For too many people in this country, the barriers to abortion have gotten so immense that individuals no longer have the ability to seek services. There may be laws that place obstacles like waiting periods in their paths. They may be struggling to make ends meet and denied insurance coverage. And the nearest clinic may be hours away, thanks in large part to regulations that specifically target abortion providers, forcing them to adhere to prohibitively expensive standards. These difficulties, and the policies that lead to them, are the direct result of abortion stigma, which has created a climate in which the judgment and personal beliefs of lawmakers are used to advance limitations on people’s ability to access care.

But when it comes to reproductive rights restrictions, anti-abortion stigma is not the only cultural force at play. Racism and classism, too, often affect the judgments made by individuals and lawmakers: Negative perceptions inspire policies dramatically reducing the ability of people of color or people living in poverty to make their own decisions when it comes to abortion.

For example, take a look at the slew of laws aimed at banning sex-selective abortions. These policies have been introduced and signed into law in Arizona, Kansas, North Carolina, North Dakota, Oklahoma, Pennsylvania, and South Dakota. Illinois also has a law on the books, though the state agreed in a court settlement not to enforce it.

On face value, these bans look like just another attempt to chip away at abortion access, which they are. When we take a closer look, however, it is clear that they are also predicated on antiquated beliefs about women of color and immigrant communities. As a recent report by the National Asian Pacific American Women’s Forum (NAPAWF) in partnership with the University of Chicago and Advancing New Standards in Reproductive Health stated, “Laws banning sex-selective abortion have been enacted on the basis of misinformation and harmful stereotypes about Asian Americans.”

Shivana Jorawar from NAPAWF told Rewire that when it comes to laws like these, “Old stereotypes of Asian Americans as dangerous foreigners [are] being conjured up again to serve the anti-choice agenda.” Jorawar continued, “For women in our community, this adds insult to injury. Not only are [legislators] restricting women’s access to health, but they are using racism and xenophobia to do it.”

Trying to use racist and anti-immigrant stereotypes to restrict health care is not a new tactic. Federal health programs include various limitations on immigrant women and families’ access to medical services—including the five-year waiting period on Medicaid, the restriction on undocumented people’s ability to purchase health insurance in state health exchanges, and a provision included in an immigration reform bill that would keep immigrant women from accessing essential health services for up to 15 years. In turn, as with other kinds of stigma, members of the public allow limits like these to continue by believing and propagating myths, in these cases about the dangers of “illegals” and immigrant communities’ “drain” on government resources.

When it comes to sex-selection bans, the parade of stereotypes continues: The sponsors claim to be advancing the bills in order to address a preference that some communities have for having a son. A representative in South Dakota, for instance, talked about the necessity of this kind of law because of Asian immigrants in the state. Other legislators reportedly discussed “those people bringing this stuff here.” But as NAPAWF’s Miriam Yeung told Rewire in August, “If these lawmakers are truly concerned with gender disparities, they would work with us on issues like equal pay and education.”

In practice, these bans subject women of color and immigrant women to scrutiny no one else must endure. All in all, they make obtaining an abortion—again, already a frequently stigmatized act—even harder and associated with even more shame from the public, legislators, and sometimes even medical providers.

Sex-selection bans are not the only example of restrictions inspired by a combination of abortion stigma and negative, out-of-touch assumptions about vulnerable populations. When Henry Hyde introduced an amendment to deny health coverage for women who use Medicaid benefits in 1976, he referenced a desire to prevent anyone from seeking care, but acknowledged that low-income women were the only people he could realistically target.

Supporters of this policy portray it as a means to prevent their tax dollars from having to pay for someone else’s abortion. Often, they will also make statements that play on a crass stereotype of low-income people wanting a “free ride.” Again, this uses stereotypes to make abortion access disproportionately difficult for certain groups of women—in fact, Henry Hyde himself talked about how rich women could “enjoy their high-priced vices” in reference to the class disparity of his policy. The Hyde Amendment also has an unequal impact on women of color, who are more likely to utilize Medicaid benefits for services.

Sex-selection bans and the Hyde Amendment are not the only examples of prejudice surfacing in reproductive rights limitations, of course. From our country’s history of forced sterilization to current policies that coerce women into using contraception, it is clear that many of our laws are influenced by racist and classist control of women and their families. And as these policies continue to survive and to resurface, they create even more shame around abortion for specific groups of women by suggesting that only some women “deserve” the ability to obtain the procedure.

Work to shift the political climate and to oppose the myriad of abortion restrictions in an effort to combat stigma is essential for activists. And yet, we cannot act as if laws controlling reproductive rights occur in a vacuum. We have to continue to confront the ways in which racism and economic injustice are also factors in preventing people from having true access to the right to abortion.

“For the women I work with it is not enough to talk about removing stigma and judgment. Folks still won’t have access because of economic instability. They still won’t have the ability to get the same treatment because of the color of their skin. They will continue to bump up against challenges that come from class and race and other systems of oppression,” Monica Simpson of the reproductive justice organization SisterSong told Rewire.

As we work to alleviate stigma for people seeking or providing abortions, we need to push back on misinformation, support those who are sharing stories, and promote respect for every person working to make the best decision for their unique circumstances. This is an important part of acknowledging personal decision-making and bodily autonomy. Simply put, though, without continuous understanding and attention within the reproductive rights movement to the way in which race and class play a role in these fights, there will still be far too many people for whom abortion is still out of reach.