Impacts of restrictive abortion laws in the United States

Last updated

The fallout from Dobbs v. Jackson Women's Health Organization and the resulting restrictive abortion policies are causing increasing barriers to abortion access in the United States, which is statistically negatively affecting, among other things, the health and well-being of birthing people and young children, with ripple effects to other populations. [1] [2] [3]

Contents

Deaths of pregnant people

Since new post-Roe stringent, restrictive abortion laws have been implemented, maternal deaths nationwide rose 11%, with certain states much higher, such as Texas which had a 56% increase in maternal deaths. Instead of trying to fix the problem, some states have tried harder to hide or ignore the problem; Texas has legally prohibited a committee from reviewing maternal deaths in the years following Dobbs. [4] Indiana does not include delays in access to abortion care as elements contributing to death. [5]

Some specific deaths stemming from restrictive abortion laws include:

Rise in infant mortality

In April 2023, national infant mortality was 7% higher than normal (pre-the overturning of Roe v Wade), resulting in an average of 247 extra infant deaths per month. [15] Texas had the highest infant mortality rise in the year after Dobbs; infant deaths rose 13%. [3] Many of these deaths were due to fetal abnormalities; deaths due to birth defects went up 23%, as the Texas Heartbeat Act bans all abortions after six weeks, with no exceptions for rape, incest or fetal abnormalities. "In the absence of an abortion ban, pregnant people that receive a diagnosis of a fetal anomaly would be counseled on the option to terminate, which is the choice many people make when the anomalies are incompatible with life or would cause significant suffering for the child. [3]

When asked whether this was merely correlation, or causation, public health expert Dr. Suzanne Bell explained they used "one of the strongest study designs for estimating causality... which make us confident that the increase in infant mortality we observed in Texas during this period was a result of S.B.8. [3]

Inequality

Abortion restrictions disproportionately affect people of color, immigrants, low-income earners, and non-English speakers. This on top of the United States' existing racial inequities in maternal and neonatal outcomes, such as Black birthing people being over twice as likely to experience maternal mortality and severe maternal morbidity than White birthing people. [1]

In 1973, the Roe v. Wade decision reduced maternal mortality rates by 30–40% for people of color; "Legal abortion substantially improved maternal health for disadvantaged groups." [16] But Dobbs overturned Roe v Wade's ruling, removing federal protection for abortion access and allowing states to regulate, limit, or ban abortion. [17]

Negative impacts on medical training

"Abortion-restrictions hamper physicians’ skills needed to care for patients, particularly in emergent situations. This puts patients at risk and places physicians in precarious ethical positions." [18] Restrictive abortion laws are causing a rise in maternal care deserts - places where access to healthcare providers is limited. [19]

Medical residents now have a gap in education as over half of OB-GYN residency training programs are in states with restrictive abortion laws. [20] [21] Even if there is the odd abortion procedure in a state with strict laws, it's not going to be enough for residents to truly learn, argues some doctors, including Kavita Vinekar, MD, an OB-GYN at the David Geffen School of Medicine at UCLA in Los Angeles. She says, "when it comes to learning procedures, the way you master a skill is by doing it over and over. Volume is everything. And where abortion is practically out of the picture, that exposure declines significantly." [22]

And in some states abortion training is so limited that residents must go out of state just to learn to perform abortions. For instance, two Texas OB-GYN residents had to rotate to a California hospital for a month to try to bridge this gap in their training. [22]

Hospitals having to put in more resources to bridge gaps in their residents' training are then taking resources away from other initiatives, for instance, at a Texas hospital a rotation in complex family planning had to be shuttered. [22]

As of 2021, 20% of medical schools did not report providing curricular related content to abortion. [23] In the year 2022, it was projected that of that year's class of medical residents, 70.77% of the 129,295 (91,502) US medical students have medical training restricted by state laws, due to highly restrictive abortion laws. [24] 57% of OB-GYN residency programs are at risk-averse hospitals with even stricter laws than the state laws regulating those hospitals. [25]

Restrictive abortion laws have ripple effects into other areas outside of OB-GYN. "Oncologists, cardiologists, and neurosurgeons will be unable to perform lifesaving interventions for pregnant patients with a positive urine pregnancy test." [2]

Rise in elective sterilizations

Analysis of medical record data showed a steep rise, among those eighteen to thirty years old, in sterilization procedures, following the Dobbs ruling, such as tubal ligations and vasectomies. [26] Dr. Tyler Handcock, an OB-GYN explained his patients "want something permanent because they fear that tomorrow there’ll be no other option." [27] He stated that in a normal week, he'd have maybe one or two patients inquire about sterilization, but in the weekend following the decision, he received 200 messages asking about it. [27] Between 2022 and 2024, the general fertility rate in the United States reached a historic low, which some think is related to people having too many concerns about getting pregnant with these dangerous laws in effect. [28] [29] [30]

More context on restrictive abortion laws

In the first six months of 2021, it was "Already the Worst Legislative Year Ever for U.S. Abortion Rights" - with more than 90 abortion restrictions being implemented in just the first half of the year, which was already more than any other year since 1973 - since the Roe v. Wade ruling in 1973. [31]

Some restrictions with new abortion laws range from geographic, transportation, and financial barriers in addition to decreasing already limited training opportunities medical professionals, plus dangerous medical precedents that put birthing people's lives at risk. [32] [33] [34]

As of late 2019, the majority people at risk for getting pregnant live in the US live in abortion-hostile states. [35] Since the Dobbs v. Jackson Women’s Health Organization decision, over half of the states have been able to either put new laws in place or use trigger laws that previously were not able to be enforced post-Roe ruling. [36] [37] [38]

Obstacles due to restrictive abortion laws

Over ten million people live in an area where they would need to travel over an hour to reach the nearest abortion clinic. [39] Some who have to make long treks, go into debt that causes significant financial hardship, not only paying for medical care, but now paying for transportation, potentially lodging, and lost time from work. [40] This not only impacts the distance these individual patients must travel, but also the congestion of each center serving both local and visiting patients. [41] The influx of patients at some facilities as others close their doors, due to restrictive abortion restrictions, negatively impacts not only the clinic's ability and bandwidth to perform abortions, but also its ability to provide additional healthcare services offered at reproductive health care clinics, such as mammograms and pap smears. [1]

See also

Related Research Articles

<span class="mw-page-title-main">Abortion in the United States</span>

In the United States, abortion is a divisive issue in politics and culture wars, though a majority of Americans support access to abortion. Abortion laws vary widely from state to state.

<span class="mw-page-title-main">Abortion law in the United States by state</span>

The legality of abortion in the United States and the various restrictions imposed on the procedure vary significantly, depending on the laws of each state or other jurisdiction, although there is no uniform federal law. Some states prohibit abortion at all stages of pregnancy, with few exceptions; others permit it up to a certain point in a woman's pregnancy, while some allow abortion throughout a woman's pregnancy. In states where abortion is legal, several classes of restrictions on the procedure may exist, such as parental consent or notification laws, requirements that patients be shown an ultrasound before obtaining an abortion, mandatory waiting periods, and counseling requirements.

Abortion is the termination of human pregnancy, often performed in the first 28 weeks of pregnancy. In 1973, the United States Supreme Court in Roe v. Wade recognized a constitutional right to obtain an abortion without excessive government restriction, and in 1992 the Court in Planned Parenthood v. Casey invalidated restrictions that create an undue burden on people seeking abortions. Since then, there has continued to be an abortion debate in the United States, and some states have passed laws in the form of regulation of abortions but which have the purpose or effect of restricting its provision. The proponents of such laws argue they do not create an undue burden. Some state laws that impact the availability of abortions have been upheld by courts. In 2022, Roe and Casey were overturned by the Supreme Court in Dobbs v. Jackson Women's Health Organization, meaning that states may now regulate abortion in ways that were not previously permitted.

Abortion in Oklahoma is illegal unless the abortion is necessary to save the life of a pregnant individual.

Abortion in Texas is illegal in most cases. There are nominally exceptions to save the mother's life, or prevent "substantial impairment of major bodily function", but the law on abortion in Texas is written in such an ambiguous way that life-threatening or harmful pregnancies do not explicitly constitute an exception. Attempts to clarify and codify these exceptions into law have been rejected by Republican lawmakers in Texas.

Abortion in Georgia is illegal after detection of embryonic cardiac-cell activity, which typically begins in the fifth or sixth week after the onset of the last menstrual period (LMP), two to three weeks after implantation. Although this law was ruled unconstitutional by a Georgia superior court judge on September 30, 2024, it remains in effect while the state appeals the ruling.

Abortion in Missouri is nominally legal up to the point of fetal viability as a result of 2024 Missouri Amendment 3 taking effect on December 6, 2024, 30 days after the November 5, 2024 general election. Although it is legal, legal challenges to allow access are ongoing.

Abortion in Arkansas is illegal except when it is necessary to save the life of the pregnant individual. Doctors determined to have performed an abortion face up to 10 years in prison and fines up to $100,000.

Abortion in Idaho is illegal from fertilization. Following the overturning of Roe v. Wade on June 24, 2022, abortion in Idaho was criminalized by the trigger law which states that a person who performs an abortion may face two to five years of imprisonment. The ban allows exceptions for maternal health, rape and incest within the first trimester. The law took effect on August 25, 2022. Minors need parental consent to travel out of state for an abortion.

As of 2024, abortion is generally illegal in Indiana. It is only legal in cases involving fatal fetal abnormalities, to preserve the life and physical health of the mother, and in cases of rape or incest up to 10 weeks of pregnancy. Previously abortion in Indiana was legal up to 20 weeks; a near-total ban that was scheduled to take effect on August 1, 2023, was placed on hold due to further legal challenges, but is set to take place, after the Indiana Supreme Court denied an appeal by the ACLU, and once it certifies a previous ruling that an abortion ban doesn't violate the state constitution. In the wake of the 2022 Dobbs Supreme Court ruling, abortion in Indiana remained legal despite Indiana lawmakers voting in favor of a near-total abortion ban on August 5, 2022. Governor Eric Holcomb signed this bill into law the same day. The new law became effective on September 15, 2022. However, on September 22, 2022, Special Judge Kelsey B. Hanlon of the Monroe County Circuit Court granted a preliminary injunction against the enforcement of the ban. Her ruling allows the state's previous abortion law, which allows abortions up to 20 weeks after fertilization with exceptions for rape and incest, to remain in effect.

Abortion is illegal in Kentucky, except to save a pregnant woman’s life or to prevent disabling injury.

Abortion in Mississippi is illegal. The new law took effect on July 7, 2022, after Mississippi State Attorney General Lynn Fitch certified on June 27, the Supreme Court decision on Dobbs v. Jackson Women's Health Organization on June 24 of that year. State Attorney General Lynn Fitch's certification made Mississippi's 2007 'trigger law' go into effect and ban all abortions in the state, “except in the case where necessary for the preservation of the mother's life or where the pregnancy was caused by rape".

Abortion in North Dakota is technically legal, but with no current providers. The state's sole abortion clinic, the Red River Women's Clinic, relocated to Minnesota.

Abortion in Ohio is legal up to the point of fetal viability as a result of abortion rights being placed into the Ohio State Constitution by November 2023 Ohio Issue 1.

Abortion in Tennessee is illegal from fertilization except to "prevent the death of the pregnant woman or to prevent serious risk of substantial and irreversible impairment of a major bodily function of the pregnant woman". Tennessee is one of four states which prohibit abortion in their state constitution; alongside Alabama, Louisiana, and West Virginia.

Abortion in Wyoming is legal up to fetal viability. A temporary court injunction was filed against an attempted near total abortion ban in 2023, and a Wyoming judge struck down the abortion ban in 2024.

Dobbs v. Jackson Women's Health Organization, 597 U.S. 215 (2022), is a landmark decision of the U.S. Supreme Court in which the court held that the Constitution of the United States does not confer a right to abortion. The court's decision overruled both Roe v. Wade (1973) and Planned Parenthood v. Casey (1992), returning to the federal and state legislatures the power to regulate any aspect of abortion not protected by federal statutory law.

Mayday Health is a 501(c)(3) non-profit organization that educates on medication abortion and how to access it in the United States. It was founded in 2022 in response to the Dobbs v. Jackson (2022) court decision that limited access to abortion in many U.S. states. Mayday educates on self-managed abortion and does not sell or distribute the abortion pill. Mayday was founded after the leak of the Dobbs v. Jackson decision that overturned Roe v. Wade (1973) and Planned Parenthood v. Casey (1992). The organization launched on the day of the Dobbs decision.

<span class="mw-page-title-main">Death of Amber Thurman</span> 2022 death attributed to abortion laws

Amber Nicole Thurman was a 28-year-old medical assistant who died of septic shock and retained products of conception following a medication abortion. Georgia's maternal mortality committee determined that Thurman's death was preventable and noted that the voluntary delay in performing the dilation and curettage (D&C) procedure significantly contributed to her death.

Blackmon v. State of Tennessee is a court case heard by the Tennessee Twelfth Judicial District Court regarding medical exceptions to the state's abortion ban, specifically relating to pregnant persons with emergent health conditions. The lawsuit was filed by the Center for Reproductive Rights on September 11, 2023, and a hearing was held April 4, 2024.

References

  1. 1 2 3 Kheyfets, Anna; Dhaurali, Shubhecchha; Feyock, Paige; Khan, Farinaz; Lockley, April; Miller, Brenna; Cohen, Lauren; Anwar, Eimaan; Amutah-Onukagha, Ndidiamaka (December 2023). "The impact of hostile abortion legislation on the United States maternal mortality crisis: a call for increased abortion education". Frontiers in Public Health. 11. doi: 10.3389/fpubh.2023.1291668 . ISSN   2296-2565. PMC   10728320 . PMID   38115843.
  2. 1 2 DiCenzo, Natalie; Giglio, Marisa (August 2023). "Post-Dobbs: The Consequences of Abortion Bans on Complex Family Planning Training". Journal of Graduate Medical Education. 15 (4): 416–418. doi:10.4300/JGME-D-23-00013.1. PMC   10449356 . PMID   37637343.
  3. 1 2 3 4 "Infant mortality spiked in Texas after abortion ban, study reveals". PBS News. 2024-06-27. Retrieved 2024-12-31.
  4. ↑ Mallon, Elaine (2024-11-27). "Texas health committee won't review maternal deaths in 2022, 2023 - Washington Examiner" . Retrieved 2024-12-31.
  5. ↑ Branstetter, Kavitha Surana,Mariam Elba,Cassandra Jaramillo,Robin Fields,Ziva (2024-12-18). "Are Abortion Bans Across America Causing Deaths? The States That Passed Them Are Doing Little to Find Out". ProPublica. Retrieved 2024-12-31.{{cite web}}: CS1 maint: multiple names: authors list (link)
  6. ↑ Jaramillo, Cassandra; Surana, Kavitha (2024-10-30). "A Texas Woman Died After Waiting 40 Hours for Miscarriage Care". ProPublica. Retrieved 2024-12-31.
  7. ↑ Presser, Lizzie; Surana, Kavitha; ProPublica (2024-11-03). "A pregnant teenager died after trying to get care in three visits to Texas emergency rooms". CNN. Retrieved 2024-12-31.
  8. ↑ Surana, Kavitha (2024-09-18). "Afraid to seek care amid Georgia's abortion ban, she stayed at home and died". Georgia Public Broadcasting. Retrieved 2024-12-31.
  9. ↑ "Investigation links Georgia's abortion ban to preventable deaths of 2 women". PBS News. 2024-09-18. Retrieved 2024-12-31.
  10. ↑ Presser, Lizzie; Kavitha, Surana (2024-11-25). "A Third Woman Died Under Texas' Abortion Ban. Doctors Are Avoiding D&Cs and Reaching for Riskier Miscarriage Treatments". ProPublica. Retrieved 2024-12-31.
  11. ↑ "Georgia Mom, 28, Dies of 'Preventable' Infection After Being Denied Life-Saving Procedure Due to State's Abortion Laws". People.com. Retrieved 2024-12-31.
  12. 1 2 Rahman, Khaleda (2024-09-17). "Amber Thurman first named "preventable" abortion death since bans". Newsweek. Retrieved 2024-12-31.
  13. ↑ Walrath-Holdridge, Mary. "Georgia's abortion ban linked to Amber Thurman's death in ProPublica investigation: What to know". USA TODAY. Retrieved 2024-12-31.
  14. ↑ "The Indianapolis Star Subscription Offers, Specials, and Discounts". subscribe.indystar.com. Retrieved 2024-12-31.
  15. ↑ McPhillips, Deidre (2024-10-21). "Infants died at higher rates after abortion bans in the US, research shows". CNN. Retrieved 2024-12-31.
  16. ↑ Farin, Sherajum; Hoehn-Velasco, Lauren; Pesko, Michael F. (2022-06-28). "The Impact of Legal Abortion on Maternal Health: Looking to the Past to Inform the Present". ASHECON - ASHEcon 2022 Conference. Archived from the original on 2024-07-18.
  17. ↑ "Dobbs v. Jackson: The Overturning of Roe v. Wade and its Implications on Substantive Due Process". lawreview.syr.edu. Retrieved 2024-12-31.
  18. ↑ Gyuras, Hillary; Field, Meredith; Thornton, Olivia; Bessett, Danielle; McGowan, Michelle (November 2022). "The double-edged sword of abortion regulations: Decreasing training opportunities while increasing knowledge requirements". Medical Education Online. 28 (1). doi:10.1080/10872981.2022.2145104. PMC   9668273 . PMID   36373897.
  19. ↑ "The impact of restrictive abortion laws on maternal health in Tennessee". rollingout.com. 2024-12-31. Retrieved 2024-12-31.
  20. ↑ Vinekar, Kavita; Karlapudi, Aishwarya; Nathan, Lauren; Turk, Jema K.; Rible, Radhika; Steinauer, Jody (August 2022). "Projected Implications of Overturning Roe v Wade on Abortion Training in U.S. Obstetrics and Gynecology Residency Programs". Obstetrics & Gynecology. 140 (2): 146–149. doi:10.1097/AOG.0000000000004832. ISSN   0029-7844. PMID   35852261.
  21. ↑ Wulf, Sarah; Vinekar, Kavita; Dehlendorf, Christine; Srinivasulu, Silpa; Steinauer, Jody; Carvajal, Diana (November 2023). "Implications of Overturning Roe v Wade on Abortion Training in US Family Medicine Residency Programs". Annals of Family Medicine. 21 (6): 545–548. doi:10.1370/afm.3042. PMC   10681702 . PMID   38012041.
  22. 1 2 3 "How the repeal of Roe v. Wade will affect training in abortion and reproductive health". AAMC. Retrieved 2024-12-31.
  23. ↑ "Curriculum Resources". AAMC. Retrieved 2024-12-31.
  24. ↑ Traub, Ariana; Mermin-Bunnell, Kellen; Pareek, Priyasha; Williams, Sonya; Connell, Natalie; Kawwass, Jennifer; Cwiak, Carrie (July 2022). "The implications of overturning Roe v. Wade on medical education and future physicians". The Lancet Regional Health - Americas. 14. doi:10.1016/j.lana.2022.100334. PMC   9904004 . PMID   36777391.
  25. ↑ Giglio, Marisa E.; Magalski, Gabrielle R.; Doan, Yen P.; Bowman, Sydney (2022-02-23). "Abortion Training in Medical Education — Implications of the Supreme Court's Upcoming Decision". New England Journal of Medicine. 386 (8): 707–709. doi:10.1056/NEJMp2117368. ISSN   0028-4793. PMID   35021003.
  26. ↑ "More young people choosing permanent sterilization after abortion restrictions, new research shows". NBC News. 2024-04-12. Retrieved 2024-12-31.
  27. 1 2 "More women searched for info on getting their tubes tied after Roe was overturned". NBC News. 2022-07-20. Retrieved 2024-12-31.
  28. ↑ Beheraj, Alex Fitzpatrick,Kavya (2023-10-04). "Where in America the birth rate fell the most, mapped". Axios. Retrieved 2024-12-31.{{cite web}}: CS1 maint: multiple names: authors list (link)
  29. ↑ "U.S. Fertility Rate Drops to Another Historic Low". www.cdc.gov. 2024-04-24. Retrieved 2024-12-31.
  30. ↑ McPhillips, Deidre (2024-04-25). "US fertility rate dropped to lowest in a century as US births dipped in 2023". CNN. Retrieved 2024-12-31.
  31. ↑ "State Policy Trends at Midyear 2021: Already the Worst Legislative Year Ever for U.S. Abortion Rights | Guttmacher Institute". www.guttmacher.org. 2021-07-01. Retrieved 2024-12-31.
  32. ↑ BUJPH (2023-04-24). "The Reality of Maternal Health in Post-Roe America – Brown Undergraduate Journal of Public Health". sites.brown.edu. Retrieved 2024-12-31.
  33. ↑ "The Consequences of Overturning Roe v. Wade – UAB Institute for Human Rights Blog". sites.uab.edu. Retrieved 2024-12-31.
  34. ↑ "The biggest health risks women would face if Roe v. Wade is overturned". NBC News. 2022-05-04. Retrieved 2024-12-31.
  35. ↑ Polic, Aleksandra; Rapkin, Rachel B. (2020). "Access to abortion training". Seminars in Perinatology. 44 (5): 151271. doi:10.1016/j.semperi.2020.151271. ISSN   1558-075X. PMID   32828563.
  36. ↑ Institute, Guttmacher. "Interactive Map: US Abortion Policies and Access After Roe". states.guttmacher.org. Retrieved 2024-12-31.
  37. ↑ Kheyfets, Anna; Miller, Brenna; Amutah-Onukagha, Ndidiamaka (July 2022). "Implications for racial inequities in maternal health if Roe v Wade is lost". The Lancet. 400 (10345): 9–11. doi:10.1016/S0140-6736(22)01024-8. ISSN   0140-6736. PMID   35659035. Archived from the original on 2024-11-21.
  38. ↑ McCann, Allison; Johnston, Taylor (2022-05-03). "Where Abortion Could Be Banned Without Roe v. Wade". The New York Times. ISSN   0362-4331 . Retrieved 2024-12-31.
  39. ↑ Lai, K. K. Rebecca; Patel, Jugal K. (2019-05-31). "For Millions of American Women, Abortion Access Is Out of Reach". The New York Times. ISSN   0362-4331 . Retrieved 2024-12-31.
  40. ↑ Yang, John; Corkery, Andrew; Zahn, Harry (November 2024). "Why both abortion and infant mortality rates have gone up in post-Roe America". PBS News. Retrieved 2024-12-31.
  41. ↑ Lindo, Jason M.; Myers, Caitlin; Schlosser, Andrea; Cunningham, Scott (April 2017), How Far Is Too Far? New Evidence on Abortion Clinic Closures, Access, and Abortions (Working Paper), Working Paper Series, doi:10.3386/w23366 , retrieved 2024-12-31
This page is based on this Wikipedia article
Text is available under the CC BY-SA 4.0 license; additional terms may apply.
Images, videos and audio are available under their respective licenses.