Read more of our articles on the Tennessee ballot initiative here.

Early voting in Tennessee has begun and many residents have already taken to the polls to cast their ballots for Amendment 1, a highly controversial and extreme anti-choice ballot initiative.

The Memphis-based reproductive rights organization SisterReach on Thursday held a conference on Amendment 1, its impact for Black communities, and the need for Black women to get out to the polls in the next week.

“We stand today because pending legislation has the potential to send women back to the back alleys where we died from unsafe and unsanitary abortions,” SisterReach founder and CEO Cherisse Scott said. “It has the potential to exacerbate not only the mass incarceration of our men and boys. We assemble today to impress upon Black women and women of color, many of whom are heads of households, to get out and vote.”

If passed, Amendment 1 gives state lawmakers the power to enact, amend, or repeal state laws regulating abortion by writing into the state constitution language that includes, “nothing in this Constitution secures or protects a right to abortion or requires the funding of an abortion.”

A Tennessee Supreme Court decision in 2010 found that a law restricting abortion access violated the state constitution, which provides more explicit protection for abortion than the U.S. Constitution. By changing the state constitution to clarify that it does not protect the right to abortion access, Amendment 1 would likely open the floodgates for a wave of anti-choice restrictions, many of which other red states have already seen.

Though abortion restrictions affect everyone, women of color, and particularly Black women, are in a unique position: Black women in the United States are five times more likely to have an abortion than a white woman, according to the Centers for Disease Control and Prevention.

The evidence as to why this is the case is clear: It’s due to inequality. Lower incomes mean less access to health care and low-cost contraception, which leads to a higher rate of unintended pregnancy and in turn abortion.

Low-income women often have more unstable living conditions, which could contribute to lower contraceptive use; women who must focus on survival often can’t put contraception high on their list of priorities, according to the Guttmacher Institute.

Black women are also the target of racist anti-choice campaigns, which use Black women’s decisions to get an abortion as a jumping-off point for arguments for “pro-life” policy.

At least one Georgia anti-choice bill was mobilized by printed billboards across the state with the slogan “Black Children are an Endangered Species.” The bill was eventually quashed by a coordinated effort, primarily on the part of SisterSong, a women of color reproductive justice collective in the state.

“The voices of Black women are often demonized, marginalized and tokenized in many human rights discussions like abortion, mass incarceration, criminalization, sexual assault, domestic violence, and rape,” Scott said. “Our goal is to provide space for women most impacted to speak directly to the conditions we are expected to thrive in—conditions which have reduced us to mere survival instead of the ability to lead healthy lives, raise and provide for our families in safe and sustainable communities free from violence from individuals or the government.”

At the conference on Thursday, held in a church, reproductive rights activists were joined by faith leaders in the state, including the Rev. A. Faye London, who gave an impassioned speech.

“I stand here with Black women and declare that our voices do matter, our lives do matter, our stories do matter, our families do matter,” she said. “We must vote, because our lives matter, our lives are in our hands.”