Between a Rock and a Hard Place

Much of the political debate about abortion in America focuses on abortions performed late in pregnancy, but the overwhelming majority of them occur in the first trimester. Forty-three percent of all abortions occur in the first six weeks of pregnancy, and 92 percent in the first 13 weeks. Advocates are hopeful that voters will turn out in November to secure abortion rights in the states, which would require over 60 percent of voters to agree to amend the state constitutions. When voters head to the polls this November, they can send a message to politicians that decisions about whether to have an abortion should be between a patient and a provider, not a constituent and their politician.

Julianna Truesdale

Medical Care and the Health Risks Forced Upon Women by Abortion Bans

For nearly five decades, the Supreme Court upheld the central tenet in Roe v Wade: The Constitution safeguards an individual’s right to make personal medical decisions, including abortion before fetal viability, when the fetus can survive outside the womb. The Court reaffirmed this protection in significant cases, but in 2022, the Supreme Court overturned the half-century-old precedent with its decision in Dobbs v. Jackson Women’s Health Organization.

Dobbs v. Jackson Women’s Health Organization was a challenge to a Mississippi law banning abortion after 15 weeks of pregnancy, which experts say stood in direct opposition to what the Supreme Court decided in Roe – that states may not ban abortion before fetal viability, which experts generally understand to mean between 22 and 24 weeks of pregnancy.

Between 2016 and 2020, anti-abortion politicians in the Senate and White House sought to appoint three new justices — Neil Gorsuch, Brett Kavanaugh, and Amy Coney Barrett — known for their opposition to reproductive health and rights. So, in June 2022, when the new case came to them, they landed on a 6-3 decision; the conservative majority on the high court sided with the state of Mississippi, upholding its ban in a massive reversal of precedent. After the ruling, states were left to take their stances on the controversial issue and did so legislatively and through elections. While lawmakers have worked to introduce several new restrictions and bans, questions over the legality of these new laws have led to many being blocked from taking effect while they’re debated in court. Since then, abortions have increased nationally despite drops in states that have banned or greatly restricted the procedure.

Since the US Supreme Court overturned Roe v Wade, at least 15 states have banned or severely restricted abortion. Physicians in many states where abortion bans went into effect left their states due to the impact abortion bans have had on their ability to practice medicine and provide the best care possible for patients.

Most Americans Want Abortion to Be Legal

  • 63% of women say abortion should be legal in all or most cases.
  • 58% of men say abortion should be legal in all or most cases.
  • 74% of adults under age 30 say abortion should be legal in all or most cases.
  • 62% of adults between age 30-49 say abortion should be legal in all or most cases.

Nearly 25% of American women will undergo an abortion by age 45.

Six in 10 women who have abortions are already mothers, and half of them have two or more children, according to 2019 data from the Centers for Disease Control and Prevention.

Abortion is Healthcare

Imagine if someone you loved faced a medical emergency during their pregnancy, but because of abortion bans, their health care was jeopardized, pushing them to the edge of survival. Because fetal anomalies are usually diagnosed sometime between 18 and 20 weeks of pregnancy, and patients often do not develop high-risk conditions until after 21 weeks of pregnancy, they are almost certainly too far along to qualify for abortions now.

These are real stories of women who desperately wanted to carry their pregnancies to term but were denied proper medical care when they needed it most.

They weren’t seeking an abortion initially, but their lives were put in danger due to restrictive laws. They were turned away during emergencies, told to wait for care, or forced to continue pregnancies despite receiving devastating news about their babies’ health, even when it endangered their well-being.

A married couple in Texas was actively trying to grow their family, so they were pleased to learn the wife was pregnant. However, at 20 weeks, they learned that the brain of the fetus was not developing brain tissue and was filling with fluid. Their baby would not survive, but she would have to carry the baby to term because the Texas abortion ban does not make exceptions for fatal fetal anomalies. They said carrying a baby for nine months that they knew would not live was torture. The baby died shortly after his birth.

A mother of one in Alabama said her baby was diagnosed with a severe genetic abnormality causing two holes in his heart, no nose bone, and his brain was not developed. In Alabama, the abortion ban makes exceptions if the unborn child would come out stillborn, die after birth, or die shortly after, but she was still denied appropriate care. She said, “The experience, going through everything with finding out that your child is not going to live … it inflicted so much trauma on me that I just had a [sterilization, I didn’t want any more kids.” She said, “I think back to what happened, and I don’t ever want to go through that again, and I wouldn’t wish this upon my worst enemy.”

A young woman in Arizona was excited that she was pregnant and looked forward to a sibling for her 6-month-old baby girl, especially after learning it was another girl. At 21 weeks, her ultrasound had “red flags,” and she was told that her unborn baby had a severe birth defect. The baby would not be able to breathe on their own for long, would likely never be able to eat on their own, and would have severe facial abnormalities, but most importantly, their brain function would be extremely abnormal, and the average lifespan is hours or days.

She was now 23 weeks and four days into her pregnancy. She was scheduled to have an induction of labor (abortion) for medical reasons, but it was canceled when Roe v. Wade was overturned because the hospital’s committee of ethics decided that her pregnancy was not a threat to her life.

She had scheduled a termination appointment at a clinic in Colorado. However, after she shared her situation on social media, she faced threats to her life and the lives of clinic staff. She said, “It wasn’t safe for me to try and go out there, and inevitably, I was turned away from all the clinics that I tried going to.” She was now 30 weeks pregnant without any options but to carry her nonviable pregnancy to term and wondering all the while if the baby was suffering inside of her. She watched her baby die a painful death 44 hours after she was born. “Those two days were absolutely horrible because there was nothing that I could do to protect her, to make her more comfortable besides giving her the pain medicine. After watching a piece of my heart die, I’m not me anymore,” she said.

One couple in Florida found themselves pregnant after 17 miscarriages. The wife was in her second trimester in December 2022 when, one evening, she was drenched by a clear fluid leaking from her body. At the hospital, she was diagnosed with preterm premature rupture of membranes (PPROM), which is not an uncommon complication when a pregnant woman’s water breaks before the pregnancy is viable. At her stage of pregnancy, doctors said there was nothing they could do to save the fetus. Left without care, doctors say the mother’s health could be in danger as well.

However, her medical care now hinged on Florida’s 15-week abortion ban, which went into effect in July 2022 after Roe v. Wade was overturned. She was already more than 15 weeks pregnant. If she lived in a state without restrictions on abortion care, she would have been admitted, counseled, and offered induction of labor to protect her from infection, which in this case would be considered abortion care. Instead, she was discharged from the emergency room because she was not yet sick enough to qualify for the emergency medical exception in Florida’s law, despite her risk for infection and hemorrhage. She would later find herself on the brink of death.

In certain instances, these women’s medical decisions were reviewed by panels of doctors or even lawyers in their home states. Consequently, they endured weeks of pregnancy while awaiting appointments in other states. With many states halting most abortion services, facilities near state borders experienced a surge of tens of thousands of women seeking care from neighboring states, as reported by the Guttmacher Institute.

Many of these women had to embark on journeys spanning hundreds of miles, whether by car or plane, often facing financial strain. Throughout this ordeal, they grappled with the emotional toll of losing a wanted child.

Another Couple in Texas had six embryo transfers in an attempt to grow their family. At the scheduled 12-week checkup appointment, she learned her baby had a rare anomaly called Limb Body Wall Defect, a condition where a fetus has multiple malformations and will die in utero or shortly after birth if it gets to that point. “Every single one of my son’s organs were growing outside of his body, including his heart — everything. But the heart was still beating outside of his body, and I couldn’t even get the care,” the mother said.

Texas’ abortion bans lack exemptions for fatal fetal anomalies, leaving Nelson unable to access abortion care locally. Her choices boil down to carrying the pregnancy to term despite the inevitable loss of her baby or traveling to another state for care. However, such travel and care expenses can amount to thousands of dollars. “Instead of being able to grieve the news that we just received, we have to plan travel to a foreign place we don’t want to be in in the first place, spending money that we don’t wanna spend or may not have, to go do something to take care of ourselves,” she said.

A husband and wife in Wisconsin who found it difficult to conceive due to polycystic ovary syndrome was very excited to be pregnant finally. During a routine 20-week ultrasound in July, their physician detected an anomaly: the fetus was notably undersized, signaling a potential issue. Subsequent tests confirmed skeletal dysplasia, a serious and life-limiting condition. Complicating matters, she experienced bleeding and was diagnosed with placenta previa, a condition where the placenta covers the cervix, heightening the risks associated with her pregnancy.

At the time, Wisconsin enforced a strict abortion ban, permitting exceptions solely to save the mother’s life, but the law mandated approval from three doctors. Their doctor identified the pregnancy as endangering Meagan’s life and endeavored to secure a facility for the procedure, contacting hospitals statewide without success despite other physicians concurring on the risk to her life. Following extensive research, they searched for an out-of-state facility for abortion care by going through seven different degrees and texting and calling people after hours to find routine care for her. She had to wait three weeks before she was able to get a termination at a hospital about 100 miles away from her home.

Despite working hard to find care that her insurance would cover, the procedure itself and part of her hospital stay for recovery were denied. It cost her more than $3,000, but she says if she didn’t have insurance coverage at all, it would have cost them around $20,000.

Some women had to travel even farther away from their homes to get abortion care in another state. The need to travel to another state can push women further along in their pregnancies, and the cost of later-term care can skyrocket.

A 45-year-old Florida woman, originally from Brazil, faced limited options due to neighboring states implementing abortion bans following the Dobbs decision in July 2022. Her fetus was diagnosed with trisomy 18, a lethal anomaly with low survival rates. Complicating matters, she had thrombosis, heightening the risks of her pregnancy.

Feeling isolated and overwhelmed, with limited options due to fear of legal repercussions for violating the state’s ban, she sought care at an abortion clinic, where she faced three days of uncertainty as the clinic navigated the unclear state law. Eventually, she was able to get an appointment at a clinic in Washington, D.C., 1,000 miles away from her home state of Florida, but she feared for her life. She was scared to tell anyone on the flight what the couple was going there to do and called her flight to D.C. a “nightmare.”

A woman in Arkansas discovered at 20 weeks that her baby had severe abnormalities, including a missing chest cavity and organs wrapped around the heart, resulting in a much smaller size than normal. Unable to find abortion care in their home state, the couple had to travel to Illinois due to neighboring states discontinuing abortion services.

Her husband said, “One thing people don’t realize: health insurance is not going to cover it at all. They will not touch it; they will not even remotely listen to you. So, it has to come out of your pocketbook, and for some families, that’s their whole savings,” her husband said. “It was ours,” the wife added.

The husband was neither allowed to be with his wife during the procedure at the facility due to Illinois state law, nor could the couple have their baby girl’s remains. The couple said they do not feel safe getting pregnant again in Arkansas. “I don’t think that any woman should feel safe to get pregnant in the United States right now — period,” her husband said.

The wife later said she doesn’t think they will have any more children. “I just can’t go through that again. It was hard enough the first time. I don’t think I could come back from that a second time. So, we made the decision to keep our family exactly the way it is, and we are OK with that,” she said.

When a woman from Tennessee, bordered by states with abortion bans, arrived at a clinic in New York, her health was critically at risk. Her baby had passed away inside her, and doctors couldn’t determine the time of death. Just over a week prior, her last ultrasound had shown a fetal heartbeat. “The doctor told me that because we don’t know when my daughter passed, there is about a two-week window when you carry a deceased fetus when your body doesn’t recognize it when you are at risk for blood clots, infections, or going septic,” she said. Because she was nearing the end of that window, she had an abortion within an hour and wouldn’t leave her room for two weeks afterward.

How Many States Have Abortion Bans in Place?

There are abortion bans in effect with only limited exceptions in 41 states. There is a total abortion ban in 14 of those states, and in 27 of those states, access to abortion is currently limited depending on gestational age, with bans ranging from six weeks to 18 weeks.

VOTE! Your Vote Can Change Healthcare for Women

Nearly 40% of Republicans and those who lean toward the Republican Party (60%) say abortion should be legal in all or most cases. While 80% of Democrats and those who lean toward the Democratic Party say abortion should be legal in all or most cases.

Much of the political debate about abortion in America focuses on abortions performed late in pregnancy, but the overwhelming majority of them occur in the first trimester. Forty-three percent of all abortions occur in the first six weeks of pregnancy, and 92 percent in the first 13 weeks. Advocates are hopeful that voters will turn out in November to secure abortion rights in the states, which would require over 60 percent of voters to agree to amend the state constitutions. When voters head to the polls this November, they can send a message to politicians that decisions about whether to have an abortion should be between a patient and a provider, not a constituent and their politician.

This isn’t the first time abortion has appeared on ballots; Ohio passed a measure supporting abortion access in 2023, while initiatives in Kansas and Kentucky rejecting state constitutional protection for abortion were defeated by voters in 2022. The issue of reproductive rights appears to be mobilizing voters from various political backgrounds.Bottom of Form

Anti-abortion politicians put this amendment on the primary ballot with the goal of low voter turnout, but they discounted voters in states who said loud and clear they believe and trust patients to make their own medical decisions.

 

Get out there and vote like your life depends on it because it could!

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