Kavita Mehra says she knows intimately how difficult getting access to reproductive care can be for Asian immigrants.
During early pandemic lockdowns, she fielded calls from South Asian women in New York who were experiencing sexual violence at home, many of them low-income recent immigrants. They reached out often with a single request and nowhere else to turn.
“They were asking us to help them secure contraception,” said Mehra, the executive director of the women’s organization Sakhi.
Lower-income Asians in the U.S. who have less access to health care are often shrouded in data that group all ethnicities together. Experts are working to disentangle the snarl now for fear that things could get worse if Roe v. Wade is overturned.
The margins vary across ethnic groups, but research has found that for Asians across the board, those born in the U.S. get abortions at a rate 1.5 times higher than their foreign-born counterparts. For some groups, like Japanese women, the rate is five times higher.
Myriad factors might prevent immigrants from getting reproductive care, including the fact that Asians face the largest wealth gap in the country.
English proficiency, income level, stigma and immigration status all vary drastically among Asian groups, said Sheila Desai, the research director of the Coalition to Expand Contraceptive Access, who was the author of a study last year that analyzed Asian abortion rates in New York City.
“All of these issues will be amplified with the mounting legal barriers that devastatingly come with accessing abortion services,” Desai said.
Through Sakhi, Mehra has worked with survivors of domestic abuse and sexual violence. She says she has seen firsthand the impacts when needs for reproductive care aren’t met.
“The South Asian diaspora has the greatest amount of economic inequity,” she said. “There are individuals that represent that 0.1 percent and individuals that represent the working poor. … If Roe v. Wade is overturned, it’s going to directly impact those who are of less financial means.”
For example, Korean and Chinese New Yorkers, the two groups with the lowest abortion rates in Desai’s study, are more likely than other Asian groups to be uninsured and have lower English proficiency, according to the 2015 NYC Community Health Survey.
There is an overall lack of understanding about the needs of Asian immigrant communities across the country, experts say. AAPI-focused abortion data are scarce — disaggregated data even more so. Usually lumped into an “other” category with Native Hawaiians and Pacific Islanders, Asians who don’t speak English might be forced to rely on family members or community organizations in navigating reproductive health care.
“Over 90 percent of the survivors that we work with are recent immigrants to the United States,” Mehra said.
And family members might not always give immigrant women the support they need.
“It is important to emphasize the fact that community stigma is very prevalent,” said Sruthi Chandrasekaran, a senior associate research scientist at Ibis Reproductive Health, a global nonprofit group dedicated to reproductive research.
Chandrasekaran said that, in her research, South Asian women in particular reported facing cultural pressures when it came to sexual and reproductive care. Others said they actually felt less free to talk about abortions in the U.S. because of how polarizing the dialogue can become.
“Some respondents felt that there was more freedom to talk about abortion and reproductive health, seek support in [their] country of birth rather than in the United States,” she said, citing preliminary data from her research.
Stigma and conservatism exist outside Asian groups, too, Desai said, but people who can’t get access to English-language services might have nowhere else to turn. With looming restrictions on abortions across several states, it will only become more difficult.
“Abortion restrictions are inextricably linked to systemic racism,” Chandrasekaran said. They “disproportionately impact Black, Indigenous and other people of color, people with disabilities, people in rural areas, young people, undocumented people and those having difficulty making ends meet.”
Desai’s study found that Asians were separated by several factors when it came to abortion care. Country groups were some of the biggest indicators.
When the statistics are taken together, Asians in the U.S. have a low rate of abortions compared to other communities. Desai’s study found that the rate for Asian women in New York City was 12.6 abortions per 1,000 women.
But when they are disaggregated, the data tell a different story.
Desai found that for Indian women, the rate was 30.5, a number more similar to that of Latinas than to those of others under the Asian American and Pacific Islander umbrella.
Korean women, on the other hand, had closer to 5.1 abortions per 1,000 women.
“If you speak to anyone in this population, what you will quickly learn is that it is an extremely heterogeneous population,” she said. “It is actually feasible to look at that population versus lumping them into an ‘other’ category or not including them at all.”
As advocates try to push for more resources for Asian immigrants seeking care, they say they are up against a sheer lack of data. Even when Asian American data are isolated, the differences among communities under the umbrella term usually go unacknowledged. Desai’s study is largely the first of its kind.
“Without having this information, there’s no way to actually understand what is happening in these communities,” Desai said.