When the U.S. Supreme Court overturned Roe v. Wade in 2022, the media flooded with cases of women who had been denied abortion care during emergency situations, putting their lives at risk.

Whether pregnant patients have the constitutional right to abortion care when their health is severely at risk is at the heart of Idaho v. United States, whose oral arguments are being heard by the high court this week. The federal Emergency Medical Treatment and Labor Act, often known as EMTALA, requires hospitals to provide the care that’s medically necessary to stabilize patients in emergencies. It was enacted by Congress in 1986. But as the political and legal battlefield surrounding abortion rights continues, it’s become a point of controversy.

Any decision by the court, set to come later this year, will be consequential for Black families across the country as it could determine how restrictive states are allowed to be in their abortion policies. It also has implications for the state’s role in preventing hospitals from providing other types of emergency care, including gender-affirming treatments. And although cases concerning the abortion pill, mifepristone, have been front and center, this case could result in the most significant ruling since the 2022 Dobbs decision that ended the constitutional right to an abortion.

“What’s being proposed is extremely dangerous,” said Dr. Serina Floyd, a Washington-based OB-GYN. “There is a reason why this EMTALA was put in place.”

A Worldacad analysis of data from the Centers for Disease Control and Prevention shows that Black women are far more likely than white women to turn toward emergency rooms for care during pregnancy, a disparity that has widened from 2016 to 2021.

The data raises questions about the implications of denying Black women abortions as they seek emergency care, which they are more likely to need due to a variety of factors, including lack of access to health insurance, primary care providers, and OB-GYNs, as well as higher instances of preexisting conditions such as hypertension, diabetes, and asthma, which bleed into higher rates of severe complications in pregnancy.

“This is a result of structural racism,” said Khiara M. Bridges, a law professor specializing in race, class, and reproductive rights. “Racism has made it hard on our bodies.”

Prior to the 2022 Dobbs decision, the choice in many emergency situations where the mother’s life was at risk would be to terminate the pregnancy, Bridges said. But now, as states have begun to criminalize miscarriages and limit the legality of the procedure, the decision can be murky for providers. Doctors have to wait until it’s abundantly clear a patient’s life is in imminent danger before providing an abortion, she said. In states like Idaho, the law prohibits providers from performing the procedure even when the complications might cause serious harm or disability.

The Biden administration has sued the state with the claim that this law conflicts with EMTALA, saying that federal law outweighs the state in such medical instances. Now, it is up to the Supreme Court to decide, in a ruling that could have ripple effects for states across the country.

To deny pregnant people life-saving care is to say their lives are less than, Floyd said. As a provider, she cannot imagine what some doctors are weighing. She said they are caught in a place of not being able to do what they swore an oath to do, which is save patients’ lives, and if they do and that means providing an abortion, they may face criminal consequences.

She worries about providers leaving states and trainees not accepting positions in places with restrictive abortion laws, which could lead to more health care deserts.

“It’s very scary,” Floyd said.

The EMTALA law was first enacted to serve many purposes, including preventing hospitals from not treating poor, uninsured patients. Now, the decision around abortion could have direct implications for the most vulnerable groups.

In a country where Black women are at least three times more likely to die due to pregnancy-related causes than white women, and even more suffer life-threatening complications, the case could further widen disparities.

“We’re the ones suffering,” Bridges said. “This will jeopardize Black folks’ health.”

Even outside of pregnancy, Black people are more likely to show up at the emergency room than their white counterparts, she said. Racism is permeating so many different facets of life, the stress is taking its toll on Black health.

“These are vulnerable people,” Bridges said. “These are uninsured people. These are poor people. These are people of color.”

Margo Snipe is a health reporter at Worldacad. Twitter @margoasnipe