Protesters gather to celebrate the one-year anniversary of the US Supreme Court ruling in Dobbs v Women’s Health Organization case in Washington, DC on June 24, 2023.
ANDREW CABALLERO-REYNOLDS/AFP via Getty Images
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ANDREW CABALLERO-REYNOLDS/AFP via Getty Images
Protesters gather to celebrate the one-year anniversary of the US Supreme Court ruling in Dobbs v Women’s Health Organization case in Washington, DC on June 24, 2023.
ANDREW CABALLERO-REYNOLDS/AFP via Getty Images
Ever since the Supreme Court ruling overturning abortion rights leaked last spring, researchers and experts have begun to predict the consequences.
A year later, the data began to focus on actual effects. Via a dozen states There is a near-total abortion ban, with several other state bans in the works. At least 26 clinics closed. In Texas, almost 10,000 more babies was born in the state since the 2021 “heartbeat bill” went into effect.
The number of abortions occurring across the country has decreased, though not by as much as many predicted. Healthcare staff provided 25,000 fewer abortions through the end of March 2023. For context, there are approx 930,000 abortions in 2020 according to the Guttmacher Institute.
As the United States enters its second year without abortion access provided by Roe sues WadeNPR asked abortion researchers and clinicians what they expect to change in the coming year.
1. The entire Southeast could become an abortion desert
More and more states are taking steps to ban or severely restrict abortion. The researchers think as many as 25 states could eventually do so.
“There are a few states in the Southeast that really need access to abortion – Florida, North Carolina, Virginia, South Carolina,” says Ushma Upadhyay, a professor and public health scientist at the University of California San Francisco. She analyzed abortion data from providers for #WeCount, a project of the Family Planning Association. She explained that there was a huge influx of people coming to those states for abortions this first year, from places like Texas, Alabama, and Oklahoma.
But those states are considering or starting to implement new bans of their own. If and when those bans go into effect, “it will cut off people’s access to the entire Southeast,” she said, from western Texas to half the Atlantic coast.
What happens in Florida could have a particularly big impact. It’s a large, populous state, with 21 million residents. Currently, abortion is legal there for 15 weeks, but Republican governor and presidential candidate Ron DeSantis is keen to change that. A six-week ban is on hold, pending a decision in a case challenge existing abortion laws.
At a national conference of anti-abortion rights activists last month, the attendees clarified Their goal is to ban abortion in all states.
2. Doctors can begin to push legal boundaries more
Doctors who violate abortion laws can face the possibility of imprisonment, fines, and loss of medical licenses. There are many unanswered legal questions about exactly what would violate these laws and what the consequences would be. Those questions remain unanswered because so far in the following first yearfish roe, There are no charges against doctors who provide illegal abortions.
Dr Nisha Verma, an Atlanta-based OB-GYN who has consulted for the American College of Obstetricians and Gynecologists, said: “The doctors and the institution were very careful. In Georgia, where she practices, abortion after six weeks of gestation is illegal, before many people know they are pregnant.
In places where abortion is prohibited, health care providers are often faced with situations where they must balance worrisome health risks to pregnant patients with compliance with the law.
For example, when the patient’s membranes rupture too early, before 22 weeks or so, the pregnancy cannot continue and the patient is at high risk of infection. Many doctors and hospitals in states that ban abortion will not offer an abortion procedure unless the fetal heart stops or the pregnant patient’s condition is severe enough to warrant an emergency.
For cases like this, Verma says, “a lot of organizations have said … though .” [the patient’s] the risk of getting sick is so high, we can’t take care of them until they’re sick.”
This approach is called “expectation management,” and the results can be bad for the patient. Verma points to a study of 28 Texas patients who were only offered chronological management rather than immediate care after premature rupture of membranes. Most of these patients were in serious condition, of which 10 had an infection, 5 needed a blood transfusion and one required a hysterectomy.
Bioethicists have argued that doctors and hospitals have a moral obligation to intervene early, and Verma thinks that may be starting to happen, including at her own hospital. “Now we’re looking, how much can we push the envelope?” she speaks. “But it’s scary – no one wants to be a test case.”
As doctors and hospitals become bolder, she thinks, one doctor will eventually be charged with an abortion — perhaps within the next year. The questions are who, where and what the next legal case will change about access to abortion.
3. Key Abortion Pills Are In Danger
There is a lot of legal activity going on around either drug used for home abortion: mifepristone. Since more than half of all abortions in the United States are medical abortions, this can have huge spillover effects.
Have two federal cases conflict while playing. A judge in Texas ruled that the Food and Drug Administration inappropriately approved mifepristone; another judge in Washington ruled that the FDA must maintain access to mifepristone.
Currently, mifepristone is still available in states where abortion is legal and will not change until the Supreme Court hears the arguments over the case in Texas and issues a decision, which will not happened for many months.
“If medical abortion is meaningfully restricted as a result of this [Texas] the case – and that’s a big ‘if’ – it will significantly reduce access to abortion, especially most realistically in the states that currently have the highest levels of access,” said economics professor. of Middlebury University said Caitlin Myersmanager one abortion facility database.
Many abortion clinics only offer medical abortions, not surgical abortions, she said, so the decision could lead to many clinics closing. “California will lose more facilities than any other state if drug abortions actually go away.
“I don’t know what will happen, but it could be bigger Dobbs,” about its impact on access to reproductive health, Myers said. “I think that’s very important for people to understand.”
4. Some funds to protect access to abortion may run out
One reason abortion doesn’t drop as much as expected in the first year after Dobbs is because support for access to abortion has emerged in response, say Diana Greene FosterThe author of Research turns heada landmark research project documenting the long-term social and medical effects of abortion on women’s lives.
This support includes abortion funds and online guides that help women find appointments, raise money to cross state boundaries, and navigate the confusing legal landscape. Greene Foster said: “New funds came in, people were very generous. “There was a sense of urgency and the money came in.”
But that may not last, she said. “I worry about running out of resources,” she said. “On the other hand, the first year is the year that requires the most resources to set up the system and advertise.”
5. A clearer view of what just happened will develop
Upadhyay notes that it’s really unclear how many people seek an unviable abortion by 2022. Of the fewer than 25,000 people who have abortions with healthcare providers, “we don’t know how many of those 25,000 managed their own abortions [with abortion medication at home] and how many end up getting pregnant,” she explains. “We won’t know until birth data is published about a year from now.”
The actual impact of abortion bans on the number of children born takes time to collect and analyze, in part because full-term pregnancies take almost a year. After the CDC releases 2022 birth data next year, the number of people denied abortions will be easier to calculate.
6. Access to contraceptives may increase but not change the need for abortion
FDA seems likely to approve over-the-counter birth control pills this summer. But both Greene Foster and Upadhyay doubt it will have a big impact on demand for abortions.
“People want to know that there are some positive forecasts and that contraceptive use will increase,” says Greene Foster. “But most people who get pregnant and try to have an abortion are already using birth control.” Every method of birth control has a failure rate.
Upadhyay agrees. “There will always be a need for an abortion,” she said. “No matter how careful or responsible one is, one always needs an abortion.”
7. ‘sanctuary’ countries can go further to protect patients and doctors
Since patients have to go further and raise more money for out-of-state abortions, their care may be delayed until they are further pregnant. Upadhyay did an analysis found that abortion providers increased their use of telehealth and began providing post-pregnancy care to meet patient needs.
Many states have passed “shield” laws to protect out-of-state patients and the doctors who treat them. But Upadhyay notes, some states are similar spending millions to increase access to abortion, have their own abortion restrictions.
“A lot of states that claim to protect abortion rights actually limit the possibility of getting pregnant,” says Upadhyay. In rare cases, these limitations can baffle parents in difficult and tragic circumstances. States with these limits include California, Illinois, New Mexico, Massachusetts, New York, and others.
Upadhyay says she hopes that these states will do more to increase access to abortion, especially as residents in states do not have access. farther to travel.
Edited by Carmel Wroth.
