Reproductive Justice is Black History: Honoring the Past, Building the Future

Reproductive justice didn't happen by accident. 

It was built deliberately, with intention, by Black women who refused to accept a healthcare system that routinely failed them. Women who showed up, organized, and demanded something better when the mainstream conversation wasn't making room for them.

Their work reached past the narrower conversation about abortion rights that had long dominated reproductive health policy. It asked a question the mainstream reproductive rights movement hadn't fully grappled with: what does it mean to have a choice when the conditions around you make that choice nearly impossible? 

Black women in America had lived experience with a different set of stakes: coerced sterilization, medical indifference during childbirth, barriers to prenatal care, the compounding weight of systemic racism on pregnant bodies. 

Reproductive Justice was built to hold all of that. It acknowledged that freedom means something different when your life is genuinely at risk.

This Black History Month, we're honoring that legacy, confronting the crisis that makes this work still urgent, and committing to the movement that continues it.

How Black Women Redefined Reproductive Rights

In the summer of 1994, a group of Black women gathered in Chicago and created something that would permanently shift how we talk about reproductive rights. They called it Reproductive Justice, and the concept is deceptively simple: every person has the right to have children, not have children, and raise their children in safe and supportive environments.

The group, which later became the SisterSong Women of Color Reproductive Justice Collective, recognized that the mainstream reproductive rights conversation centered on access to abortion while ignoring the full spectrum of issues Black women faced, including coerced sterilization, poverty, housing instability, and medical neglect. The Reproductive Justice framework said that bodily autonomy means nothing if the conditions around you make it impossible to exercise.

That 1994 meeting is Black history. So is every policy, organization, and telehealth visit that builds on it.

The Maternal Mortality Gap Is Not Closing for Black Women

Thirty years after that founding moment, the numbers are sobering. According to the CDC's most recent data, the maternal mortality rate for Black women in 2023 was 50.3 deaths per 100,000 live births, significantly higher than rates for White women (14.5), Hispanic women (12.4), and Asian women (10.7).

That means Black women had a mortality rate more than three times the rate for White women. And more than 80 percent of pregnancy-related deaths in the United States are preventable.

It’s not “biological.” Research consistently points to structural racism, bias within clinical settings, and unequal access to quality care as primary drivers. Maternal death rates in abortion-restricted states are 62 percent higher than in states with abortion access, and 45 percent of Black women and girls under 55 live in states with heavy reproductive health restrictions or total bans.

These numbers are the reason reproductive justice organizations do their work. They're also the reason we do ours at Twentyeight Health.

Black-Led Reproductive Justice Organizations You Should Know

The reproductive justice movement is powered by Black-led organizations doing essential, often underfunded work. Here are some of the groups that are shaping policy, building community, and saving lives:

• Black Mamas Matter Alliance (BMMA) is widely regarded as the gold standard for Black maternal health advocacy and research. BMMA centers the voices of Black mothers in research, policy, and advocacy, pushing for systemic change at every level of government and healthcare.
• Black Women's Health Imperative is the first national nonprofit dedicated solely to the health of Black women and girls. For over 40 years, they have been producing research, creating programs, and fighting for policy that directly serves Black women's wellbeing.
  
  
• National Birth Equity Collaborative (NBEC) builds data-driven solutions to reduce disparities in Black maternal and infant health. Their work includes training providers, developing community programs, and holding health systems accountable.
  
  
• SisterLove, Inc. addresses sexual health, HIV, and Reproductive Justice with a specific focus on communities in the South, where access to care is often most severely restricted.
  
  
• The Afiya Center is the only Reproductive Justice organization in North Texas founded and directed by Black women. They provide direct services alongside advocacy and community organizing, rooting their work in the specific needs of Black Texans.

How Twentyeight Health Supports Equity in Reproductive Health

We are not a neutral company. Twentyeight Health was built specifically to serve individuals who have been failed by the traditional healthcare system, and we know that "traditionally failed" disproportionately means Black women.

The racial disparities in maternal mortality reflect structural racism, particularly inequities in access to quality healthcare services, and telehealth has a real role to play in addressing that gap. When someone in a rural county with no OB-GYN within 40 miles can connect with a licensed provider, get birth control delivered to their door, and message their care team with no judgment, that is Reproductive Justice in practice.

More than half of Twentyeight Health's users identify as Black, Hispanic/Latinx, Asian, or multiracial. About half use Medicaid. We accept Medicaid in more states than any other telehealth platform, and our services are available in 43 states, including the rural and non-urban areas where healthcare deserts are most common.

Some of the ways we work to close the gap:

• Affordable birth control options starting at $0 with Medicaid, with no waiting rooms and no transportation barriers
• STI prevention and sexual health care delivered with the discretion and respect everyone deserves
  
  
• Prenatal vitamins and preconception support for people preparing for or navigating pregnancy
  
  
• Emergency contraception available quickly, affordably, and without judgment
  
  
• Provider messaging 365 days a year, so questions never go unanswered because of clinic hours or cost
  
  
• Our sex health guide, a free, doctor-vetted library covering birth control, STIs, pregnancy, and reproductive health topics written in plain language and without judgment 

We are committed to our part in the movement to ensure Black women and families never have to choose between their health and their dignity.

Books and Podcasts on Black Reproductive Justice

If you want to go deeper into this history and the ongoing fight for Reproductive Justice, these are worth seeking out:

• The 1619 Project Podcast: Nikole Hannah-Jones and her collaborators examine how the consequences of slavery and the contributions of Black Americans shaped American history and culture. The episode on healthcare is essential.
  
  
• Just Medicine: A Cure for Racial Inequality in American Health Care by Dayna Bowen Matthew: A rigorous and readable examination of how implicit bias and structural racism shape health outcomes, with concrete proposals for change.
  
  
• Killing the Black Body: Race, Reproduction, and the Meaning of Liberty by Dorothy Roberts: First published in 1997 and still urgent, Roberts traces the long history of reproductive control and coercion wielded against Black women in America, from slavery through the welfare reform era. It is foundational reading for understanding why the Reproductive Justice movement exists.

Support Black-Led Health Equity 

Black History Month is a good time to redirect resources toward organizations doing this work right now. Here are direct links:

The Reproductive Justice movement is a living, ongoing project built by Black women, and it deserves to be honored with more than a social media post. It deserves our time, our resources, and a genuine commitment to making healthcare equitable for everyone.

If you're ready to access care that respects your whole story, Twentyeight Health is here.