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pregnancy
Young Pregnant People Need Choices, Not Shame
With young people’s autonomy so limited, we must ensure young pregnant and parenting people have the support they need.
Aug 09, 2025
Access to affordable family planning and sexual health services is under attack, with the current administration threatening millions of dollars in Title X funding.
Millions of poor, uninsured, low-income individuals rely on this program not only for contraception but for cancer detection, HIV testing, and other essential services. The administration’s hostility toward proven programs like this puts young people at greater risk of pregnancy, in an environment where reproductive choices are limited. The consequences of abortion bans are clear: People are getting sick and losing their lives because access to basic reproductive healthcare is being stripped away. But what if you are young? What if you are Black? What if you live in a state restricting abortion? What if you do not get to decide?
For young pregnant people, these bans and funding cuts are even harder to navigate because of barriers to their independence. With the potential cuts to Title X programs, young people’s access to contraception will be even more limited. If they become pregnant when they don’t want to be, some states that still allow abortion have restrictions requiring consent from parents. With young people’s autonomy so limited, we must ensure young pregnant and parenting people have the support they need.
Reproductive justice is a human rights framework coined in 1994 by 12 Black women in response to the reproductive rights and health groups that excluded the lived experiences of those who have been marginalized. This concept includes the right to parent, the right not to parent, the right to parent children in safe and healthy communities, and the right to bodily autonomy. Young people, too, deserve reproductive justice.
What if young people had access to healthcare free from biases and shame?
A powerful misconception is that we are often just one decision away from shaping the course of our lives. But it isn’t the one individual decision. It’s the collective punitive reaction from society that stands in the way of young people getting the support they need. For the young pregnant person who is parenting, there is a systemic lack of support coupled with stereotypes that lead to negative outcomes.
As a child, my knowledge about the consequences resulting from decisions we make about our bodies was limited to the concrete and practical, such as skinning my knee in the neighborhood kickball tournaments when I ran around the bases too quickly. That knowledge quickly expanded when my older sister became pregnant as a teen, and I observed the organized shunning she experienced from family members to healthcare workers to teachers and friends. This was the first time I witnessed shame. I heard how family members talked about her pregnancy as a defining moment, as if any glimpse of a future was now extinguished. Those family members and friends who were “supportive” disappeared once my niece was born. It was at this moment that I decided that I wanted to offset that shame for her, for us, for every young Black girl who is navigating a pregnancy.
I did my best to be a supportive little sister as a child, standing up to all who spoke negatively about my sister and her choices. This experience stayed with me, and as a first year medical student, I founded Sisters Informing Healing Living Empowering (SIHLE) Augusta, renamed Choices Within Reach, an organization that works to support young Black mothers in Augusta, Georgia, through providing community, financial resources, and infant supplies. For the past seven years, in addition to my medical and residency training, we have worked to disempower the systems that shame and marginalize young people about their reproductive choices. Transforming that childhood rage to triumph, this ever-expanding sisterhood is my greatest accomplishment.
Now, as an OB-GYN and community organizer, I continue to hear the echoes of my sister’s story through my patients and the young people I serve in Georgia.
These stereotypes of young parenting people that go back to public condemnation of “teen moms” and “welfare queens” in the 1970s and 80s are still alive in the collective shunning of young Black pregnant people. In many schools, there is a “pregnant student” policy that states that the school won’t make accommodations for a pregnant student unless required by documented medical circumstances. High school students are not granted “maternity leave.” These policies are penal and don’t support the pregnant student’s success, especially when combined with isolation that the pregnant adolescent may be enduring within her community.
It is these punitive policies and attitudes that lead to statistics like only 50% of teen mothers receive their high school diploma by age 22, compared to 90% of teens who do not give birth in their adolescence. The lack of education and support makes it hard for them to find job opportunities, leading to a hard time making ends meet, and so on. This is a collective shunning of young motherhood.
These roots also shape our healthcare system. Just as young moms slip through the cracks of the community, they also often do in the healthcare system. Adolescent medicine providers try to close these gaps for young people. However, the gap widens when they become pregnant. Is it the OB-GYN who receives little to no training on how to specifically care for a pregnant teen or the pediatrician who has not specialized in pregnancy that is trying to care for the teen who is pregnant? When the gaps are felt by young moms, they might disengage from prenatal care, lose trust in their providers, and face poor health outcomes for the mother and baby.
This is especially true when the stereotypes of pregnant adolescents are woven into the implicit and explicit biases of the providers. These biases affect how their providers view them, the care they receive, and their outcomes. Kia, who experienced pregnancy at 16 years old, had her pregnancy confirmed by her pediatrician, who had been caring for her since she was an infant. However, once her urine pregnancy test was positive, there was an obvious disconnect. They told her she could no longer be seen in the office and was not offered any options counseling, OB-GYN references, or even an ultrasound. This experience led Kia to delay seeking prenatal care. What if the pregnancy was in the wrong location? What if there were complications? As we attempt to close the gap of maternal morbidity and mortality rates in the U.S., which are disproportionately higher in Black people, we must address the systems that increase risks faced by young Black parents.
The fight against the societal punishment of young Black parents is an issue of reproductive justice. In a nation where systemic barriers persist, the futures of young Black parents don’t come down to personal choices; they are intricately tied to the what kind of support, education, and resources they can access. It is far beyond time to restructure the narratives and fill the gaps society created for our young Black pregnant and parenting people.
What if we had culturally sound, group prenatal care that focused on and highlighted the needs of young, Black pregnant people? What if we built a community that came together to support young parents with childcare, financial resources, and school or job support? What if medically accurate, comprehensive sex education were available to all young people? What if young people had access to healthcare free from biases and shame? We can create the kind of world where we all have equitable access to the full spectrum of reproductive freedoms, no matter our age or location.
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'Shame': Homeless Woman Was in Labor and Needed Care, But Was Given Ticket Instead
One advocate called out "the politicians who paved the way for this tragedy."
Dec 19, 2024
"I've got to go to the hospital," a pregnant woman filmed by the Louisville Metro Police Department's body cameras in late September told officers, standing near a mattress beneath a busy overpass. "What am I doing wrong?"
The woman was in labor and had told the police as they approached her that she thought her water had broken, but that didn't stop the officers from giving her a ticket for violating a new Kentucky law that bans all street camping—one of dozens of laws criminalizing homelessness that were passed this year.
Lt. Caleb Stewart, who cited the woman in Louisville, told her that he would call an ambulance for her, but when she began moving toward the street to wait for the emergency workers, he yelled at her to stop.
"Am I being detained?" she asked.
"Yes, you're being detained," he replied. "You're being detained because you're unlawfully camping."
Stewart was later heard on the body camera's audio saying he didn't believe the woman was in labor; a public defender representing her told Kentucky Public Radio that she had in fact given birth later that day and the family was living in a shelter while waiting for a January trial date regarding her citation.
The upcoming trial and the video underscore "both the absurdity and cruelty of anti-camping laws in KY and those cropping up nationwide," said Jesse Rabinowitz of the National Homelessness Law Center. "This is an extreme incident, but unfortunately, it is not an isolated one. Instead of addressing the cause of homelessness—the fact that more and more people struggle to afford rent—politicians are passing laws that kick people when they are down and make homelessness worse. The solution to homelessness is housing and help, not tickets or fines."
The U.S. Supreme Court ruled in July that officials can ban sleeping and camping in public places. Since then, said Rabinowitz, nearly 150 cities across the U.S. have passed anti-camping bills.
The video was also publicized days after Republican elected officials celebrated "the person who murdered Jordan Neely, a homeless New Yorker," said Rabinowitz. "And [President-elect] Donald Trump and his billionaire cronies want to round up homeless people and put them in detention camps. All of these things make homelessness worse."
Shameka Parrish-Wright, director of advocacy group VOCAL-KY, said that "the disregard and disrespect of these two lives is the direct result of the so-called 'Safer Kentucky Act' that was enacted this year."
"People experiencing homelessness are fighting for their lives across the country and right here in Louisville. Investing in immediate, affordable housing and healthcare is the only way to stop this from happening again—not by handing out more tickets that won't house a single person," said Parrish-Wright. "Shame on the politicians who paved the way for this tragedy.”
"If politicians actually cared about homeless Kentuckians," she added, "they would focus on getting them the housing and support they need."
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Third Death Tied to Texas Abortion Ban as 'Stigma and Fear' Disrupt Miscarriage Care
"The only reason she is not with us is because of Donald Trump, Greg Abbott, and every single Republican politician who helped put Texas' abortion ban in place," said one advocacy group.
Nov 26, 2024
Friends and family of Porsha Ngumezi, a 35-year-old mother of two in Houston, were stunned last year to learn that she had died in a hospital after suffering a miscarriage when she was 11 weeks pregnant—and medical experts who spoke to the investigative outlet ProPublica on Monday had the same reaction.
"All she needed was a [dilation and curettage]," one friend told Ngumezi's grieving husband, Hope Ngumezi, referring to a standard procedure which is often given to pregnant patients who have first-trimester miscarriages. Commonly called a D&C, it is also diagnose or treat other health conditions and provide abortion care.
Dr. Daniel Grossman, an obstetrics and gynecology professor at University of California, San Francisco, told ProPublica that "at every point" of Ngumezi's visit to Houston Methodist Sugar Land, a hospital outside Houston, medical providers' response to her case was "kind of shocking."
"She is having significant blood loss and the physician didn't move toward aspiration," Grossman told ProPublica.
Like at least two other Texas women—Nevaeh Crain and Josseli Barnica—Ngumezi's death in June 2023 was the result of the abortion ban that went into effect in Texas in 2022, according to medical experts who reviewed her case.
Ngumezi arrived at the hospital on June 11, 2023 after experiencing heavy bleeding 11 weeks into her pregnancy with her third child. Doctors noted that Ngumezi had a blood-clotting disorder and that she was experiencing "significant bleeding" with large clots.
"Doctors assume that a D&C is not standard in Texas anymore, even in cases where it should be recommended. People are afraid: They see D&C as abortion and abortion as illegal."
An ultrasound showed a "sac-like structure," but no fetus or cardiac activity were detected, indicating that she was having a miscarriage.
But instead of providing a D&C, in which a small tube is inserted into the uterus to gently remove any remaining fetal tissue, doctors took a "wait-and-see approach [that] has become more common under abortion bans," according to the medical experts who spoke to ProPublica.
Dr. Gabrielle Taper, who has worked as an OB-GYN in Austin, told ProPublica that since Texas' abortion ban went into effect in 2022—two months after the right-wing majority on the U.S. Supreme Court overturned Roe v. Wade—there has been "much more hesitation [among doctors] about: When can we intervene, do we have enough evidence to say this is a miscarriage, how long are we going to wait, what will we use to feel definitive?"
For Ngumezi, that hesitation meant that Dr. Andrew Ryan Davis, the obstetrician on duty, prescribed misoprostol to help Ngumezi pass the fetal tissue without a D&C.
Dr. Alison Goulding, another OB-GYN in Houston, told ProPublica that because misoprostol can also be used for women in labor or to treat postpartum bleeding, under Texas' abortion ban, "stigma and fear are there for D&Cs in a way that they are not for misoprostol."
"Doctors assume that a D&C is not standard in Texas anymore, even in cases where it should be recommended," Goulding said. "People are afraid: They see D&C as abortion and abortion as illegal."
But more than a dozen doctors told ProPublica that considering Ngumezi's blood-clotting disorder, doctors should have provided a D&C.
"Misoprostol," reported ProPublica, "is an effective method to complete low-risk miscarriages but is not recommended when a patient is unstable."
Some critics who support abortion bans have dismissed Ngumezi's case—and that of other women who have died because of the laws—as the result of medical malpractice that had nothing to do with recently passed state laws. They claim Texas' law protects women who have miscarriages.
But ProPublica noted that Ngumezi had a similar case to one described on social media by podcast host Ryan Hamilton earlier this year. Hamilton's wife experienced bleeding while miscarrying at 13 weeks, and was prescribed misoprostol and sent home after an ultrasound at Surepoint Emergency Center Stephenville showed no fetal cardiac activity. The bleeding got worse, but an emergency doctor told the couple they couldn't provide a D&C because of "the current stance" in Texas.
Greer Donley, a law professor at University of Pittsburgh, said that "the antiabortion movement wants us to blame the doctors and sometimes that is warranted. But abortion bans are the ultimate cause of this harm."
"When life in prison is the penalty for violating a ban, doctors will understandably be risk averse. And that chill in care will cause death," said Donley.
ProPublica reported that "performing a D&C attracts more attention from colleagues, creating a higher barrier in a state where abortion is illegal."
Doctors, added Goulding, "have to convince everyone that it is legal and won't put them at risk [of prosecution]."
In Ngumezi's case, the bleeding continued after she took misoprostol, and her heart stopped three hours later—a "preventable" death, according to the experts.
"The only reason" Ngumezi died, said Reproductive Justice for All, is that Republican politicians including President-elect Donald Trump helped put Texas' abortion ban in place.
"We are heartbroken and enraged by the tragic, preventable death of Porsha Ngumezi," said Planned Parenthood Texas Votes. "This nightmare reality, where political agendas outweigh patients' lives, has left another family shattered."
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