, that this aggregate treatment fails to address the millions of Asian Americans who live in the South—including in Texas, which has the third-largest population of Asian Americans in the country and has passed one of the most draconian abortion bans of any state. If Roe is struck down, pregnant Texans—including many Asian Americans—will have to travel an additional 525 miles across state lines to access an abortion. In Georgia, where the Asian American population has grown by over 138% since 2000, pregnant people will have to travel over 200 miles for a legal abortion.

“Even with the legal right to abortion, the path to abortion for AAPIs has so many barriers,” Lee said. “With the Dobbs decision [that is expected to end legal abortion], the court is threatening to pull the rug out from under us.”

Asian Americans and Pacific Islanders face unique challenges to reproductive care

AAPI people already face significant linguistic and economic barriers to abortion access, such as the 1976 Hyde Amendment, which prevents federal programs like Medicaid from covering abortion care for low-income patients. NAPAWF argues that many of the anti-abortion efforts have drawn upon anti-Asian rhetoric to justify state-level abortion bans, a strategy that also stigmatizes Asian American patients seeking abortion. Those fears aren’t unfounded: Current abortion bans have already resulted in the criminalization of pregnant patients in a pattern that has disproportionately impacted women of color, especially Black women. In Indiana, the state first leveraged fetal homicide laws against Asian American women: In 2011, Bei Bei Shuai became the first pregnant person charged with murder in Indiana after a failed suicide attempt resulted in miscarriage, and in 2015, Purvi Patel was sentenced to 20 years in prison for a self-administered abortion, although the conviction was eventually overturned upon appeal.

“Asian women have been singled out when it comes to criminalized reproduction because of ugly stereotypes that claim we have a disregard for life,” writes Miriam Yeung, former executive director of NAPAWF in an op-ed for The Washington Post.

For Pacific Islanders in the three U.S. Pacific territories—Guam, the Northern Mariana Islands, and American Samoa—abortion access and care is particularly difficult to obtain, even under Roe v. Wade. For instance, while abortion isn’t illegal in Guam, the local legislature followed a similar playbook to states that passed policies restricting abortion access as much as possible. Additionally, the only surgical abortion provider on the island retired in 2018 and hasn’t yet been replaced. A ruling in 2021 removed barriers to pregnant people seeking abortion care through telehealth, but those whose needs require direct physical care have no option but to travel. Residents of the Northern Mariana Islands and American Samoa face similar obstacles. Hawaii is often the closest U.S.-based destination, but flights are at least eight hours long and travelers still incur considerable costs.

Lee says that the striking down of Roe will only compound these existing barriers to abortion access for AAPI people. These challenges vary across ethnic and geographic differences within the AAPI communities, but their impacts are hard to predict due to the lack of disaggregated data. While some studies on abortion attitudes and access include Asians, these data aggregate all AAPI people into a single monolithic group, or include them in the “Other” category. Disaggregated data on structural barriers to abortion access are virtually nonexistent, but Lee says that other studies of AAPI people that include disaggregated data can reveal key socioeconomic disparities across AAPI ethnic groups that can then be used to infer how some will be disproportionately affected by abortion bans.

“This data can inform us that those who don’t have health insurance probably aren’t going to have access to abortion care,” says Lee. “They’re making significantly less [in annual income] than others; we can say that their ability to pay for an abortion is also going to be less.”

For example, Lee notes that AAPI women are overrepresented in service and low-wage industries where there’s often less ability to get time off, lower pay, and lack of health insurance. This is particularly true for some ethnic groups such as Vietnamese Americans, who represent the second-largest Asian American ethnic group in Texas, of which 26% work in the service industry. In Texas’ Harris County, 34% of Vietnamese Americans have a household income of less than $25,000 annually—lower than the poverty line for a family of four—compared to 24% of Chinese and Taiwanese Americans, 20% of Indian and Pakistani Americans, and 12% of Filipino Americans. Similarly, disaggregated data reveals stark differences in health insurance coverage: Thirty-four percent of Vietnamese Americans living in Harris County lacked health insurance in 2010, compared to 20% of Chinese Americans and 13% of Indian Americans. Native Hawaiians face considerable obstacles to obtaining comprehensive health care including a shortage of health care practitioners and facilities, and are more likely to experience poverty, unemployment, being unhoused, and other socioeconomic ills.

Additionally, AAPI communities can also struggle with barriers stemming from limited English-language proficiency and immigration status. While Roe v. Wade doesn’t address any of these issues, its removal will undoubtedly make them worse.

Reproductive justice is an AAPI issue

NAPAWF has made improving reproductive rights for AAPI people a key advocacy issue for years. Lee says that NAPAWF has often served as a bridge between AAPI advocacy spaces and gender and reproductive justice spaces where Asian American and Pacific Islander stakeholders are either treated as a monolith or rendered invisible.

“Given the many years we’ve been doing advocacy in reproductive health and justice in AAPI spaces, we can really push the needle on how our communities and organizations are talking about and supporting abortion access at the local, state, and national levels,” Lee said.

NAPAWF plans to redouble those efforts in the pending fight to restore abortion access in the wake of the likely striking down of Roe. In the meantime, the organization is co-mobilizing in its chapters and nationwide to make their opposition to a reversal of Roe v. Wade heard.

AAPI partnerships with other reproductive rights organizations—including many grounded in other communities of color—are vital to establish and protect reproductive rights at the state level. NAPAWF’s New York City chapter, for example, recently partnered with the National Latina Institute for Reproductive Justice to advance the Reproductive Freedom and Equity Act, which would ensure pregnant New Yorkers have abortion access regardless of health insurance status. NAPAWF has also developed reproductive justice solidarity statements that they plan to encourage other AAPI advocacy groups to sign, which they believe will help demonstrate strong communal support for abortion in AAPI communities.

But what advocates say is most critical is to ensure that marginalized AAPI voices are heard in the upcoming reproductive justice fight. AAPI communities represent considerable voting blocs: Asian Americans are the fastest-growing electorate in the U.S. and were key in President Joe Biden’s election in 2020, particularly in swing states. Targeted, community-specific messaging and outreach are essential to mobilizing AAPI people in the fight for reproductive justice.

NAPAWF plans to launch surveys—which will involve phonebanking and canvassing in multiple Asian languages—to capture disaggregated data on the abortion attitudes of AAPI people living in southern states like Georgia and Florida. In Texas, NAPAWF has published abortion access guides. And in all three of these states, NAPAWF will be working on voter mobilization to center reproductive rights issues in the coming election.

“There’s so much at stake right now that if folks weren’t already involved, it’s important they get involved now,” Lee said.

It’s especially important that AAPI advocacy groups actively and openly demonstrate their support for abortion access and not get discouraged in the face of anti-abortion efforts. By building movements, power, and coalitions, AAPI communities can push the needle further in not only ensuring abortion access, but the full range of reproductive rights and justice.

“Even though things are really dire, at the same time we can’t fall into despair,” Lee said. “We need to see and find hope and continue to build power and fight on to defend and expand abortion access.”

Jenn is a proud Asian American feminist, scientist and nerd who currently blogs at Reappropriate.co, one of the web’s oldest AAPI feminist and race activist blogs. Follow her on Twitter @Reappropriate.

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