Though we are only halfway through 2021, this has already been the most catastrophic year for reproductive freedom  in the United States since 1973 when Roe v. Wade established the constitutional right to an abortion. Eight states have passed unconstitutional abortion bans, and two, Oklahoma and Arkansas, have passed laws that seek to prohibit abortion in nearly all circumstances.
Texas has taken it a step further: Its ban on abortions after the sixth week of pregnancy invites the criminal prosecution of both patients and providers by private citizens and would provide for these self-appointed prosecutors to collect personal compensation from defendants.
In addition to being unconstitutional, there is no medical justification for these bans; rather they exist to create a false narrative about abortion, to manipulate people, and to create stigma and judgment against patients and their providers.
Sadly, North Carolina could be on the verge of joining the ranks of this intrusive and repressive group of eight. House Bill 453 , vetoed by Gov. Cooper, would take the extraordinary step of banning abortions based on the reasons of the people seeking them. Under the bill, if it’s somehow determined that a patient’s reason for seeking an abortion is the presumed race of the fetus or a diagnosis of Down syndrome, the doctor would be prohibited from performing the abortion – no matter what other factors might be present. A vote to override the Governor’s veto  could come at any time.
It’s hard to overstate what a massive and destructive invasion of the doctor-patient relationship such an intrusive law would represent. By compelling providers to interrogate their patients regarding the reasons behind their most intensely personal decisions (and requiring the denial of care if their answers run afoul of a state-prescribed test), the bill would force doctors to scrutinize and second-guess their patients, discourage honest, confidential conversations, and compromise care.
Though cloaked by supporters as being part of an effort to combat “eugenics,” nothing could be further from the truth. As survivors and historians can attest, a central premise of North Carolina’s disastrous and deeply racist eugenics program of the 20th century was that it was the state that should make decisions about pregnancy and family planning rather than individuals themselves. Any law that seeks to enshrine that premise of state control over individual reproductive health decisions has no place in North Carolina.
If HB 453 supporters were genuinely concerned about race equity in pregnancy and childbirth, they would have long ago directed their efforts toward passing legislation like the North Carolina Momnibus Act (Senate Bill 632)  – a measure designed to address the disparate birth outcomes for Black and brown people in North Carolina. Though introduced four months ago, that bill has yet to even receive a hearing.
Similarly, if they were authentic in their concern for people with disabilities, they would focus on the priorities people with disabilities and their families have shared with them. This includes ensuring adequate funding for Medicaid Innovation Waiver slots, a program to meet the needs of people with intellectual and developmental disabilities that currently has a more than 15,000-person waiting list in the state.
If North Carolina lawmakers wanted to address urgent issues of systemic discrimination, they would immediately and fully expand Medicaid to all who need it.
Don’t be fooled: Supporters of HB 453 want to pretend the bill is about something other than restricting abortion, but it is undeniably part of a larger campaign to stigmatize and restrict access to a safe and legal medical procedure. The bill would allow legislators who seek to eliminate all access to abortion to become judges of the deeply complex and intersecting reasons people choose to obtain an abortion and sends the message that women, and particularly women of color, cannot be trusted to make their own decisions about what is best for them and their families.
What’s more, HB 453 is just the latest in a long line abortion restrictions – including bans on funding, medically unnecessary restrictions on clinics, arbitrary gestational bans, and parental consent laws – that are all weaponized to create a false narrative about abortion in which it is inaccurately portrayed as dangerous, outside the scope of basic healthcare, and a procedure that has arisen solely in the wake of Roe v. Wade.
In truth, abortion predates that Supreme Court decision by millennia, but prior to 1973, safe abortion in the United States was often only accessible to patients with financial means. If passed into law, HB 453 will, like laws that have come before it, fall hardest on those who have traditionally been blocked from access to any kind of healthcare and create, once again, inequitable circumstances that leave reproductive autonomy only for those with privilege.
The bottom line: HB 453 does not address discrimination or the needs of people with Down syndrome. Nor does it combat racial discrimination in North Carolina. Rather, it is part of a concerted campaign to enact as many laws as possible that strip the constitutional right to abortion care and create stigma around those who chose to obtain and provide this service.
North Carolina already has far too many barriers to comprehensive and quality healthcare, and state lawmakers should be focused on tearing them down, not compounding the problem.
Tara Romano is the executive Director of NARAL Pro-Choice North Carolina .