It’s been a year since the US Supreme Court revoked constitutional protection for abortions, and the decision has impacted states far beyond those with existing bans or restrictions on terminating a pregnancy. In states where abortions are still legal, pressure is mounting on groups trying to maintain access, with skyrocketing demands from other states, as well as rising costs due to lengthy waits for care and more complex logistics. Recent research also reveals how these restrictions are affecting not just those seeking to terminate a pregnancy, but anyone who might conceive and the medical professionals caring for them, while continuing to magnify racial and economic disparities.
According to a KFF survey released earlier this week, one in five office-based OB-GYNs nationwide feel constrained from offering adequate care to patients suffering from miscarriages and other pregnancy-related medical emergencies. Seven in ten of those surveyed admitted that the Supreme Court’s decision has further widened racial and ethnic inequities in maternal health.
Last December’s Dobbs v. Jackson Women’s Health Organization verdict uprooted the landmark 1973 Roe v. Wade ruling, allowing states to set their own laws on abortions. This led to a ban on abortions in 14 states, with several others enforcing strict gestational limits making it impossible to secure an abortion before patients realize they are pregnant.
The Impact of Abortion Restrictions on Access to Care
According to a study conducted by the Society of Family Planning, more than 25,000 people were unable to get an abortion from a provider between July 2022 and March of this year. Even more concerning is the fact that over 80,000 people in states with abortion bans or six-week gestational limits faced disruptions in accessing abortion care during this same period.
As a result of these restrictions, many individuals are being forced to travel across state lines to seek abortion care, placing increased pressure on organizations such as the New York Abortion Access Fund.
Since the Dobbs decision last year, the organization has committed approximately $1.7 million towards covering abortions for more than 2,000 people from 29 states as well as several other countries. However, with the fund on track to reach a total expenditure of over $2 million this year – four times the amount spent in 2021 – the organization is at risk of running out of money by October.
While the New York Abortion Access Fund is working to cut costs and raise more money, they may be forced to turn some individuals away. This will only make accessing abortion care even more challenging and costly.
Furthermore, access to mifepristone – a drug widely used in medication abortions – could become even more restricted depending on the outcome of a court case. A federal appeals court in New Orleans is set to rule on a case brought by anti-abortion advocacy groups and doctors challenging the Food and Drug Administration’s approval of mifepristone. If access to this medication is cut off nationwide, more individuals will be struggling to obtain surgical abortions which can be far more expensive.
With this ongoing assault on reproductive healthcare, it is imperative that individuals and organizations continue to fight for access to safe and affordable abortion care for all.
Abortion bills causing legal upheaval and confusion
According to the Guttmacher Institute, over 700 abortion bills have been introduced in state legislatures this year, posing a challenge for reproductive-rights advocates who support safe and accessible abortions. These bills are almost evenly split between those aimed at restricting access and those seeking to expand it while protecting the rights of abortion providers. However, even with increased efforts towards abortion policy reform, some advocates say that the taboo surrounding abortions remains unbroken.
Failure to Acknowledge the Stigma
Despite the persistent stigma surrounding abortions, Planned Parenthood Action Fund, an organisation that advocates for reproductive rights, recently sent out an invitation to a reception featuring political heavyweights such as President Joe Biden, Vice President Kamala Harris, First Lady Jill Biden and Second Gentleman Douglas Emhoff. The message did not contain the word “abortion,” although it alluded to the Dobbs decision’s anniversary and called for “supporters, partners, and political leaders to gather in community.”
Reproductive-rights advocates, such as Renee Bracey Sherman, founder and co-executive director of We Testify, which supports those who have had abortions voiced their dissatisfaction with the omission of the word “abortion” from the message. They argue that this failure amounts to complicity and does nothing to break the stigma surrounding abortions.
The White House and Planned Parenthood have yet to acknowledge these criticisms and are yet to comment on the matter. Anti-Abortion Laws Leave Disadvantaged Populations Behind
Conservative lawmakers and anti-abortion activists are celebrating the one-year anniversary of Roe’s reversal, hailing it as a historic victory. Republican representative, Elise Stefanik, highlighted the need to protect ‘the sanctity of life’ in her speech at the National Press Club. However, whilst some individuals have been able to work around state abortion restrictions, others have been left behind.
Professor Diana Greene Foster, from the University of California San Francisco, has stated that disadvantaged populations – those most affected by anti-abortion laws – have the least amount of money, information and resources. This includes people who are hospitalized, incarcerated or under court supervision. Her research suggests those denied an abortion incur long-term financial ramifications, including higher household poverty and lower credit scores, as well as heightened rates of bankruptcy and eviction.
Whilst politicians continue to advocate anti-abortion laws as fundamental to human rights and the American dream, Foster’s research calls into question who these laws actually serve. In reality, it appears that they primarily disadvantage the very people they are being implemented to protect.
Abortion Funds Struggle to Meet Increased Demand Amid Financial Obstacles
As new abortion restrictions continue to be enacted across the US, many people seeking abortion care are forced to travel longer distances, resulting in higher costs and financial hardships. This puts a strain on the already-stretched abortion funds, with calls for financial help increasing by the day.
At the D.C. Abortion Fund, for instance, the average amount spent per caller has skyrocketed to $710 from $260 before the Dobbs decision. This is due largely to the higher travel costs, inflation, and job losses which the callers are facing. The fund board member Devin Simpson says that they are striving to help fill these financial gaps.
The National Network of Abortion Funds’ Executive Director, Oriaku Njoku, highlights the urgent need for long-term, sustained investment in the funds. While they initially received a surge in donations after the Dobbs decision leaked last year, fundraising has been tapering off since then.
Surgical abortion procedures in New York start around $600 for a first-trimester procedure but could cost up to $28,000 for later-in-pregnancy abortions. Reproductive-rights advocates warn that as people struggle to access and afford abortions, their financial situations tend to worsen, leading to more expensive care later in pregnancy.
Abortion funds need ongoing support to meet the growing demand for their services effectively. Urgent action is needed to ensure that they have the resources to cater to everyone who needs their help.
Refusal to Provide Care Due to Abortion Ban
A recent report by Advancing New Standards in Reproductive Health (ANSIRH) found that a pregnant patient experiencing obstetric complications was denied care by multiple medical professionals due to the state’s abortion ban. Despite being in advanced labor and extreme pain, anesthesiologists refused to give the patient pain relief in fear of violating state law.
According to the report, one hospital provider claimed that even aiding a patient in the midst of miscarriage by helping them onto a gurney could be considered “aiding and abetting an abortion.” The incident was deemed “a gross violation of common sense and the oath I took when I got into this profession to soothe my patients’ suffering.” The doctor involved in the patient’s care was so disturbed by the situation that they contemplated leaving the state.
The consequences of banning abortion extend beyond just limiting access to the procedure. They can also put the health and safety of anyone who can become pregnant at risk. Health care providers may delay necessary care due to fears about violating the law, which can be physically harmful, impact fertility, and cause emotional distress.
As medical professionals pledge to uphold their oath to do no harm, refusing care due to abortion bans is a clear violation of this promise. Patients deserve access to comprehensive and compassionate care regardless of political restrictions.
The Gray Areas of Abortion and Healthcare
Abortion laws may be cut and dry, but for healthcare providers, medicine is in shades of gray. Recent research shows that healthcare providers in states with gestational limits are confused about the legal limits of abortion. Moreover, doctors are treating patients with fear of criminalization and violence.
Between September 2022 and March 2021, researchers documented cases where patients did not receive standard care due to new abortion restrictions. These cases included ectopic pregnancies, medical conditions hazardous to continued pregnancy, and other issues.
It is necessary for hospitals to have clear policies on treatment for certain conditions such as ectopic pregnancies, researchers suggest.
Dr. Jamila Perritt of Physicians for Reproductive Health, states that the current situation causes a paralyzing effect on healthcare systems, pitting patients against providers. Doctors are forced to focus on legalities rather than patient care, which is not in line with the oaths all healthcare providers take.