Table of Contents
Overview
Definition and Scope
Abortion is defined as a medical procedure that terminates a pregnancy, serving as a critical aspect of healthcare for millions of women, girls, and individuals capable of becoming pregnant. It is estimated that one in four pregnancies ends in an abortion annually, highlighting its prevalence and necessity in reproductive health care.[2.1] The scope of abortion encompasses various methods, including medical and surgical procedures, each with specific indications and effectiveness. Medical abortion, often referred to as medication abortion, involves the administration of prescription pills to end a pregnancy, particularly effective in the early stages, typically up to 12 weeks gestation. The most common regimen includes two medications: mifepristone and misoprostol.[13.1] In contrast, surgical abortions are performed by trained medical professionals in clinical settings and include methods such as suction abortion (vacuum aspiration) and dilation and evacuation (D&E).[13.1] The safety of abortion procedures is notable, with complication rates being extremely low; only about 2% of women experience complications, most of which are minor and manageable.[14.1] This statistic underscores that abortion is generally safer than many common medical procedures, reinforcing its role as a vital healthcare service.[14.1] Overall, the definition and scope of abortion reflect its significance in reproductive health, the variety of methods available, and the emphasis on safety and accessibility.Key Terms and Concepts
Roe v. Wade, decided in 1973, is a pivotal case in the legal landscape of abortion rights in the United States. The Supreme Court ruled that the Constitution protects a woman's right to have an abortion prior to fetal viability, thereby invalidating many state laws that restricted access to abortion services. This decision not only enshrined the freedom of choice within constitutional principles but also ignited a prolonged debate regarding the legality of abortion, the extent of governmental interests in regulating it, and the influence of moral and religious perspectives in the political arena.[6.1] In 1992, the Supreme Court reaffirmed the core holding of Roe v. Wade in Planned Parenthood v. Casey, which introduced the "undue burden" standard. This standard prohibits states from imposing substantial obstacles in the path of a woman seeking an abortion before fetal viability, thereby reinforcing the legal framework established by Roe.[8.1] The implications of these rulings continue to resonate in contemporary legislative discussions surrounding abortion rights, particularly in light of recent challenges to these precedents. Access to abortion services is significantly influenced by various social determinants of health, particularly in marginalized communities. Factors such as socioeconomic status, language barriers, and access to technology can create disparities in abortion access among different racial and ethnic groups. For instance, studies indicate that low-income women often face financial barriers that delay their access to abortion services, while racial minorities may encounter additional obstacles due to systemic inequities in healthcare access.[20.1] The recent Supreme Court decision in Dobbs v. Jackson Women's Health Organization, which overturned Roe v. Wade, has further complicated the landscape of reproductive health in the United States. This ruling has prompted states to enact new restrictions on abortion, exacerbating existing disparities in access to reproductive health services and maternal health outcomes, particularly for women of color and those in low-income communities.[21.1] As such, the intersection of legal rulings and social determinants continues to shape the ongoing discourse surrounding abortion rights and access in the United States.History
Early Attitudes Toward Abortion
Abortion has been a part of human history for centuries, with early attitudes toward the practice varying significantly across cultures and time periods. In many societies, abortion was historically accepted as a means of contraception or population control, reflecting a more liberal stance on reproductive choices before the influence of religious and moral values began to shape public opinion against it.[53.1] During the colonial period in America, social and legal rules governing abortion were relatively permissive, with the practice being legal until "quickening," the point at which fetal movement could be felt.[55.1] This perspective was consistent with broader historical practices where abortion was viewed as a common reality rather than a controversial issue. However, starting around the time of the Civil War, a coalition of male doctors, supported by the Catholic Church and other groups, began advocating for stricter laws to outlaw abortion entirely, marking a significant shift in societal attitudes.[48.1] By the late 19th century, the medical community, particularly the American Medical Association (AMA), began to assert control over reproductive health care, scrutinizing the practices of midwives and nurses, which contributed to the stigmatization of abortion.[57.1] This shift in authority and the increasing influence of moral and religious perspectives led to a decline in the acceptance of abortion, transforming it into a contentious issue by the early 20th century. Despite these changes, public attitudes toward abortion began to liberalize again in the mid-20th century, as evidenced by the gradual emergence of national surveys on the topic starting in 1965, which indicated a trend toward more permissive views.[54.1] This evolution of attitudes reflects the complex interplay between medical practices, societal norms, and legal frameworks that have shaped the discourse surrounding abortion throughout history.Legislative Changes Over Time
The history of abortion legislation in the United States reflects a complex interplay of social, legal, and political factors. The first restrictive law on abortion was enacted in Connecticut in 1821, making it illegal for a pregnant woman to receive or take any type of "poison" intended for miscarriage.[49.1] By 1910, abortion had become illegal in all states, with exceptions only to save the life of the patient, a decision that was predominantly made by male doctors.[51.1] This period marked a significant restriction on women's reproductive rights, as the legal framework surrounding abortion was largely shaped by male-dominated medical and legal institutions. The landscape began to shift in the mid-20th century. In 1959, the American Law Institute proposed a model penal code advocating for the legalization of abortion under certain circumstances, including threats to the mental or physical health of the mother and pregnancies resulting from rape.[50.1] This proposal laid the groundwork for future legal challenges and reforms. A landmark moment occurred in 1973 with the Supreme Court's decision in Roe v. Wade, which established that the Constitution protects the right to an abortion as a fundamental right.[52.1] This ruling was pivotal, as it asserted that states could not impose undue restrictions on a woman's right to choose before fetal viability, which was defined as approximately 24 weeks of pregnancy.[60.1] However, the ruling also sparked ongoing debates and legislative efforts aimed at either codifying or restricting abortion rights at the state level.[61.1] In subsequent years, the Supreme Court further refined the legal standards surrounding abortion. In Planned Parenthood v. Casey (1992), the Court introduced the "undue burden" standard, which prohibited states from placing substantial obstacles in the path of a woman seeking an abortion before viability.[60.1] This decision allowed for some state regulations but maintained a baseline of protection for reproductive rights. The legal landscape shifted dramatically again in 2022 with the Supreme Court's ruling in Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade. The Court held that the right to privacy implied in the 14th Amendment did not extend to abortion, thereby allowing states to regulate abortion without the constraints previously imposed by federal law.[59.1] This decision has led to a patchwork of state laws, with some states enacting trigger laws that immediately restricted abortion access following the ruling.[70.1] As a result, the accessibility of abortion services now varies significantly across the United States, with some states imposing stringent restrictions while others seek to protect and expand access.[67.1] The implications of these legislative changes are profound, as they not only affect individual reproductive choices but also have broader consequences for public health and socio-economic stability.[68.1]Recent Advancements
Current Legal Landscape
The legal landscape surrounding abortion in the United States has experienced significant changes following the Supreme Court's decision in Dobbs v. Jackson Women's Health Organization, which overturned nearly 50 years of precedent established by Roe v. Wade. This ruling, issued on June 24, 2022, has led to a dramatic shift in abortion access, with 21 states enacting bans or severe restrictions by mid-2023.[116.1] As of January 2023, abortion was banned in 14 states, reflecting a broader trend of states exercising their newfound authority to regulate reproductive health following the removal of federal protections.[118.1] In response to these restrictions, states with more permissive abortion laws, such as Illinois, have seen a surge in demand for services. For instance, the number of abortions performed in Illinois rose an estimated 69 percent in 2023 compared to the same period in 2020, increasing from approximately 26,000 to about 45,000 procedures.[93.1] This increase highlights the growing difficulty in accessing abortion in many areas due to new laws, prompting individuals to seek services in states with fewer restrictions.[119.1] In 2022, 15 states enacted laws related to abortion, with nine states implementing restrictions and six states expanding access.[117.1] As legislative sessions began in 2023, a new wave of proposed legislation emerged, potentially complicating the situation for reproductive rights advocates.[117.1] These legal changes have profound implications, as policies restricting access to legal abortion care pose serious risks to the physical health of pregnant individuals. These risks include delays in receiving essential obstetric and gynecological care, the inability to seek legal abortion services within one's own state, unintended pregnancies, and challenges in accessing desired abortion services.[120.1] Ultimately, limiting access to legal abortion is likely to increase adverse birth outcomes, including maternal and infant mortality, contribute to financial instability for families, and hinder women's educational and economic achievements.[120.1] Additionally, the emergence of online-only clinics has introduced a new dimension to abortion access. By the first half of 2023, these clinics accounted for 8% of all abortions provided within the formal healthcare system, offering medication abortion via telemedicine as a safe and effective alternative to in-person services.[95.1] This development reflects an adaptation to the changing legal environment and the ongoing need for accessible reproductive healthcare options.Impact of Recent Legislation
Recent state-level regulations regarding abortion have significantly impacted reproductive healthcare services across the United States. The Supreme Court's decision in Dobbs v. Jackson Women's Health Organization, which overturned Roe v. Wade, prompted many states to enact restrictive laws, profoundly affecting women's access to abortion. Indiana and West Virginia, for example, implemented complete bans, while states like Georgia introduced six-week bans, limiting access shortly after a missed period.[97.1] These restrictions have led to fewer maternity care resources, increased maternity care deserts, and poorer Medicaid coverage benefits, resulting in higher maternal mortality rates in states with stringent abortion laws compared to those with protective policies.[96.1] Additionally, limited access to legal abortion care poses serious health risks, including delays in necessary obstetric and gynecological care, increased unintended pregnancies, and adverse birth outcomes.[99.1] In contrast, some states have enacted measures to protect abortion access in response to the changing legal landscape. Interstate shield laws have been established to protect abortion providers and helpers in states where abortion remains legal from civil and criminal repercussions when providing care to out-of-state residents.[98.1] This legal framework aims to mitigate the impact of restrictive laws in other states and ensure continued access to necessary reproductive healthcare services.In this section:
Social And Ethical Considerations
Public Opinion and Cultural Perspectives
Public opinion regarding abortion is significantly shaped by a variety of socio-cultural factors, including political ideology, education, and community attitudes. The influence of political ideology on abortion laws is evident in many countries, where conservative and religious beliefs often lead to stricter regulations surrounding abortion access. This ideological framework varies globally, influenced by factors such as religious dominance and cultural attitudes, which in turn shape public perceptions of reproductive rights.[137.1] Cultural context plays a crucial role in shaping individual attitudes toward abortion. Research indicates that both contextual factors, such as local abortion legislation and gender inequality, and individual factors, including gender role attitudes and religious beliefs, significantly influence how people perceive abortion.[138.1] Furthermore, education has been shown to affect cultural traits like trust and respect, which can also impact attitudes toward abortion. Higher educational attainment is associated with more progressive views on reproductive rights, suggesting that educational initiatives could be pivotal in shaping public opinion.[151.1] Abortion stigma, which arises from cultural norms and community attitudes, can negatively affect individuals seeking abortion care, thereby limiting reproductive autonomy. This stigma is often reinforced by prevailing religious and gender norms within communities.[153.1] Studies have highlighted that understanding the origins and characteristics of abortion stigma is essential for addressing decision-making difficulties faced by individuals considering abortion.[154.1] Public education campaigns play a vital role in shaping public attitudes, behaviors, and opinions regarding various social issues, including abortion. These initiatives are essential for raising awareness, educating the public, and inspiring action, which collectively contribute to a positive impact on individuals and society as a whole.[155.1] Understanding the intricate relationships between race, religiosity, and abortion attitudes is crucial for improving abortion training and support. A better understanding of these factors will allow for enhancements in abortion training while paving the way to support a more informed practice in diverse communities.[152.1] Historical events and social movements have also played a significant role in shaping contemporary attitudes toward abortion. For instance, the political and professional movements advocating for legal reform began gaining traction well before public opinion was systematically studied, indicating a gradual liberalization of attitudes over time.[159.1] Additionally, the evolution of abortion attitudes has often mirrored broader political and historical shifts, reflecting changes in power dynamics and societal values.[158.1] In the United States, the recent surge of anti-abortion policies has been linked to underlying ideological shifts among constituents, demonstrating how public sentiment can influence legislative changes.[157.1]Ethical Debates Surrounding Abortion
The ethical debates surrounding abortion are complex and multifaceted, reflecting a range of social and moral considerations. A significant aspect of this discourse is the varying perceptions of the morality of abortion among the American public. Research indicates that only 7% of U.S. adults view abortion as morally acceptable in all circumstances, while 13% consider it morally wrong in all cases. Additionally, a third of respondents believe abortion is morally wrong in most situations, and approximately 24% find it morally acceptable most of the time.[129.1] This diversity in opinion underscores the nuanced nature of ethical considerations regarding abortion. Globally, abortion is one of the most common gynecological procedures; however, the social, political, and ethical implications of terminating a pregnancy differ significantly across cultures and historical contexts.[130.1] The World Health Organization (WHO) emphasizes that access to safe and legal abortion is a fundamental component of healthcare, which is crucial for reducing the risks associated with unsafe abortions.[132.1] This perspective highlights the ethical obligation to ensure that women have access to safe medical procedures, thereby framing abortion not only as a personal choice but also as a public health issue. The debate often centers around the question of fetal personhood, with differing viewpoints on whether a fetus possesses the right to life. Proponents of the view that fetuses are not persons argue that abortion is morally permissible throughout pregnancy, while others contend that the potential for personhood grants the fetus moral status and the right to life.[133.1] This fundamental disagreement shapes the ethical landscape of the abortion debate. Moreover, socioeconomic factors play a critical role in the decision to seek an abortion. Women's economic security is closely tied to their reproductive choices, influencing their educational and employment opportunities.[135.1] As access to abortion services becomes increasingly restricted, the disparities in economic outcomes for women may widen, further complicating the ethical considerations surrounding abortion access.Health Implications
Physical and Mental Health Effects
Access to safe abortion services is crucial for women's health, as it is associated with improved physical health, financial security, and the ability to care for existing and future children. Research indicates that women who have access to safe abortions report better overall health outcomes compared to those who are denied the procedure. For instance, women in the Turnaway Study who were denied an abortion experienced higher levels of anxiety, stress, and lower life satisfaction than those who received the procedure, highlighting the significant mental health implications of restricted access to abortion services.[177.1] While the physical health risks associated with safe abortion practices are low, unsafe abortions pose severe threats, including complications that can lead to infertility, severe disability, and even death. It is estimated that over 9 million women will face complications from unsafe abortions each year, underscoring the urgent need for safe and legal abortion access.[203.1] The World Health Organization emphasizes that barriers to safe abortion access must be removed to prevent the dire consequences of unsafe procedures.[205.1] Mental health outcomes following abortion can vary significantly. Although data suggest that abortions are not generally linked to poor mental health outcomes, stigma and societal attitudes can exacerbate feelings of grief, sadness, and anxiety in some women. The American Psychological Association's Task Force on Mental Health and Abortion found that a small percentage of women may experience clinically significant disorders, including post-traumatic stress disorder (PTSD), following an abortion.[181.1] Furthermore, societal disapproval and judgment can create barriers to accessing care and contribute to feelings of ostracism, which may hinder emotional recovery.[179.1]Access to Reproductive Health Care
Restricting access to safe and legal abortion services has profound implications for women's health and societal well-being. The limitations on abortion access can lead to an increase in unsafe procedures, which pose severe health risks and are a significant cause of mortality and complications among vulnerable women in the United States.[182.1] Research has established a clear link between state-level abortion restrictions and adverse maternal health outcomes, with restrictive states often having fewer maternity care resources and higher maternal mortality rates compared to those with more protective policies.[184.1] Beyond immediate health risks, the denial of abortion access has broader social and economic consequences. Individuals denied abortions who subsequently give birth often report worse health outcomes and increased chronic pain compared to those who can terminate their pregnancies.[186.1] Furthermore, children born from unwanted pregnancies may face challenges such as poorer maternal bonding and economic insecurity, exacerbating public health issues.[186.1] The multifaceted implications of restricted abortion access include significant health risks due to delays in receiving necessary obstetric and gynecological care and the inability to seek legal abortion services within one's state.[187.1] These restrictions contribute to adverse birth outcomes, including increased maternal and infant mortality, and can lead to economic instability for families, hindering women's educational and economic progress.[187.1] Following the U.S. Supreme Court's decision to overturn Roe v. Wade, many states have enacted laws further limiting abortion access, positioning the U.S. as an outlier globally, where most women live in countries with more permissive abortion laws.[185.1] This situation underscores the urgent need for federal protections, such as those proposed in the Women's Health Protection Act, to safeguard access to abortion care and mitigate the negative health impacts on women in restrictive environments.[189.1]Economic Factors
Economic Impact on Women and Families
Access to abortion has significant economic implications for women and families, particularly in low- and middle-income countries (LMICs) where economic factors can exacerbate delays in decision-making regarding abortion. Research indicates that economic constraints can hinder women's ability to seek timely care, thereby affecting their overall reproductive health outcomes.[207.1] In a study conducted in Maputo and Quelimane, four key factors were identified that negatively impacted young women's decision-making processes regarding abortion: lack of autonomy, insufficient knowledge about available services, poor accessibility of local abortion services, and the overpowering influence of healthcare providers.[208.1] These factors highlight the intersection of economic status and reproductive rights, where financial limitations can restrict access to necessary information and services. The broader economic impact of abortion access is also evident in workforce participation and educational attainment. Legalization of abortion in the 1970s in the United States led to an increase in women's workforce participation, with studies showing that the probability of women working 40 weeks or more per year rose by nearly 2 percentage points following legalization.[217.1] This trend was particularly pronounced among Black women, whose workforce participation increased by 6.9 percentage points.[212.1] Furthermore, access to abortion has been linked to improved educational outcomes, with Black women experiencing increases in high school graduation and college attendance rates in states where abortion was accessible.[214.1] The economic ramifications extend beyond immediate employment outcomes. Women who are denied abortions are more likely to experience poverty, rely on public assistance, and face challenges in achieving financial stability.[218.1] Conversely, access to abortion has been shown to enhance women's economic freedom, allowing them to delay motherhood and pursue career opportunities, which can lead to increased wages and reduced financial burdens.[211.1] Overall, the relationship between abortion access and women's economic empowerment underscores the critical role that reproductive rights play in shaping the economic landscape for women and families.Case Studies
Abortion in Kentucky
The study of abortion attitudes in Kentucky reveals significant complexities in how individuals perceive changes in their beliefs over time. Utilizing qualitative approaches, researchers have generated insights into the emerging aspects of attitudinal change and stability regarding abortion. This qualitative data is crucial as it provides a deeper understanding of the factors influencing public perception, particularly in regions with restrictive abortion laws like Kentucky.[266.1] Furthermore, quantitative methods have been employed to identify characteristics that predict individuals' perceptions of change in their abortion attitudes, highlighting the dynamic nature of these beliefs and their potential implications for legislative approaches.[266.1] This combination of qualitative and quantitative research contributes to a more nuanced understanding of abortion attitudes, which is essential for informing public discourse and policy-making in the state.National Trends and Comparisons
National trends in abortion access and legislation have been significantly influenced by socio-cultural factors, legal decisions, and public health outcomes. Over the past three decades, there has been a notable evolution in the understanding of sexual and reproductive rights, particularly concerning abortion, which remains a highly controversial and stigmatized topic in public discourse.[247.1] Women's experiences of abortion are deeply intertwined with socio-cultural narratives surrounding gender and maternity, which can shape their perceptions and experiences of stigma associated with abortion.[248.1] The U.S. Supreme Court's decision in June 2022, in Dobbs v. Jackson Women's Health Organization, marked a pivotal moment in the legal landscape of abortion rights, effectively eliminating the federal constitutional right to abortion that had been established nearly fifty years prior by Roe v. Wade.[261.1] This ruling has empowered individual states to regulate abortion care, leading to widespread bans and severe restrictions in 21 states within a year of the decision.[260.1] The implications of this legal shift have been profound, as it has not only limited access to abortion services but has also exacerbated existing disparities in maternal and child health outcomes, particularly among low-income individuals and communities of color.[265.1] Research indicates that the growing restrictive abortion policies nationwide, particularly following the Supreme Court decision on Dobbs v. Jackson Women's Health Organization, have created significant barriers to abortion access in the United States. These restrictions disproportionately affect low-income individuals, people of color, immigrants, and non-English speakers, potentially exacerbating existing racial inequities in maternal and child health outcomes.[263.1] New research shows that these abortion bans have led to an increase in unwanted or unsafe pregnancies carried to term, resulting in higher rates of live births and infant deaths, particularly among populations facing the greatest structural disadvantages.[265.1] Furthermore, states with abortion bans experience adverse outcomes such as limited maternity care providers, maternity care deserts, and elevated rates of maternal mortality and infant death, especially among people of color.[264.1] The implications of these findings underscore the urgent need for comprehensive abortion education and training as strategies to address these disparities and improve reproductive health care access.[264.1] The legal landscape surrounding abortion in the United States has been significantly altered by the US Supreme Court's ruling in Dobbs v. Jackson Women's Health Organization in June 2022, which ended the federal constitutional right to abortion. This ruling eliminated a fundamental right that had been recognized for nearly fifty years, leaving the regulation of abortion to individual states, with 20 states enforcing more limited abortion laws one year after the decision.[261.1] The personal narratives of women facing unplanned pregnancies provide critical insights into the complex emotions and choices involved in seeking an abortion, effectively humanizing the often abstract debates surrounding reproductive rights.[251.1] These narratives illustrate the social norms and stigma that may contribute to or cause low perceptions of community attitudes towards abortion, as well as fears and expectations regarding the service.[252.1] By examining these real-life stories, policymakers can better understand the societal attitudes towards reproductive rights, which is essential for developing informed policies that address the complexities surrounding abortion.[252.1]Future Directions
Potential Legislative Changes
In the context of potential legislative changes regarding abortion access, healthcare professionals play a crucial role in advocating for policies that ensure safe and legal abortion services. Advocacy efforts are essential as they transcend various medical specialties and communities, emphasizing the collective strength of healthcare providers in promoting access to these services.[310.1] One significant area of focus for advocacy is the opposition to legislation that imposes undue regulations on abortion care providers. The American College of Obstetricians and Gynecologists (ACOG) actively opposes measures that require healthcare providers to deliver inaccurate or biased information, mandate unnecessary procedures, or impose excessive regulations on facilities providing abortion care.[312.1] In light of recent developments, particularly following the U.S. Supreme Court's decision to overturn Roe v. Wade in June 2022, the landscape of abortion access has changed dramatically. Many states have enacted bans or restrictions, underscoring the urgent need for legislative measures that protect and expand abortion rights.[314.1] For instance, proposals such as authorizing physician assistants to perform abortions and establishing "abortion shield laws" to protect medical providers and patients from out-of-state subpoenas are currently being monitored and advocated for by organizations like the American Society for Reproductive Medicine (ASRM).[313.1] Healthcare professionals are not only tasked with providing care but also with advocating for legislative changes that dismantle barriers to accessing safe abortion services. This includes addressing the various obstacles that individuals face when seeking care and pushing for reforms that enhance access to reproductive health services.[311.1] As the political landscape continues to evolve, the role of healthcare providers as advocates remains critical in shaping the future of abortion access in the United States.Emerging Trends in Abortion Access and Rights
Twelve states currently enforce abortion bans in almost all circumstances, primarily through trigger laws that were enacted while abortion was still protected but became effective after the Supreme Court's decision to overturn Roe v. Wade. For instance, Georgia has implemented a ban on abortions after approximately six weeks, although the constitutionality of this law is under challenge and is expected to be reviewed by the state's highest court soon. In Alabama, where abortion is banned but patients cannot be prosecuted, the attorney general has indicated intentions to utilize the state's chemical endangerment law against individuals who take abortion medication.[284.1] In response to these restrictive laws, telehealth abortions are on the rise, particularly in states with bans or limitations. This method allows medications to be dispensed via mail following a remote consultation with a clinician. The combination of shield laws and the ability to travel out of state has enabled residents in some areas to access abortions at rates comparable to, or even exceeding, those prior to the Dobbs decision. For example, in the latter half of 2023, West Virginia saw nearly double the number of abortions among its residents, with over 1,000 performed out of state and more than 200 accessed through shield laws.[285.1] As legislative efforts intensify to restrict access to abortion and other reproductive health services, organizations such as the American Society for Reproductive Medicine (ASRM) are closely monitoring various policy measures. These include proposals that would allow physician assistants to perform abortions and the introduction of "abortion shield laws" designed to protect medical providers and patients from out-of-state subpoenas related to reproductive health care.[286.1] However, the legal landscape remains uncertain, particularly for clinicians relying on shield laws to provide telehealth abortion services in states with restrictive laws, as ongoing legal challenges may test the effectiveness of these protections.[287.1] The legal battles surrounding telemedicine, particularly in states like Texas and Louisiana, represent a critical juncture in the fight for healthcare access. The outcomes of these lawsuits could significantly impact the availability of telemedicine services across state lines, potentially limiting access to broader telehealth options if courts favor restrictive state laws. While shield laws aim to protect clinician autonomy, they still face significant legal hurdles.[288.1] Telehealth is increasingly seen as a vital tool for expanding access to abortion care, especially in restrictive environments. It also holds promise for enhancing OB-GYN services, including prenatal and postpartum care, for individuals in areas lacking adequate maternity care. Despite its proven safety and effectiveness, some states continue to impose substantial barriers to telehealth access.[289.1] In particular, states with telemedicine abortion shield laws, like New York, are working to protect physicians who assist women in abortion-restrictive states, although challenges remain regarding jurisdictional authority over medical care.[290.1] Access to telehealth abortion services, along with self-managed abortion options and care in protective states, has been vital for managing demand in states like Colorado.[291.1] Shield laws have played a crucial role in protecting clinicians who provide remote or in-person care to individuals seeking abortions in states with bans.[291.1] As of September 2023, direct-to-patient telehealth abortion is legal in only 24 states and Washington, D.C., although many states permit abortion care while prohibiting telehealth services.[295.1] Despite these limitations, direct-to-patient telehealth abortion may significantly mitigate existing geospatial inequities in abortion access.[295.1] Furthermore, the variation in restrictive abortion policies has been associated with racial, ethnic, and educational inequities, which can lead to adverse birth outcomes in the United States.[292.1]References
[2] Abortion Rights - Amnesty International — An abortion is a medical procedure that ends a pregnancy.It is basic healthcare needed by millions of women, girls and people who can get pregnant. It's estimated that one in four pregnancies ends in an abortion every year. In places where abortion is legal and accessible and where there is less stigma, people can get abortions safely and with no risk.
[6] Roe v. Wade: The Debate Over Abortion Rights and Its Legacy — The 1973 Supreme Court decision in Roe v.Wade was a landmark ruling that dramatically altered the landscape of reproductive rights in the United States. By declaring that a woman's right to choose an abortion fell within the constitutional right to privacy, the Court's decision ignited legal, political, and social debates that have endured for decades.
[8] Abortion & Reproductive Rights Supreme Court Cases — Wade, freedom of choice was enshrined in constitutional principles. In Planned Parenthood v. Casey, the Supreme Court developed the "undue burden" standard for reviewing abortion restrictions. It provided that a state could not place substantial obstacles in the path of a woman seeking an abortion before a fetus reaches viability.
[13] Types of Abortion: By Trimester, What to Expect, and Resources - Healthline — According to reproductive health research, more than half of all abortions in the United States are medical abortions. Medical abortion involves taking pills that terminate a pregnancy. Learn more about medical abortion here. Medical abortion is an extremely effective way to end a pregnancy, especially when used at or before 12 weeks gestation. A surgical abortion is a procedure done by a trained medical professional in a clinical setting like an abortion clinic or, sometimes, a hospital. If you think you’re experiencing complications and live in an abortion-hostile state, you should still seek medical care. The types of abortion are medical and surgical. Abortion. Medication abortion. https://www.guttmacher.org/state-policy/explore/medication-abortion
[14] Abortion Access Fact Sheet - ACOG — Complication rates from abortion are extremely low. Only about 2% of women who undergo abortion experience a complication associated with the abortion, and most complications are minor and easily treatable with follow-up procedures or antibiotics. Abortion is safer than many common medical procedures. The risk of complication or mortality from
[20] Racial and Ethnic Disparities in Reproductive Health Services and ... — Despite significant strides in women's reproductive health, disparities in access and outcomes remain, especially for racial–ethnic minorities in the United States.1–4 Reports document decades-long racial–ethnic disparities in several areas of reproductive health, including contraceptive use, sexually transmitted infection care and human papillomavirus vaccination among younger women aged 18–25 years,5 reproductive cancers,6 preterm deliveries and low-birth-weight neonates, and maternal morbidity and mortality.7 Data suggest that the disproportionate risk for women of color for reproductive health access and outcomes expand beyond individual-level risks and include social and structural factors, such as fewer neighborhood health services, less insurance coverage, decreased access to educational and economic attainment, and even practitioner-level factors such as racial bias and stereotyping.1,4,8 The Center for Reproductive Rights describes this racial–ethnic gap as a human rights issue and suggests that, “several U.S. policies may exacerbate these disparities by disproportionately burdening access to health care for women of color.”4 Solutions that lead to increased access for women must remove these social and structural barriers so that women, especially underserved racial and ethnic minority women, may access and utilize reproductive health services as needed without clinician bias or other obstacles.9
[21] Economic Effects of Banning Abortion | Commonwealth Fund — In June, the Supreme Court in Dobbs v.Jackson Women's Health Organization overturned Roe v.Wade, changing America's health care landscape.This triggered new and existing legislation in states seeking to restrict abortion, which will deepen already-existing inequities among states in terms of access to abortion, maternal health, and reproductive health services.
[48] Abortion in U.S. History - Planned Parenthood Action — The Rise of Laws Banning Abortion in the U.S. Starting around the time of the Civil War, a coalition of male doctors — with the support of the Catholic Church and others who wanted to control women’s bodies — led a movement to push state governments to outlaw abortion across the board. Planned Parenthood is fighting for abortion access for all people. In the meantime, we’ll keep sharing ways to give, take action, and get involved to support Planned Parenthood Action Fund and protect reproductive health and rights. The Planned Parenthood Action Fund works to advance access to sexual health care and defend reproductive rights. © 2024 Planned Parenthood Action Fund, Inc. This website uses cookies
[49] History of Abortion in the U.S. Timeline | Eastside Gynecology — It's a topic that has often been met with resistance. Here's a history of abortion timeline of laws, beginning in 1821 Connecticut. 1821 - Connecticut: The first restrictive law on abortion was passed, making it illegal for a pregnant woman to receive or take any type of "poison" intended for miscarriage. Contributing to this was the
[50] A timeline of abortion law in the United States — U.S. abortion law timeline. 1910. Abortion is illegal in all states, with some exceptions to save the life of the patient. 1959. The American Law Institute proposes a model penal code for state abortion laws. The code advocates legalizing abortion for reasons including the mental or physical health of the mother, pregnancy due to rape and
[51] Historical Abortion Law Timeline: 1850 to Today - Planned Parenthood Action — By 1910, abortion was not only restricted but outright illegal at every stage in pregnancy in every state in the country.These abortion bans had some exceptions in instances to save the patient's life — a decision that only doctors, 95% of whom were men, had the power to make. By this time, America had experienced several decades of increased immigration.
[52] Abortion in America: a visual timeline - The 19th — (Click to expand the photos for caption information.) 1973. In a 7-2 decision, the all-male Supreme Court ruled that the Constitution protects the right to an abortion.Justices find abortion is a "fundamental" right to a person's "life and future," and that Texas violated the rights of "Jane Roe" when an abortion ban prevented her from obtaining one.
[53] The Shift In Public Perception: How Society's Views On Abortion Evolved — Societal attitudes towards abortion have undergone significant changes over time. In many cultures, abortion was historically practiced and accepted as a means of contraception or population control. However, as societies became more influenced by religious and moral values, attitudes towards abortion began to shift.
[54] Abortion in Context: Historical Trends and Future Changes — tions began to study public attitudes to-ward abortion. Attitudes had probably been slowly becoming more liberal long before the first national survey on the topic was conducted in 1965. To chart an overview of trends in public attitudes toward abortion in the United States, we rely primarily upon data from the General Social Survey (GSS), con-
[55] A Brief History of Abortion in the U.S. | Hopkins Bloomberg Public ... — Yet for the first century of the country's existence—and most of human history before that—abortion was a relatively uncontroversial fact of life. ... the U.S. attitude toward abortion was much the same as it had often been elsewhere throughout history: It was a quiet reality, legal until "quickening" (when fetal motion could be felt
[57] Historical Abortion Law Timeline: 1850 to Today - Planned Parenthood Action — It became the male-dominated authority on medical practices. The AMA scrutinized reproductive health care workers, like midwives and nurses, and the obstetric services they provided were phased out. ... This history of abortion laws and court decisions provides important context to the road ahead. Right now, 80% of Americans want abortion to be
[59] Roe v. Wade and Supreme Court Abortion Cases — In Dobbs v. Jackson Women’s Health Organization (2022), the Supreme Court overturned Roe v. Wade (1973), which guaranteed a constitutional right to abortion. In Roe v. Wade, the Supreme Court decided that the right to privacy implied in the 14th Amendment protected abortion as a fundamental right. Writing for the majority in Dobbs, Justice Samuel Alito said that the only legitimate unenumerated rights — that is, rights not explicitly stated in the Constitution — are those “deeply rooted in the Nation’s history and tradition” and “implicit in the concept of ordered liberty.” Abortion, the majority held, is not such a right. Following Dobbs, reproductive rights are being decided state by state. Predictably so: Dobbs is arguably the first case to formally rescind a fundamental constitutional right.
[60] Abortion & Reproductive Rights Supreme Court Cases — Casey, the Supreme Court developed the "undue burden" standard for reviewing abortion restrictions. It provided that a state could not place substantial obstacles in the path of a woman seeking an abortion before a fetus reaches viability. This is when a child can survive outside the womb, which often occurs at about 24 weeks of pregnancy.
[61] Roe v. Wade and the Abortion Rights Battle: 50 Years of Debate — 4. How has Roe v. Wade influenced subsequent legislation and court rulings? Roe v. Wade has had a profound impact on subsequent legislation and judicial rulings both within and beyond abortion law. After the decision, numerous states sought to either codify the protections of Roe or create restrictions within the bounds allowed by the ruling.
[67] Reproductive Rights: U.S. Supreme Court Cases - FindLaw — Reproductive rights in America can vary significantly from one state to the next. Each jurisdiction has its own laws relating to abortion rights, contraception, and family planning. Federal courts and district courts have served as venues for contesting these issues for decades. The final decision-maker on these laws is the U.S. Supreme Court.
[68] Abortion Policy in the United States: The New Legal Landscape and Its ... — Policies restricting access to legal abortion care will bring with them significant harm to the physical health of pregnant people through four specific types of serious health risks, including risks associated with 1) restrictions and delays regarding essential evidence‐based obstetric, gynecological, and maternal/fetal health care; 2) the inability to seek legal abortion care within one's own state; 3) the experience of unintended pregnancy and childbirth; and 4) the inability to access abortion services when desired. Limiting access to legal abortion in the United States will increase the incidence of serious adverse birth outcomes (including maternal and infant mortality), the number of children born into and living in poverty, and the number of families experiencing serious financial instability and hardship and will thwart the educational and economic achievements of women.
[70] State Abortion Laws: Protections and Restrictions — State trigger laws, which could not take effect until Roe was overturned, may now be enforced. In addition, several states passed laws in the months following the decision. The table below lists state statutes on common abortion policies. Please note that the list covers common policy trends; it is not an exhaustive list of abortion laws.
[93] Abortions Rose in Most States This Year, New Data Shows - The New York ... — In Illinois, for example, where abortion is legal, abortions rose an estimated 69 percent in 2023 compared with the same period in 2020, to about 45,000 from 26,000. Did you try to get an abortion
[95] Medication Abortion Accounted for 63% of All US Abortions in 2023—An ... — Online-only clinics, after first appearing as a new type of abortion provider in 2021, accounted for 8% of all abortions provided within the formal health care system in the first six months of 2023. Medication abortion provided via telemedicine is as safe and effective as provision in a health care facility. Offering options besides in-person
[96] Insights: The Impacts of Abortion Bans on Maternal Health — Reproductive Health Access Project | Insights: The Impacts of Abortion Bans on Maternal Health Home > Resources > Insights: The Impacts of Abortion Bans on Maternal Health Insights: The Impacts of Abortion Bans on Maternal Health Even prior to Dobbs, the association between state-level abortion restrictions and adverse maternal health outcomes has been well-established.1 In December 2022, the Commonwealth Fund reported that, compared to states with protective policies, those with restrictive policies have fewer maternity care resources, more maternity care deserts, poorer Medicaid coverage benefits, and higher rates of maternal mortality (15.9 vs. Provide patients with information about their health and pregnancy, how to use abortion pills, and trusted resources on where to obtain abortion care like INeedAnA.
[97] How major abortion laws compare, state by state - The Fuller Project — Indiana and West Virginia became the first states to pass new laws fully banning abortion. Other states — including Georgia, historically a hub of abortion access in the South — have enacted six-week bans, essentially allowing abortion only up to two weeks after a missed period.. On the flip side, some states reacted to Dobbs by enacting measures to protect abortion access.
[98] Abortion Laws: State-By-State Differences And Their Impact — Interstate shield laws have been enacted to protect abortion providers and helpers in states where abortion is legal from civil and criminal consequences when providing care to out-of-state residents. Interstate and telehealth shield laws protect abortion providers and helpers in states where abortion is legal from civil and criminal consequences when providing care to out-of-state residents. Interstate shield laws protect abortion providers and helpers in states where abortion is legal from civil and criminal consequences of providing care to out-of-state residents. Wade in 2022 means that states can now impose any regulation on abortion, provided it does not conflict with federal law. What are some states with abortion laws that protect access?
[99] Abortion Policy in the United States: The New Legal Landscape and Its ... — Policies restricting access to legal abortion care will bring with them significant harm to the physical health of pregnant people through four specific types of serious health risks, including risks associated with 1) restrictions and delays regarding essential evidence‐based obstetric, gynecological, and maternal/fetal health care; 2) the inability to seek legal abortion care within one's own state; 3) the experience of unintended pregnancy and childbirth; and 4) the inability to access abortion services when desired. Limiting access to legal abortion in the United States will increase the incidence of serious adverse birth outcomes (including maternal and infant mortality), the number of children born into and living in poverty, and the number of families experiencing serious financial instability and hardship and will thwart the educational and economic achievements of women.
[116] One Year After Dobbs—Vast Changes to the Abortion Legal Landscape — June 24, 2023, marked the 1-year anniversary of Dobbs v Jackson Women's Health Organization, when the US Supreme Court overturned nearly 50 years of precedent safeguarding the constitutional right to previability abortion, prompting 21 states to ban or severely restrict the procedure. 1 Meanwhile, the federal government and multiple states have acted to preserve legal abortion. Litigation
[117] More Changes to Abortion Laws on Tap for 2023 - FindLaw — In 2022, 15 states enacted laws relating to abortion, with nine states restricting access to some degree and six expanding it. Though legislative sessions have just begun in 2023, a new wave of proposed legislation is already on shore.
[118] Abortion Restrictions and the Threat to Women's Health — Apply Departments Biochemistry and Molecular Biology Biostatistics Environmental Health and Engineering Epidemiology Health Policy and Management Health, Behavior and Society International Health Mental Health Molecular Microbiology and Immunology Population, Family and Reproductive Health Faculty Topics Abortion Restrictions and the Threat to Women’s Health The abortion rights landscape a year after Roe v. Wade was overturned Published May 19, 2023 By Annalies Winny Drugs Family Planning Health Equity Reproductive and Sexual Health It’s been almost a year since the U.S. Supreme Court overturned Roe v. Wade, dismantling the constitutional right to abortion more than 50 years after the case was decided. At least a dozen states have banned abortion entirely, and more states are seeking to further restrict access to abortion—making the U.S. an outlier on the global stage: Some 59% of the world's female population currently reside in a country where abortion is broadly allowed. During the briefing, Bell, an assistant professor in Population, Family and Reproductive Health at the Bloomberg School, and Joanne Rosen, JD, MA, a senior lecturer in Health Policy and Management, discussed the state of abortion access in the U.S. and the impact on women’s health—and on physicians—since Roe was overturned. How states have responded With federal protections for abortion overturned, states were empowered to regulate reproductive health. In the 11 months since Dobbs was decided, abortion has been banned in 14 states.
[119] Here's what's likely to change for abortion access in year 2 ... - NPR — It's already harder to get an abortion in many places and access is likely to be limited more with the passage of new laws.
[120] Abortion Policy in the United States: The New Legal Landscape and Its ... — Policies restricting access to legal abortion care will bring with them significant harm to the physical health of pregnant people through four specific types of serious health risks, including risks associated with 1) restrictions and delays regarding essential evidence‐based obstetric, gynecological, and maternal/fetal health care; 2) the inability to seek legal abortion care within one's own state; 3) the experience of unintended pregnancy and childbirth; and 4) the inability to access abortion services when desired. Limiting access to legal abortion in the United States will increase the incidence of serious adverse birth outcomes (including maternal and infant mortality), the number of children born into and living in poverty, and the number of families experiencing serious financial instability and hardship and will thwart the educational and economic achievements of women.
[129] 2. Social and moral considerations on abortion - JSTOR — 2. Social and moral considerations on abortion Relatively few Americans view the morality of abortion in stark terms: Overall, just 7% of all U.S. adults say abortion is morally acceptable in all cases, and 13% say it is morally wrong in all cases. A third say that abortion is morally wrong in most cases, while about a quarter (24%) say it is morally acceptable most of the time.
[130] Abortion in legal, social, and healthcare contexts — Worldwide, abortion is one of the commonest gynaecological procedures (Sedgh et al., 2012). The common occurrence of abortion around the globe, however, belies considerable diversity in the social, political, and ethical meanings of terminating a pregnancy, as well as the practices surrounding abortion. All of these vary from locale to locale, from one historical time to another, and among
[132] Understanding Abortion: Ethical Perspectives, Legal Debates, and Women ... — Understanding Abortion: Ethical Perspectives, Legal Debates, and Women’s Rights HomeHealthUnderstanding Abortion: Ethical Perspectives, Legal Debates, and Women’s Rights Understanding Abortion: Ethical Perspectives, Legal Debates, and Women’s Rights The World Health Organization (WHO) considers access to safe and legal abortion to be an essential component of healthcare. Health and Safety: Legal abortion ensures access to safe and regulated medical procedures, reducing the risk of dangerous, illegal abortions. While the debate over abortion rights is likely to continue, it is essential to recognize that access to safe and legal abortion is a critical aspect of healthcare for many women. As medical technology advances and the global conversation around reproductive rights evolves, the future of abortion will be shaped by ongoing legal, political, and cultural shifts.
[133] Ethics and Abortion - Psychology Today — Both of the arguments I summarize here focus on the question of whether or not the fetus is a person, or whether or not it is the type of entity that has the right to life. Mary Ann Warren has argued that fetuses are not persons; they do not have the right to life.2 Therefore, abortion is morally permissible throughout the entire pregnancy. However, this argument contends that fetuses are persons because in an important sense they possess all of the traits Warren lists.3 Proponents of this argument claim that possessing the traits of personhood, in their latent form, is sufficient for being a person, for having full moral status, including the right to life.
[135] The Economic Effects of Abortion Access: A Review of the Evidence — Deciding whether and when to have a child is central to a woman's economic well-being. It has implications for continuing education and joining the workforce, which can affect other long-term economic outcomes. As threats to abortion access increase and widen existing disparities, it is crucial to examine the range of economic effects that can result from this changing landscape.
[137] Exploring The Socio-Cultural Factors That Influence Abortion Laws — Exploring The Socio-Cultural Factors That Influence Abortion Laws | MedShun Abortion laws are highly influenced by a multitude of socio-cultural factors that shape a society's perceptions and understanding of reproductive rights. What role does the influence of political ideology play in shaping abortion laws across different countries? What role does the influence of political ideology play in shaping abortion laws across different countries? Both countries have historically had strict laws regarding abortion due to the influence of conservative and religious ideologies. These examples illustrate how political ideology can shape and influence abortion laws across different countries. The degree of influence of political ideology on abortion laws varies from country to country, depending on factors such as religious dominance, cultural attitudes, and the strength of progressive or conservative political movements.
[138] Abortion attitudes across cultural contexts: Exploring the role of ... — Exploratory analyses highlight how these relationships vary as a function of cultural context. We can conclude that both contextual factors (e.g., local abortion legislation and gender inequality) as well as individual factors (e.g., gender role attitudes and religious/spiritual belief) shape people's attitudes toward abortion.
[151] Attitudes towards abortion: what role do educational attainment and ... — Additionally, education has been shown to affect cultural traits like trust and respect in societies. Building on this literature and employing an extensive individual-level cross country data from World Value Survey (WVS), we explore the role of educational attainment and cultural traits in shaping attitudes towards abortion.
[152] Racial diversity in abortion education and intention to provide ... — Conclusion: Racial differences in intention to provide abortion in postresidency practice are mediated by religiosity and abortion attitude. Better understanding the intricate relationships between race, religiosity, participation in training, and future practice will allow us to improve abortion training while paving the way to support a more
[153] Frontiers | The role of community and culture in abortion perceptions ... — Culture and community can play a role in abortion stigma, which, in turn, can negatively impact people's experiences seeking and accessing abortion care and lead to decreased reproductive autonomy . Studies have shown that community stigma toward abortion arises as a result of cultural norms, including religious and gender norms.
[154] Different Social and Cultural Responses to Abortion — A number of scholars have studied abortion stigma, contraceptive knowledge, attitudes towards abortion, and decision difficulty. Abortion stigma is reinforced by different social and cultural responses to abortion, researchers worked in different ways to understand where abortion stigma comes from, the characteristics of the people it affects most, and how it affects decision-making difficulty
[155] The Benefits of Public Education Campaigns - HIVO — Public education campaigns play a vital role in shaping public attitudes, behaviors, and opinions. Through their ability to raise awareness, educate the public, and inspire action, these campaigns have a positive impact on individuals and society as a whole.
[157] PDF — In the past few years an unprecedented wave of anti-abortion policies were introduced and enacted in state governments in the U.S., affecting millions of constituents. We study this rapid spread of policy change as a function of the underly-ing ideology of constituents. We examine over 200,000 pub-lic messages posted on Twitter surrounding abortion in the year 2013, a year that saw 82 new anti
[158] Abortion in America: How access and attitudes have changed ... - Stacker — Rather, attitudes toward abortion have changed over the centuries, often evolving alongside political and historical moments that reflect shifts in power and privilege. In Colonial times, abortion was not a matter of federal or ethical significance, but a common decision made and acted upon by pregnant people and their midwives.
[159] Abortion in Context: Historical Trends and Future Changes — Trends in Public Attitudes The political and professional movement for legal reform was well under way be-fore social scientists and polling organiza-tions began to study public attitudes to-ward abortion. Attitudes had probably been slowly becoming more liberal long before the first national survey on the topic was conducted in 1965.
[177] The facts about abortion and mental health — The women in the Turnaway Study who were denied an abortion reported more anxiety symptoms and stress, lower self-esteem, and lower life satisfaction than those who received one (JAMA Psychiatry, Vol. 74, No. 2, 2017).Women who proceeded with an unwanted pregnancy also subsequently had more physical health problems, including two who died from childbirth complications (Ralph, L. J., et al
[179] Abortion attitudes across cultural contexts: Exploring the role of ... — Abortion attitudes matter—disapproving and judgmental attitudes toward abortion may create barriers to accessing needed abortion care as well as ostracism and stigma toward those receiving abortion care. Our findings, across the United States, the United Kingdom, India, and Mexico, demonstrate that achievement of gender equality (United Nations' SDG #5) and promoting well-being and healthy
[181] Abortion Stigma and Its Relationship with Grief, Post-traumatic Stress ... — While data consistently show that abortions are not associated with poor mental health outcomes, abortion stigma, particularly self-judgment, may contribute to increased perinatal grief following abortion. ... Steinhard J, et al. Psychological impact on women after second and third trimester termination of pregnancy due to fetal anomalies
[182] The negative health implications of restricting abortion access — The negative health implications of restricting abortion access | Harvard T.H. Chan School of Public Health December 13, 2021—Ana Langer is professor of the practice of public health and coordinator of the Women and Health Initiative at Harvard T.H. Chan School of Public Health. Q: How do laws that restrict abortion access impact women’s health? A: Restricting women’s access to safe and legal abortion services has important negative health implications. If the current trend in the U.S. persists, “back alley” abortions will be the last resource for women with no access to safe and legal services, and the horrific consequences of such abortions will become a major cause of death and severe health complications for some of the most vulnerable women in this country.
[184] Insights: The Impacts of Abortion Bans on Maternal Health — Reproductive Health Access Project | Insights: The Impacts of Abortion Bans on Maternal Health Home > Resources > Insights: The Impacts of Abortion Bans on Maternal Health Insights: The Impacts of Abortion Bans on Maternal Health Even prior to Dobbs, the association between state-level abortion restrictions and adverse maternal health outcomes has been well-established.1 In December 2022, the Commonwealth Fund reported that, compared to states with protective policies, those with restrictive policies have fewer maternity care resources, more maternity care deserts, poorer Medicaid coverage benefits, and higher rates of maternal mortality (15.9 vs. Provide patients with information about their health and pregnancy, how to use abortion pills, and trusted resources on where to obtain abortion care like INeedAnA.
[185] Abortion Restrictions and the Threat to Women's Health — Apply Departments Biochemistry and Molecular Biology Biostatistics Environmental Health and Engineering Epidemiology Health Policy and Management Health, Behavior and Society International Health Mental Health Molecular Microbiology and Immunology Population, Family and Reproductive Health Faculty Topics Abortion Restrictions and the Threat to Women’s Health The abortion rights landscape a year after Roe v. Wade was overturned Published May 19, 2023 By Annalies Winny Drugs Family Planning Health Equity Reproductive and Sexual Health It’s been almost a year since the U.S. Supreme Court overturned Roe v. Wade, dismantling the constitutional right to abortion more than 50 years after the case was decided. At least a dozen states have banned abortion entirely, and more states are seeking to further restrict access to abortion—making the U.S. an outlier on the global stage: Some 59% of the world's female population currently reside in a country where abortion is broadly allowed. During the briefing, Bell, an assistant professor in Population, Family and Reproductive Health at the Bloomberg School, and Joanne Rosen, JD, MA, a senior lecturer in Health Policy and Management, discussed the state of abortion access in the U.S. and the impact on women’s health—and on physicians—since Roe was overturned. How states have responded With federal protections for abortion overturned, states were empowered to regulate reproductive health. In the 11 months since Dobbs was decided, abortion has been banned in 14 states.
[186] UCSF Turnaway Study Shows Impact of Abortion Access on Well-Being — Over the longer term, those who were denied an abortion and subsequently gave birth reported worse health and greater chronic pain compared to those who were able to terminate their pregnancy. The study also found negative effects on the children born from unwanted pregnancies, including poorer maternal bonding and economic insecurity.
[187] Abortion Policy in the United States: The New Legal Landscape and Its ... — Policies restricting access to legal abortion care will bring with them significant harm to the physical health of pregnant people through four specific types of serious health risks, including risks associated with 1) restrictions and delays regarding essential evidence‐based obstetric, gynecological, and maternal/fetal health care; 2) the inability to seek legal abortion care within one's own state; 3) the experience of unintended pregnancy and childbirth; and 4) the inability to access abortion services when desired. Limiting access to legal abortion in the United States will increase the incidence of serious adverse birth outcomes (including maternal and infant mortality), the number of children born into and living in poverty, and the number of families experiencing serious financial instability and hardship and will thwart the educational and economic achievements of women.
[189] Women's Health Protection Act (WHPA) - Center for Reproductive Rights — The Women's Health Protection Act (WHPA) is federal legislation that creates a new legal protection for the right to provide and access abortion care, free from medically unnecessary restrictions and bans on abortion. The need for federal abortion rights is more urgent than ever.
[203] Unsafe Abortion: Consequences, Facts & Statistics — There are immediate and long-term health risks of having an unsafe abortion—the toll on women is devastating. This year, over 9 million women will face complications as a result of unsafe abortion including life-long injuries, severe disability, heavy bleeding, damage to internal organs, or losing the ability to become pregnant in the future.
[205] Why restricting access to abortion damages women's health — Upholding reproductive rights is crucial for the health of women and girls worldwide, and access to a safe abortion is central to this, yet policies in several countries either severely limit or actively prevent access to appropriate abortion care and services . Lending international weight to this argument, dissolution of barriers to safe abortion access was emphasized in the March 2022 update of WHO guidance on abortion care , echoing a 2018 comment on the International Covenant on Civil and Political Rights released by the United Nations Human Rights Committee that called on member states to remove existing barriers and not enact new restrictions on provision of safe abortion services so that pregnant women and girls do not need to turn to unsafe abortions.
[207] History and scientific background on the economics of abortion — Across diverse contexts and populations, economic factors influence delays to abortion-related decision-making, attempts to seek care and the receipt of care. By unpacking the points at which economic factors introduce or compound delays to abortion-related care, greater insight into the points at which information and services might be better
[208] Factors Influencing Abortion Decision-Making Processes among Young ... — The objective of this study was to describe abortion procedures and to explore factors influencing the abortion decision-making process among young women in Maputo and Quelimane. Analysing the results, we were confronted with four recurring factors that negatively impacted on the decision-making process: (1) women’s lack of autonomy to make their own decisions regarding the termination of the pregnancy, (2) their general lack of knowledge, (3) the poor availability of local abortion services, and (4) the overpowering influence of providers on the decisions made. These abortion stories illustrate the lack of autonomy in decision-making process given the power and gender inequalities between adults and young women, and also between man and women_._ They also show the lack of knowledge not only on the availability of abortion services at some health facilities, as well as, on the new law on abortion.
[211] PDF — Being able to delay motherhood by one year due to access to legal abortion increased women’s wages by 11% on average. Access to abortion increased women’s workforce participation, “increasing the probability of a woman working 40 weeks or more per year by almost 2 percentage points (from 29 percent).” Professional occupational attainment. Specifically, “Being denied an abortion increases the amount of debt 30 days or more past due by 78 percent and increases negative public records, such as bankruptcies and evictions, by 81 percent.” Abortion Access Is Key to Economic Freedom Page 2 Access to abortion is crucial for racial, economic and geographic equity Ensuring access to safe and legal abortions has implications for the economic and health equity of people of color because of the systematic inequalities of the American economy and healthcare system.
[212] The Economic Consequences of Abortion Restrictions: A Growing Divide ... — The effects were particularly pronounced among Black women, whose workforce participation rates increased by 6.9 percentage points, compared to 2 percentage points among all women following the legalization of abortion in the 1970s (Amici Curiae Brief, 2021).
[214] PDF — Abortion legalization in the 1970s increased Black women’s rates of high school graduation and college attendance: in states offering access, high school graduation increased by 1.3 percent, college entrance by 3.7 percent, and college graduation by 9.6 percent.4 Among White women, abortion access lowered teen fertility but did not improve educational outcomes. By passing policies that strengthen abortion access and allow funding for low-income women, states can reverse these effects and encourage economic stability for women and families. 13 Stefanie Fischer, Heather Royer, and Corey White, “The Impacts of Reduced Access to Abortion and Family Planning Services on Abortions, Births, and Contraceptive Purchases,” Journal of Public Economics 167 (November 2018): 43–68, https://doi.org/10.1016/j.jpubeco.2018.08.009; Jason Lindo et al., “How Far Is Too Far?
[217] The Economic Effects of Abortion Access: A Review of the Evidence — [su_box title=”Key Findings: What are the effects of abortion access on labor market outcomes?” style=”soft” box_color=”#bdede7″ title_color=”#009382″ radius=”10″]Existing research suggests that greater access to abortion increased women’s future participation in the workforce—the probability of working 40 weeks or more per year increased almost 2 percentage points (from 29 percent) after the legalization of abortion. Many findings from other country contexts are similar to those from the United States: higher educational attainment among women with increased abortion access, worse outcomes for children as a result of restricted abortion access, and lower women’s labor market participation with increased fertility.[/su_box] This indicates that abortion access, shown to have reduced birth rates by 4 to 11 percent in the United States, would have significant impacts on women’s labor force participation as well.
[218] How abortion affects a woman's financial future and the broader ... - NPR — How abortion affects a woman's financial future and the broader economy : Shots - Health News : NPR But in the study, women who were denied abortions were more likely to live in poverty, less likely to work full time, more likely to receive public assistance (though not enough to offset their lost income) and less likely to have additional children later in life. When abortion became legal decades ago, access to that option — along with effective contraception — dramatically increased women's ability to work outside the home. "I was right at the line — financially — with being able to deal with it or not, and now if I was in the same situation, there's no way I could afford an abortion," Natalie says.
[247] "Regardless, you are not the first woman": an illustrative case study ... — Abstract Background Rape, unintended pregnancy, and abortion are among the most controversial and stigmatized topics facing sexual and reproductive health researchers, advocates, and the public today. Over the past three decades, public health practicioners and human rights advocates have made great strides to advance our understanding of sexual and reproductive rights and how they should be
[248] (PDF) The Sociology of Women's Abortion Experiences ... - ResearchGate — Women's experiences of abortion are shaped by socio-cultural discourse related to gender and maternity, and such discourse can impact women's perceptions and experiences of abortion stigma.
[251] Unveiling Truths: A Deep Dive into Abortion Documentaries — Through the personal narratives of women facing unplanned pregnancies, the film sheds light on the complex emotions and choices involved in the decision to seek an abortion. By focusing on these real-life stories, it humanizes the often abstract debate surrounding reproductive rights.
[252] Full article: Exploring stigma and social norms in women's abortion ... — Data from the interviews and focus groups are presented below in relation to women's attitudes towards abortion, perceptions of community attitudes, knowledge about abortion, fears and expectations for the service, and experiences seeking care. ... These findings help illustrate the social norms and stigma which may contribute to or cause low
[260] One Year After Dobbs—Vast Changes to the Abortion Legal Landscape — June 24, 2023, marked the 1-year anniversary of Dobbs v Jackson Women's Health Organization, when the US Supreme Court overturned nearly 50 years of precedent safeguarding the constitutional right to previability abortion, prompting 21 states to ban or severely restrict the procedure. 1 Meanwhile, the federal government and multiple states have acted to preserve legal abortion.
[261] Abortion Rights and Access One Year After Dobbs — In June 2022, the US Supreme Court ruled in Dobbs v. Jackson Women's Health Organization, ending the federal constitutional right to abortion. This ruling eliminated a fundamental right that women and people who may become pregnant held for nearly fifty years and left the right to abortion up to federal and state legislation. One year after Dobbs, 20 states are enforcing more limited
[263] The impact of hostile abortion legislation on the United States ... — The growing restrictive abortion policies nationwide and the Supreme Court decision on Dobbs v.Jackson Women's Health Organization place increasing barriers to abortion access in the United States. These restrictions disproportionately affect low-income people of color, immigrants, and non-English speakers, and have the potential to exacerbate already existing racial inequities in maternal and
[264] The impact of hostile abortion legislation on the United States ... — The logic model in Figure 1 explores the connections between abortion restrictions and the worsening Black maternal health crisis further, using abortion education and training as both a determinant and strategy (19–21). States with abortion bans or restrictions experience adverse outcomes including limited maternity care providers, maternity care deserts, higher rates of maternal mortality and infant death, especially among people of color, elevated death rates for birthing individuals of reproductive age, and greater racial disparities in healthcare (41, 42). Abortion hostility and restrictive legislation throughout institutions is not the only problem in accessing abortion and reproductive health care services, or training abortion provider. doi: 10.1016/j.socscimed.2017.05.013, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar] doi: 10.1016/j.lana.2022.100200, PMID: [DOI] [PMC free article] [PubMed] [Google Scholar]
[265] The Unequal Impacts of Abortion Bans - Johns Hopkins — New research shows that abortion bans led to more unwanted or unsafe pregnancies carried to term, resulting in an increase in both live births and infant deaths. We find the effects of these abortion bans are not uniformly felt, with the largest estimated impacts among populations experiencing the greatest structural disadvantages and in states with among the worst maternal and child health outcomes. Even before the Dobbs decision, the states that imposed abortion bans had much worse maternal and infant health outcomes, with many counties in these states considered maternity care deserts—a situation that is only worsening in recent years. Analysis Suggests 2021 Texas Abortion Ban Resulted in Increase in Infant Deaths in State in Year After Law Went into Effect
[266] People's perception of changes in their abortion attitudes over the ... — The study contributes to the literature by closely examining complexities in abortion attitudes over one's lifetime, using qualitative approaches to generate emerging aspects of how people perceive attitudinal change/stability and using quantitative methods to identify characteristics that are predictive of people's perceptions of change.
[284] What U.S. Abortion Legislation Looks Like in 2023 - ProPublica — Twelve states currently enforce abortion bans in almost all circumstances, in most cases through trigger laws, which were passed while abortion was protected by the court but went into effect after Roe was overturned. The same day, the Idaho Supreme Court ruled the opposite way: Its state constitution did not protect abortion, allowing a near-total ban to go into effect. Georgia bans abortion after around six weeks, but the law’s constitutionality is being challenged and the issue will likely be heard by the state’s highest court this spring. Last month in Alabama, where abortion is banned but the law doesn’t allow prosecuting the patient, the attorney general said that he’d use the state’s chemical endangerment law to go after people who took abortion medication.
[285] A shifting landscape of abortion policies means the way women ... - CNN — Meanwhile, telehealth abortions – with medications dispensed through the mail after a remote consultation with a clinician – are increasing, especially medication abortion provided under shield laws to women living in states with bans or restrictions. In many states with abortion bans, the combination of shield laws and out-of-state travel have helped residents access abortions at similar – and sometimes higher – rates than before the Supreme Court Dobbs decision revoked the federal right to an abortion and paved the way for states to make it illegal. In the second half of 2023, there were nearly twice as many abortions among West Virginia residents, with more than 1,000 provided out-of-state and more than 200 accessed through under shield laws.
[286] Changes Ahead: Abortion Policy Proposals Affecting Reproductive ... — As lawmakers and officials across the nation develop a laser focus on curtailing access to abortion care, and other forms of reproductive medicine, including in vitro fertilization (IVF) come into increasingly sharp focus, this report is intended to highlight policy measures organizations including the American Society for Reproductive Medicine (ASRM) and others are closely monitoring and responding to in this busy legislative cycle. Proposals there include legislation that authorizes physician assistants to perform abortions (this measure was approved by the Senate and sent to the House on March 7, 2023), as well as a so-called “abortion shield law” that would shield medical providers and patients against out-of-state subpoenas related to reproductive health care. The ASRM Center for Policy and Leadership (CPL) has released reports concerning States' Abortion Laws and their Potential Implications for Reproductive Medicine.
[287] Criminalizing Reproductive Care and Abortion Services through Telehealth — The NEJM authors concluded: "Clinicians who rely on shield laws to provide telehealth abortion services to patients in abortion-restrictive states face uncertain legal protections." The cases against Dr. Campbell will test the effectiveness of these laws in both a civil and criminal context.
[288] Legal Uncertainty for Telehealth Abortion — Key Takeaways: The Texas and Louisiana abortion lawsuits represent a pivotal moment in the legal battle over telemedicine, state sovereignty, and healthcare access. Cross-state enforcement could limit access to broader telemedicine services if courts side with the restrictive states. Shield laws protect clinician autonomy but still face future legal challenges. State Abortion Pill Lawsuits
[289] Telehealth Can Reduce Chaos and Confusion in Reproductive Care ... — Telehealth is driving access to abortion care in increasingly restricted environments. It also has the potential to revolutionize OB-GYN care, expanding access to services like prenatal checkups and postpartum care for millions—especially those in maternity care deserts.We know telehealth is safe, effective and in demand ... so why are some states creating significant barriers to care, or
[290] 'The battle between states is ripe for a legal showdown' — New York is one of eight states with a telemedicine abortion shield law that protect its physicians who assist women in abortion-restrictive states. But abortion-restrictive states argue that, no matter where the provider might be located, the patient, and hence the medical care, occurred in their jurisdiction and is therefore subject to their
[291] Abortion bans affect access in states without restrictions — In particular, access to telehealth abortion, access to self-managed abortion and care in other protective states have helped Colorado manage the demand. Shield laws, in particular, have been essential to protecting clinicians in abortion states in providing remote or in-person care to individuals accessing the procedure in abortion-ban states.
[292] Providing Interstate Telehealth Abortion Services to Patients in ... — Racial/ethnic and educational inequities in restrictive abortion policy variation and adverse birth outcomes in the United States.
[295] The Role of Telehealth in Promoting Equitable Abortion Access in the ... — However, direct-to-patient telehealth abortion may greatly mitigate existing geospatial inequities in abortion access , despite only being legal in 24 states and Washington, DC as of September 2023 (although more states permit abortion care but prohibit telehealth) . In direct-to-patient telehealth abortion, a clinician can
[310] Physicians and healthcare professionals as advocates for abortion care ... — Summary: Through this literature review and our lived experiences as abortion providers, we assert the importance of healthcare professionals as advocates for abortion rights and services. The need for advocacy crosses specialties and communities; together we are stronger advocates as we continue to support and fight for access to safe legal
[311] How Healthcare Professionals Can Advocate for Safe Abortion Access — As healthcare professionals, it is our duty to not only provide care but also advocate for change to ensure that all individuals have access to safe and legal abortion services. This article will delve into the various barriers to accessing safe abortion, explore the role of healthcare professionals in advocating for change, and provide
[312] Abortion Access - ACOG — At the state and federal levels, ACOG advocates against legislation that unduly regulates or criminalizes abortion care providers, including by: Forcing physicians to give patients inaccurate or biased information; Requiring unnecessary procedures and tests; Unnecessarily overregulating facilities where abortion care is provided
[313] Changes Ahead: Abortion Policy Proposals Affecting Reproductive ... — As lawmakers and officials across the nation develop a laser focus on curtailing access to abortion care, and other forms of reproductive medicine, including in vitro fertilization (IVF) come into increasingly sharp focus, this report is intended to highlight policy measures organizations including the American Society for Reproductive Medicine (ASRM) and others are closely monitoring and responding to in this busy legislative cycle. Proposals there include legislation that authorizes physician assistants to perform abortions (this measure was approved by the Senate and sent to the House on March 7, 2023), as well as a so-called “abortion shield law” that would shield medical providers and patients against out-of-state subpoenas related to reproductive health care. The ASRM Center for Policy and Leadership (CPL) has released reports concerning States' Abortion Laws and their Potential Implications for Reproductive Medicine.
[314] Eight Ways State Policymakers Can Protect and Expand Abortion Rights ... — Since the US Supreme Court overturned Roe v.Wade in June 2022, policymakers at the state level have an even more critical role to play in shoring up and expanding abortion access and rights.Abortion access has shifted dramatically around the country in the past six months, as states across the South, the Plains and the Midwest have banned abortion or restricted access to care.