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Examining the many birth disparities in Mississippi, health center CEO says

A MARTINEZ, HOST:

For this next story, we're going to Mississippi. Mississippi's the state from which the Roe v. Wade challenge at the Supreme Court originates. There we spoke with Getty Israel. She founded a women's health clinic called Sisters in Birth. Israel says she's heard from the media seeking an interview only because of the recent news, and to her, that's problematic. Our colleague Leila Fadel started the conversation there.

LEILA FADEL, HOST:

So I want to just start by actually talking to you about getting a call from us to talk in this moment, when the Supreme Court draft opinion is out. And you talked about the frustration you have with the media, with politicians, for ignoring wider issues around reproductive health until moments like this. Can you talk a little bit about that?

GETTY ISRAEL: Yes. Well, first of all, birth in Mississippi is a very complex, very complicated problem. Those problems in Mississippi started long before the controversy around - in the Supreme Court. There are so many birth disparities and social disparities, and abortion is simply one of those birth outcomes that we consider to be a birth disparity. And we don't spend the time to look for solutions, to look at underlying risk factors that we know are connected and that are driving these outcomes. And when you look at women who are more likely to experience or seek out an induced termination, those women have similar risk factors.

So that's how I see abortion within the context, a larger context of a public health crisis - not a political issue, but a public health crisis. And we have yet to address it as a public health crisis, along with all the other things, the social determinants of health and the other medical issues that we know are driving these horrible numbers in Mississippi, which I consider to be ground zero.

FADEL: Yeah. Let's talk about those underlying issues - I mean, the highest rate of teen pregnancy in Mississippi, lowest life expectancy in the U.S., highest infant mortality rate and high rates of abortion among Black women. Let's talk about the underlying issues that are driving what you call a public health crisis.

ISRAEL: We can't ignore the fact that Mississippi's considered a very poor state, particularly for women and especially for mothers. Take for consideration that 43 - almost 44% of our workforce here is made up of cashiers. Well, what do they earn? Minimum wage? Benefits? Doubt it. Highly unlikely. Well, 55% of that workforce is made up of women. Well, who are those women? They're primarily working mothers. My patients - 9 out of 10 patients that we see are working in a retail setting or a fast food setting. They work hard, but they can't qualify for health benefits. That's why Mississippi covers almost 70% - the highest in the nation - of pregnancies and births.

What I'm saying is, we need to - as a state that claims to be a pro-life state, we need to provide comprehensive services and support to a person who's in this category. And that means helping her to get out of the hole, which is called poverty, and onto her feet. And how do we do that? By helping her to go to college - community college - getting a degree in a health care area, which is in demand here.

FADEL: So then this comes down to people who have access to health care and education and people who don't.

ISRAEL: And most of those women happen to be Black women in the state of Mississippi. Keep in mind that Mississippi has the largest proportion of Black people in the country - the largest proportion, right here.

FADEL: So that number, that rate that everybody's quoting now nationally, that Black women are 2.5 to 3.5% more likely to get an abortion - that number doesn't tell the whole story.

ISRAEL: No, it doesn't tell the whole story. Over the last 10 years, Black women have accounted for 68 - an average of 68% of terminations here or abortions here, but nobody asks why. And when we get phone calls from women - and we do - who are looking for an abortion, the first question I ask is, what's going on? Why do you feel the need to have an abortion? It is not for me to judge her. It is for me to figure out, can I help her? Can I help her? Because, yes, I want to change her mind. Yes, I want to reduce the abortion rate. That's a lot of Black lives lost in an era of Black Lives Matter.

So the problem I have with people who are on the pro-choice side is that they only care about defending the law. What they don't care about, it seems to me, are the lives of the women who are really being impacted. I see, for instance - and I've already been very critical of the so-called pro-life side. Right here locally, I take them to task all the time. But the pro-choice people are willing to wage a war - a political war - to protect this law. But they're not willing to help create any community-based interventions to address the various underlying risk factors that will lead a woman to look for an abortion.

FADEL: So when you watch this national debate about access to abortion, whether it should be banned or whether it should be legal, what's missing from that conversation?

ISRAEL: What's missing is the women who are most likely impacted by this law or by abortion in general are never invited to the table. No one ever says, what do you need? What can we do to help improve your life so that you don't find that you need to have an abortion? What's going on with you? What can we do in your community? But those are the - that's what's missing, the social component. When a woman is seeking an abortion, 9 times out of 10, she is alone. She is alone in this process. Pro-choice people aren't walking down that path with her, and neither are the pro-life people, beyond beating her over the head with a Bible and scripture. Who's walking down the path with her to have the baby or to have the abortion? Neither group is. The social compact, the human component is missing from this story. Women need more than simply access to abortion. Women need a higher quality of life to start with.

FADEL: Getty Israel is the founder and CEO of Sisters in Birth. Thank you so much for your time.

ISRAEL: Thank you. Transcript provided by NPR, Copyright NPR.