- With the confirmation of Supreme Court Justice Amy Coney Barrett, the balance of the court has shifted to a firm 6:3 conservative majority.
- This could lead the court to overturn the landmark ruling Roe v. Wade.
- Experts say if states are given greater leeway to restrict abortion access, more people will be forced to carry unwanted pregnancies to term.
Under the tenure of President Donald Trump, the U.S. Supreme Court has veered right — leaving many reproductive health advocates concerned about the future of abortion rights in this country.
With the confirmation of Supreme Court Justice Amy Coney Barrett, the balance of the court has shifted to a firm 6:3 conservative majority.
This could potentially lead the court to overturn the precedent established in Roe v. Wade, which limits the authority of states to ban abortion.
The court could also change the standard used to decide which abortion regulations are constitutional, increasing the ability of conservative lawmakers to restrict abortion access.
If states are given greater leeway to restrict abortion access, more people will be forced to carry unwanted pregnancies to term. Others will cross state lines to get abortions or use illegal abortion services.
“It leads to increased barriers and hardships that a person must face in order to obtain the healthcare they need,” Dr. Mai Fleming, a family medicine physician and abortion provider who works in California and Texas, told Healthline.
“People may be forced to delay abortion care until later in pregnancy, or even be forced to carry a pregnancy to term against their will if abortion is not readily accessible in their state,” she added.
Changing abortion landscape
When the Supreme Court ruled on Roe v. Wade in 1973, it found that state laws that ban abortion are unconstitutional.
This decision helped make abortion more accessible and safe, but it didn’t have as much of an effect on birth rates as some might assume. That’s because people were already getting abortions, before they were legalized.
“I think that it’s important to understand that most people who need abortions will have abortions, whether they’re legal or not,” said Dr. Jamila Perritt, president and CEO of the national advocacy organization Physicians for Reproductive Health.
Historically, illegal abortions were medically riskier than legal abortions.
Too often, they were performed in unsanitary conditions by people who lacked the necessary medical skills and training.
Roe v. Wade opened the door to safer, legal alternatives, which led to fewer people developing complications or dying from illegal abortions.
Roe v. Wade also helped drive down complication and death rates from legal abortions by enabling more abortion research and better training.
Now, abortions aren’t only safer than they used to be, they’re also safer than carrying a pregnancy to term and giving birth.
A study conducted in 2012 found that the risk of death associated with childbirth was about 14 times higher than the risk of death from legal abortion in the United States.
Efforts to restrict abortion access
When people want to get an abortion but struggle to access it, that puts their physical and mental health at risk.
It can also cause financial strain if they need to take time off work or travel to get an abortion, pay steep prices for abortion services, or carry an unwanted pregnancy to term.
That was true before Roe v. Wade, and it’s true today.
Conservative lawmakers in many states have limited abortion access by requiring healthcare providers and patients to meet burdensome criteria.
For example, many states have passed gestational age limit laws that ban abortion beyond a specific week of pregnancy.
When researchers from the Turnaway Study examined the effects of these laws, they found far-reaching consequences.
The results show that women who are denied abortions experience increased risk of poverty. They’re more likely to experience serious complications of pregnancy, anxiety, and reduced self-esteem, and more likely to stay in abusive relationships.
Abortion clinic closures, restrictions on public funding for abortion, state-mandated waiting periods, and other regulations also make it harder for people in many parts of the country to access abortion.
“People need to travel far distances, often for multiple days at a time, delay care until later in pregnancy, and stretch already strained budgets to take off work and obtain child care just to obtain a pill or a medical procedure,” Fleming said.
“These long distances will only become longer if abortion is made illegal in certain states, forcing people to cross multiple state lines or potentially board a flight in order to obtain basic healthcare,” she added.
If the Supreme Court overturns or weakens Roe v. Wade, it will lead to increased inequalities in abortion access across the United States.
Some states will continue to protect or expand the right to abortion care. Others will make abortion illegal or severely restrict the conditions under which it can be performed, predicts the Center for Reproductive Rights.
This will compel more people to choose between carrying an unwanted pregnancy to term and getting an illegal abortion.
For those who seek an abortion in the first 9 weeks of pregnancy, abortion pills now provide a safer option than the “back alley” abortions associated with the pre-Roe era.
But people who use abortion pills or other abortion services outside of the formal medical system may face legal consequences.
“People could be more likely to be criminalized, prosecuted, and imprisoned for managing their own abortion,” Perritt told Healthline.
Members of already marginalized and heavily policed communities are more likely than others to face such consequences, Perritt said.
“Who are the folks that are more likely to be prosecuted and persecuted by the criminal legal system? Those are the folks that are going to really feel the brunt of making abortion illegal,” she continued.
“We’re talking about people of color, we’re talking about immigrants, we’re talking about young people, those with low income,” she added.
Impact of Roe v. Wade on mental health
According to Perritt, restricting abortion access worsens social inequalities and limits the ability of people to make decisions about their own lives.
“I’m a physician, I’m an abortion provider, and I know that the patients that I care for are making thoughtful decisions about what they can and cannot manage in their lives,” she said.
“Without a doubt, overturning Roe v. Wade will harm the people that I take care of,” she added.
Even if Roe v. Wade is allowed to stand, many state laws that are currently on the books make it difficult for people in those states to access abortion.
“I care for patients in both California and in Texas — a state with some of the most accessible abortion care and one with some of the least accessible care,” Fleming said.
“Though abortion care is currently legal in Texas, it is by no means readily accessible in every community. So, the effects of overturning Roe v. Wade are already the reality for many people and families living in Texas and other states with restrictive abortion laws,” she added.
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