Kathleen Graham
Roe v. Wade forever changed women’s health and empowerment. However, the battle over a woman’s right to choose abortion rages on across America. In the 40 years since Roe v. Wade, generations of women have grown up in a world where a woman has the ability to choose what happens to her body and pursue a life in good health with whatever decision she makes. Across the country, however, there has been a widespread movement of laws and bills enacted to reduce access to women’s health services, specifically access to abortion clinics. Many of these laws and regulations require facilities to meet new standards, posing burdensome restrictions not demonstrated to improve women’s health or safety. In many areas, these regulations and laws have caused women’s health clinics to close, even where there were few clinics to begin with. Placing extraneous burdens on women’s access to abortions limits their constitutional right to choose the path of their pregnancy.
Efforts to restrict abortion access and impose regulations have been around since the Roe v. Wade decision. However, since 2010 the nation has seen a sharp increase in the efforts to limit access to abortion. From 2011 to 2013, 30 states enacted 205 abortion restrictions; this dramatic three-year surge in harsh restrictions exceeded all restrictions enacted in the past decade. Many of the laws and regulations do not follow evidence-based practice and furthermore are in contrast to the safe abortion recommendations of the World Health Organization (WHO). Some of the laws and regulations include mandated invasive ultrasounds, waiting periods, and mandated counseling. Currently there are 22 states that require abortion services to go beyond the recommended accreditation level and have the same standards as ambulatory surgical centers. Additionally, some states require that physicians providing abortions have admitting privileges or connections and affiliations with a local hospital.
The WHO has stated that abortion care can be provided safely and in good capacity at the primary care level with only a plan for referral to a higher level of care if the need arises. The Centers for Disease Control conducted research on abortions performed in hospitals, clinics or physicians’ offices and determined that there was no significant difference in risk of death. Such new regulations have forced many women’s health care clinics to close due to lack of funding for renovations and/or lack of hospitals willing to associate with physicians working at the clinics. In some cases women are now being forced to face unreasonable burdens, like driving four or five hours in order to receive care.
The rationale provided for many of these new regulations and laws, that they will provide safety and protection of women’s health, is just a pretext. In reality, they are obstacles in the path of a woman’s right to choose abortion. Furthermore, states with stricter abortion restrictions under the pretext of improving women’s health have fewer policies protecting women and children’s wellbeing on average, according to reproductive rights groups. Restrictive abortion laws unfortunately do not decrease the rate of pregnancy or the need for abortion clinic access, neither are they associated with a lower incidence of abortions. On the contrary, restrictions on abortions tend to be associated with higher levels of unsafe abortions and unfairly affect poor and marginalized women. Unsafe and unsupervised abortions can have significant health consequences, including death and disability.
Access to legal abortions saves women’s lives. Access to safe abortions can also save costs to our already burdened health care system. The cost of treating complications from unsafe abortions can greatly outweigh the cost of providing access to safe abortions and effective contraception. Instead of the widespread new laws and regulations that have been enacted across the nation, there should be supportive legislation that focuses on increasing women’s access to not only abortion services but, more importantly, women’s health and preventive services. An effective way to reduce unwanted pregnancies, abortions and unplanned births is to reduce the unmet need for modern effective contraception, family planning services and other women’s health services. In providing preventive services, such as education and contraception, we can help reduce the rate of unwanted pregnancies, abortions and burdens on women’s health. In contrast, the recent wave of restrictive new laws will do far more harm to women than good.
Kathleen is a MPH & MSN-ANP Candidate at New York University’s Global Institute of Public Health and College of Nursing. She currently works as an ER Nurse in New York City.
