More than 36 million women would lose access to safe abortions if the Supreme Court’s conservative majority guts or completely overturns the landmark Roe v Wade decision this summer.
Should that happen, people in potentially half the states will no longer have access to abortion services in their state. 26 states are poised to ban abortions as a result of trigger bans if Roe is overturned or they have pre Roe bans on the books, that have not been in effect since Roe decision in 1973.
What worries Vaishali Sirkay, the Health Program Director at Manzanita Works that it’s “not just the back alley abortions.” Manzanita Works, an Oakland-based non-profit supports the welfare of workers and their families, and Srikay is concerned that women are not going to wait the 2 weeks to find out if they are pregnant or not and “get the morning after pill – which is a very high dose of estrogen. If you cannot get the morning after pill or you don’t know where to get it or it’s not sold in your CVS drugstore, then you are going to try to find someone who’s got a birth control pill pack and try to take the high dose estrogen pills. “So, what worries me is that we have half a knowledge of how this morning after pill works but are going to try to make up the science as we go along.” says Sirkay.
The states have really been a battleground for abortion access in the last few years. Last year, more than 106 abortion restrictions were passed in 2021 and so far in 2022, more than 180 bills restricting abortion have been introduced.
Polls have shown that more than 80% of Americans support access to safe and legal abortions. If Roe is overturned or gutted, it is estimated that more than 1 million people will find their nearest abortion provider in California which is nearly a 3000% increase from today, according to Planned Parenthood.
Roe v. Wade and the Hyde Amendment
The Supreme Court ruling in Roe v. Wade in 1973 made access to safe and legal abortion a constitutional right. In essence, the court ruled that the woman’s liberty (right to control whether or not she is pregnant) is stronger than the state’s interest in the fetus’ life up until a certain point in the pregnancy. That point being the “point of viability” – i.e the fetus could survive on its own outside of the womb. After the point of viability, the state’s interest in protecting the fetus outweighs the woman’s choice to terminate her pregnancy.
“The Supreme Court said that the right to choose whether or not to have an abortion is a fundamental right that is protected by the right to privacy under the 14th amendment, of the US constitution” explained Lisa Matsubara, general counsel for Planned Parenthood Affiliates of California at an EMS briefing (February 11) about how women of color face the most severe impact if Roe v Wade ends.
Though Roe v. Wade has been the law of the land for almost 50 years, many women face tremendous barriers to accessing abortion care. Three years after Roe v. Wade was decreed, Congress passed the first “Hyde Amendment” to the fiscal 1977 Medicaid appropriation bill. Introduced by anti-choice Congressman Henry J. Hyde, the Hyde Amendment barred the use of federal Medicaid funds for abortion except when the life of the woman would be endangered by carrying the pregnancy to term.
“This is a discriminatory policy and it impacts Black, Latino and indigenous people experiencing poverty at twice the rate of their white counterparts in 2019” says Jodi Hicks, CEO and President for Planned Parenthood Affiliates of California.
There are 16 states that provide their own funding for abortion coverage and California is one of those states. But across the other 34 states where it has an impact says Hicks, “the Hyde Amendment currently leaves 7.8 million women aged 15-49 with medicaid converge but without abortion coverage. Half of those affected are women of color.”
What is happening with SB8 in Texas?
Texas SB8, enacted in the summer of 2021 has effectively banned abortion after 6 weeks, after a fetal heartbeat is detected. Matsubara says “what makes this law unique – it is not enforced by any state actors. Rather, any person in the whole country is invited to bring a lawsuit in Texas state court against anyone who provides an abortion in violation of the ban or anyone who helps somebody actually obtain an abortion in violation of the ban. That means that any person who might be driving the person or assisting them in any way is potentially liable. The person who sues is entitled to a $10,000 bounty. This private right of action enforcement mechanism is a deliberate scheme designed to get around the courts by arguing that since there are no state actors to block the law, the courts do not have authority to stop it from going into effect.”
This Texas law means that there are no protections under Roe in Texas. It also meant that overnight, people in Texas could no longer to get abortion service because according to Matsubara “85% of abortions occur after 6 weeks of pregnancy, and those patients are no longer able to get an abortion without traveling outside the state.”
To make matters worse, according to a Washington Post story, women started calling clinics much earlier in their pregnancies, even before a positive test, desperately trying to schedule an appointment for an abortion. Anticipating being able to do less abortions, most clinics in Texas reduced their capacity after SB8 was enacted. Now, time has run out for these women as their 6 -week deadline passes in waiting to get an appointment.
What does it mean for California?
California’s Planned Parenthood centers have served at least 7000 out of state patients a year in 2020 to access sexual and reproductive healthcare including abortion. And because of the SB8 law Texas, neighboring cities and states, are already experiencing an impact. For example, says Matsubara “wait times in Oklahoma City have gone from 3 days to nearly 3 weeks. And these delays impact not only the folks who are coming in from out of state but also those patients in the cities that people are traveling to, who are now facing very long wait times for an appointment, for very time sensitive services.”
There are already efforts underway in California according to Matsubara to make sure that “we are prepared in California to be able to serve – not just people who live in CA but those who may be traveling here to be able to access an abortion.”
Traditionally, if you have the means, you would always be able to travel out of state to be able to get an abortion. That was the case before Roe as well. So part of the efforts underway are to really make sure that there is equitable access to abortion care. This is an issue that disproportionately impacts people who are lower income as well as women of color.
Organizations like Access Reproductive Justice where Jessica Pinckney is the Executive Director are the only statewide abortion fund in California and their mission is to remove barriers to sexual and reproductive healthcare and build the power of Californians to demand health justice and dignity. What that means in reality is that they work with women who call into their health line with procedural as well as practical support. That includes paying for people’s procedures because the patients are uninsured, underinsured or may have high deductibles, copays on their private insurance plan. And in a more practical way, they also help these women with transportation, lodging, childcare and food. Pinckney says that even in a progressive state like California where the cost of abortion is covered by MediCal, some women might have travel 3 or more hours to access the nearest clinic. Medi-Cal, is the state’s health insurance (Medicaid) program for Californians with low incomes, including 40% of all children, half of all people with disabilities, over a million seniors, and nearly 4 million adults.
Guttmacher reports that over 50% of folks getting abortions are already parents. So, these women have other child care and family care responsibilities that need to be supported. They have to balance the needs of their existing family, get time off work and plan the logistics of an abortion across state lines, all of which is tremendously intimidating.
What happens if abortions get much harder?
Clearly abortion access is already difficult in the US, and reproductive freedom and health equity are far from a reality, with all the barriers already put in place especially for women of low income. All the attempts to further limit access could further unravel abortion access in a way that we haven’t seen in 50 years.
A Turnaway Study at UCSF looked at the effects on unwanted pregnancies on women’s lives over a period of time – found that denying an women an abortion, created economic hardship and insecurity that lasts for years according to Hicks. These women are more likely to stay in contact with a violent partner, more likely to raise the resulting child alone, and the financial wellbeing and development of children is negatively impacted when their mothers are denied abortion. Giving birth is connected to more serious health outcomes for the mother as well and it affects their opportunities, their health and the trajectory of their futures.
So what now?
If Roe were to be overturned this summer, it does not necessarily mean that abortion will be illegal in every state. That will be up to every state to decide what the restrictions are. It also means that states are free to decide whether they would like to make sure that abortion remains legal in their state.
Hicks says “You measure a culture of people by how they treat women or how they treat marginalized communities. We’re already seeing things like a state trying to collect a database of pregnant women, so they can use it to criminalize or harm. I worry that for an entire generation, our entire values and culture are going to be much different; that I’m leaving something to my daughter much different than what I grew up with.”
As abortion access erodes across the country, California will become a safe haven to those seeking abortion care across the country.
Anjana Nagarajan-Butaney is a producer at DesiCollective. She is interested in strengthening communities by exploring the intersection of politics, science & technology, gender equality, social justice and health.