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The right to abortion in America – why should you care?
Congresswoman Pramila Jayapal shared her experience of abortion in a NYT op-ed that also described the dangerous birth of her first child Janak, and the realization that any future pregnancies would be extremely high risk.
Jayapal calls the abortion a heartbreaking decision she had to make, but going public with her story was important. The Congresswoman was deeply concerned “about the intensified efforts to strip choice and constitutional rights away from pregnant people and the simplistic ways of trying to criminalize abortion.”
Jayapal’s story is not unique. She was lucky to live in a state that supported a woman’s right to choose. But with the Supreme Court overturning Roe vs. Wade this year, it removed the guarantee of that choice for other women.
Maya’s Story
In the US, one in four women between the ages of 15 and 44, will have an abortion in her lifetime.
In her book ”You’re the Only One I’ve Told: The Stories Behind Abortion,” Dr. Meera Shah, a family medicine physician, writes about reality of reproductive choices for women. Shah is Chief Medical Officer at Planned Parenthood Hudson Peconic, Inc. In one story, she describes Maya, the daughter of Indian immigrant parents, who finds herself pregnant by her boyfriend, Theo. Maya’s conservative parents believed in no sex before marriage and expected her to marry someone within her community.
“In our culture, sex and love are strongly linked to marraige. Sex before marriage that leads to an abortion is often more stigmatized than an abortion that occurs within a marriage,” writes Shah.
Maya made the difficult decision to have an abortion, knowing that her family would not understand and also because she wasn’t in a committed, stable relationship.
Maya felt very alone. She did not feel she could share her abortion story with friends in the Indian community for fear of being judged as ‘easy’ or even a ‘slut’.
When Maya was in her twenties, her mother revealed that she had an abortion in her early 40s. She did not want another child late in life and already had two kids. Maya who was 14 at the time, remembers a medical procedure which caused her mother emotional anguish.
“The irony of Maya’s situation is that the one person she felt like she couldn’t tell, her own mother, was the one person who would actually understand,” adds Shah.
Abortion in the South Asian community
While Asians in the US have a lower rate of abortion compared to other communities, disaggregated data about Asians tells a different story, said Seetha Ramachandran, a partner at Proskauer Rose LLP, at an Indiaspora event on Reproductive Rights Ruling: Legal & Political Implication.
“For example, for Indian women in New York City, the rate of abortion is 30.5% disaggregated. The rate of abortion among foreign born Indian women in that group is 26.8%. And among US born women is 35.9%. And the South Asian diaspora also has the greatest amount of economic inequity of any immigrant group. So clearly, the recent decision in Dobbs is going to have a profound impact on our community” added Ramachandran.
About half of states are expected to enact bans on abortion or restrict it in some form. Abortion remains legal for now as courts determine whether existing or new bans can take effect. Without the protection afforded to women by Roe vs. Wade, the rules by which doctors and patients can play by have become murky, and could lead to many patients crossing state lines to access abortion.
Reproductive freedom in California
In California, reproductive health is a key component of individual family and community health, asserted Silvia Castillo, Director of Government and Community Affairs at Essential Access Health, at an EMS Briefing on LA County Reproductive Right.
She explained that the state legislature passed a comprehensive package of 13 legislative bills proposed by the California Future Of Abortion Council, to ensure that California becomes a true reproductive freedom state.
“Together these 13 bills aim to reduce cost barriers to abortion care, and provide practical support for Californians and others forced to travel to our state to access care”
The bills will also cover training and development of a reproductive health care workforce, which can provide culturally competent care that is reflective of communities they serve. The bills will also enact legal protections for abortion providers, patients, and people who help patients access to care, added Castillo.
Lack of access to abortion has serious outcomes
Longitudinal studies show that lack of access to basic reproductive health care severely impacts the physical health and mental health of patients.
When women are denied abortion access, they are left to live in poverty with children who continue to be in poverty in the long term.
However even though Roe v Wade was overturned at the federal level, in California, and in LA County, abortion is still legal and available. “It’s also still covered by Medi-Cal,” confirmed Dr. Susie Baldwin, Medical Director of the Office of Women’s Health for the LA County Department of Public Health.
Wait times for abortions have increased since last year, so more health care providers and community health centers are trying to integrate medication abortion services into their practices, to better serve the patients coming through their doors.
Twenty two of California’s 58 counties do not have an abortion clinics, but Los Angeles County has 56 Open abortion clinics. They are a destination for individuals without a clinic in their county, especially those from rural areas.
Can you get sued for crossing state lines?
California has passed laws to protect patients who cross state lines to get an abortion in California, said Baldwin, because uncertainty surrounds abortion laws in other states.
“There’s an association of pro bono attorneys that it’s forming to address this. Lots of lawyers want to help and make sure that no patients are going to be penalized for seeking care here, and that our doctors, nurses, advanced practice nurses nurse when midwives, anybody involved at all an Uber driver, a hotel, that they are not going to be penalized for supporting people coming here for care.”
However, according to Gowri Ramachandran at the Indiaspora event, “physicians are going to be understandably risk averse” because abortion is regulated through criminal law in the United States.
That means, even if the law has that exception in it, women often cannot actually access the health care because the clinics won’t provide it.
The ripple effect, explained Ramachandran, is that now, employers are experiencing uncertainty about paying for employees to travel to other states to obtain abortions. They fear prosecution “by some aggressive Attorney General who wants to make a name for himself because they assisted their employee with obtaining an abortion out of state.”
Despite a constitutional right to interstate travel that is recognized by the Supreme Court, “nobody wants to be criminally prosecuted.”
In the interim, as the politics of this decision plays out across states and living rooms across this country, women all over live in fear of losing their fundamental right to personal choice of their reproductive health.
Read more on this topic by Anjana Nagarajan-Butaney
Photos by Gayatri Malhotra on Unsplash