One year since the Dobbs decision, the overturning of Roe v. Wade has had chilling effects on the state of healthcare in the United States. Currently, 14 states have enacted full abortion bans and an additional six have prohibited abortion at some point during pregnancy. Among these is Georgia, which outlawed the procedure after a mere six weeks, well before many child-bearing people know they are pregnant.
Legal chaos. Across these states and in others, vague regulations and legal wrangling in the courts have left doctors confused about what services they can and cannot provide under the law. While bans may allow abortions in life-threatening emergencies, what defines “life-threatening” is not clearly understood. Physicians are unsure if they can provide care during miscarriages and ectopic pregnancies. Exceptions to “heartbeat bills,” laws based on factually incorrect information about fetal development, are unclear.
For doctors in states where abortion is legal, the consequences for providing services to out-of-state patients may be grave. In a recent case in Indiana, an Obstetrician/Gynocologist (OB-GYN) was recently sanctioned by the medical board when she spoke openly and confidentially about having provided an abortion to a 10-year-old rape survivor from Ohio, a procedure allowed by the laws of the state.
Legal risks and fears of retaliation by the right have left many doctors worried about providing what could be lifesaving care. In the first national survey of OB-GYNs since the Dobbs decision, 61% of pregnancy specialists in states with abortion bans report they are concerned about legal ramifications when making decisions about a patient’s need for an abortion.
Their concerns are well founded. Physicians who violate abortion bans now face criminal charges. In Tennessee, providing an abortion is deemed a class-C felony, with a punishment of up to 15 years in prison. In Texas, doctors could receive a life sentence.
The long-term implications for access to reproductive healthcare are significant. According to a recent study, in states with abortion bans there was an over 10% drop in applicants for OB-GYN medical residencies in 2023 compared to the previous year.
Consequences for the health and the safety of patients are dire. Reports from around the country detail stories of child-bearing people who have not been able to access critical medical treatment. In Wisconsin, a woman bled at home for over 10 days after providers would not remove fetal tissue from an incomplete miscarriage. In another case, a patient with an ectopic pregnancy had to travel hundreds of miles out of state to gain lifesaving treatment after her doctor refused her an abortion for fear there was a fetal “heartbeat.”
Access to abortion pills, gender-affirming health care, and contraception are also on the line, with the Dobbs decision setting the stage for continued attacks on reproductive justice and bodily autonomy.
Who is most impacted? Marginalized communities continue to face the greatest cost to their health and lives. Research suggests that women of color are more likely to need lifesaving abortions, because of generally inferior medical and prenatal care. Black women in particular face significantly higher rates of maternal mortality. In a group of nationally surveyed OB-GYNS, 70% stated those discrepancies have only worsened since the Dobbs ruling.
People of color, poor and working-class people, and patients with disabilities may be less likely to be believed when they report pregnancy-related pain or complications. They may also have fewer resources to be able to travel out of state for a safe and legal abortion. Laws continue to make it harder for trans and non-binary people to obtain abortion services and basic healthcare. Survivors of sexual violence also face significant barriers. While some states allow exceptions to abortion bans in cases of rape or incest, they may require the pregnant person to make a report to law enforcement if they are to legally receive care. It also remains unclear if survivors, and their abortion providers, would need to participate in an investigation or engage with the police.
Fighting back. Amidst the sea of bans and restrictions, over 60% of people in the United States support the right to abortion. Organizers and activists continue to speak out against heinous injustices as the battle continues for each person’s right to control their own reproduction and body.
Radical Women and other grassroots groups and individuals are building the National Mobilization for Reproductive Justice, a collective effort to resist reactionary attacks on these rights. The Mobilization continues to fight for the most oppressed, organize within labor, and push for a wide-ranging list of intersectional demands. Its efforts are what is needed to build a mass movement and achieve reproductive justice for all.
To learn more about how to get involved and join the movement, visit reprojusticenow.org.
Send comments to the author at cstrauss90@gmail.com.
