Abortion in North Carolina overall is on the decline, but the decrease has been more pronounced among white women than black women, according to a study of abortion trends in the state between 1980 and 2013. One factor could be that lack of access to healthcare makes it harder for women of color to get contraceptives. Dr. Rathika Nimalendren says for many women, it’s prohibitively expensive to get any form of contraception without health insurance. She says North Carolina’s decision not to expand Medicaid has diminished access to reproductive care overall – including contraception and prenatal care. A report this month by the Georgetown University Center for Children and Families found the number of women of childbearing age in North Carolina without health insurance is among the highest in the country. And among African-American women in the U-S, those in the South have the lowest rates of health coverage, according to the National Partnership for Women and Families.