PHILADELPHIA, PA - JULY 04: A sign is pictured on the ground at an abortion rights rally on July 4, 2022 in Philadelphia, Pennsylvania. The host organization, Rise Up 4 Abortion Rights, held several protests all over the country on Independence Day. (Photo by Hannah Beier/Getty Images)

President Joe Biden made his highly anticipated State of the Union address to the nation last week. In his speech, Biden promised that he would veto a national abortion ban if it ever came to pass—an important commitment made by a sitting president after the Supreme Court’s dismantling of Roe v. Wade last year. But overall, Biden made little mention of abortion rights and protections. 

In fact, the president used the term “abortion” just once during his nearly 7,300-word-long address. Although Biden was lauded for his explicit commitment to veto a potential national abortion ban, advocates say his words failed to meet the moment.

“We wish that President Biden used his State of the Union address to make clear what he plans to do to expand abortion access for all across this nation. Instead, we heard four sentences that didn’t begin to encapsulate the horrific climate right now,” according to a statement from We Testify, an organization that destigmatizes abortion by uplifting the voices of people who have accessed abortion care. 

The organization noted that Biden first used the term “abortion” 468 days into his presidency after the Supreme Court overturned Roe v. Wade in June. In his 2022 State of the Union Address, Biden did not utter the word “abortion” at all. Instead, he gave the topic just 37 words and relied on euphemisms like “healthcare” and “choice.” 

As a potential nationwide ban on abortion medication looms, Biden’s persistent reluctance to use the word “abortion” in his official capacity as president echoes the wider societal reluctance to accept abortion care as safe and normal.

Larada Lee-Wallace, an abortion activist and doula, was transparent with the people closest to her about her decision to have an abortion in 2020.  She also began sharing her story more widely—writing about the barriers she dealt with trying to access abortion care and speaking to the media—because she did not see much representation for women who felt empowered by their decision. 

“When I was trying to seek outpatient care, I had confided in people who had had abortions and the way that they felt about their abortions, [but] it was not at all really how I thought about my abortion,” said Lee-Wallace, who had an abortion as a college student during the earliest days of of the pandemic before federal protections were upended. “I was actually very excited to get my abortion, and I realize that it’s okay to feel however you want to feel about your abortion.” 

According to data from the Guttmacher Institute, one in five pregnancies in the U.S. end in abortion, with 930,160 total abortions performed in 2020 — an 8% increase from 2017. Still, abortion experts are often met with pushback when talking about the procedure. Sometimes, that stigmatization comes from people who identify as pro-choice. 

Shireen Rose Shakouri often encounters these types of supporters in her work as deputy director at Reproaction, which advocates for abortion rights and reproductive justice. She said that if a human right exists, “there shouldn’t be exceptions around it.” 

“The ‘I’m pro-choice, but’ crowd…they are positioning themselves as the decider of who is and who isn’t allowed to maintain their bodily autonomy,” said Shakouri, who is also an abortion doula. “So, ‘I’m pro-choice, but people after a certain gestational age of their pregnancy shouldn’t be able to access these services’ or ‘I’m pro-choice, but only for someone who’s raped or the victim of incest.’ There is no way to create exceptions around abortion care where the legal system in this country would actually make those restrictions followed for those people at risk.”

Rampant falsehoods around abortion persist within communities of color—such as the false belief that abortion is unsafe or can otherwise cause negative side effects—despite being one of the safest medical procedures. These beliefs further stigmatize abortion and add extra barriers to accessing abortion care.

“We know the truth of the matter is; it’s not that Black people or brown people or people of color aren’t getting abortions. We know that they are, but people are being forced to [feel] shame. The less we talk about it doesn’t mean that it’s not going to happen; it just means that it’s going to be harder to access,” said Lee-Wallace, who wrote about the false narrative that being pro-abortion means being anti-Black. According to Lee-Wallace, this perception, in part, originates from the U.S.’ history of exploiting Black bodies and the medical racism against Black patients that continues today.

The healthcare system’s horrific legacy of eugenics and other harms is also precisely why pro-choice advocates like Lee-Wallace say it is important to protect Black people’s reproductive freedom. 

“When I’m supporting a Black person who’s getting an abortion, the first thing I ask them is if this is something you want to do, that it is not against your own will. And if they say yes, they say yes…I’m now thinking about getting the person the care they need and deserve because I trust that they can make that decision,” Lee-Wallace said. 

Stigma and increased barriers to accessing abortion care also disproportionately affect Black women. According to 2019 data from the Centers for Disease Control and Prevention (CDC), Black women have the highest abortion rate compared to other racial groups, with Black women being four times more likely to have an abortion than white women. Numerous factors, including inequities in sex education and unequal access to contraception, can explain this disparity. 

Given the importance of removing stigma, elected officials can play a role in normalizing abortion as a safe and common healthcare procedure, which is why Biden’s State of the Union address was a missed opportunity. 

Shakouri said she appreciated Biden’s positive messaging about protecting reproductive rights but also noted that abortion protections were a galvanizing force in the last two elections. 

“And for that not to be, at the very least, paid the lip service that we are owed, was a little disheartening,” Reproaction’s deputy director said.

Even so, there has been a visible shift in how abortion is discussed by some political leaders. Shakouri pointed to legislators of color like Rep. Cori Bush, Rep. Pramila Jayapal, and Rep. Barbara Lee, who, at great political risk, publicly shared their own abortion stories.

“I have been really impressed and encouraged by the many women in Congress, in particular, who have told their own abortion stories as elected officials,” Shakouri said. “That cuts to the heart of the idea that abortion is something that happens to other people that so many cling to because they don’t want to face the fact that it might have to be them, or it might be someone they love.”

Natasha Ishak is a New York City-based journalist who covers politics, public policy, and social justice issues. Her work has been published by VICE, Fortune, Mic, The Nation, and Harvard's Nieman Lab...