This week marked the second dark anniversary of the ruling Dobbs v. Jacksonof the Supreme Court of the United States, the decision having invalidated Roe v. Wade, which had protected the right to abortion since 1973. The impact, a veritable tidal wave, was immediate. In 13 states, laws criminalizing abortion, sometimes as early as six weeks into a pregnancy, automatically took effect.
In the hours and days that followed Dobbsyou had to listen to the reports documenting the effects of this instant revocation of abortion rights in medical clinics, in groups offering services to pregnant women. Doctors and nurses forced to empty their waiting rooms full of pleading women, to send home teenage girls who suddenly could no longer be cared for. The tears, the anguish, the risks women were forced to take to end a pregnancy. The horror stories were everywhere.
Since then, the situation has only deteriorated, with 21 states banning or restricting abortion rights. Large swaths of the country are now under these bans, forcing women who want them to travel across state lines to obtain an abortion. For example, if a woman in Florida wants or needs a surgical abortion after the sixth week of pregnancy, she must travel to the nearest state, North Carolina (before the 12th week).e week), or in Virginia or New Mexico.
For most people, it is understandably unrealistic to travel thousands of miles to receive this care. The costs of transportation, accommodation, and lost work time are prohibitive, so poor women are disproportionately affected by these bans.
This has necessarily led to a change in the preferred methods of terminating a pregnancy. Prescriptions for the abortion pill, mifepristone, have skyrocketed and now constitute the majority of abortions. This shift was facilitated – and fortunately – by the Food and Drug Administration (FDA) which, during the pandemic, authorized the remote prescription of mifepristone. On the other hand, the effectiveness of the pill is limited to the first trimester and, unsurprisingly, attacks from the anti-abortion lobby are increasing in an attempt to limit its availability.
According to data compiled by Vox19 states have banned the remote prescribing of mifepristone, and 14 others require that the drug be taken in the presence of a doctor. In addition, legal challenges to the use of the abortion pill are increasing. The Supreme Court has just blocked an attempt to restrict access to mifepristone, but the challengers are certainly not done yet. Medical abortion remains in the crosshairs of conservative forces, and the last few years have shown that there are good reasons to fear any setbacks on the reproductive freedom front.
Moreover, it is now clear that the harmful effects of the judgment Dobbs extend beyond the right to abortion. Indeed, the post-Dobbsin the United States, is not only one in which women are deprived of the choice of whether or not to carry a pregnancy to term. It is also an era in which reproductive health care in general has deteriorated considerably.
Since June 2022 and the adoption of laws criminalizing certain medical acts, exposing health personnel to serious consequences, even desired and chosen pregnancies are now a source of uncertainty and concern. In the event of complications or miscarriage, it is not at all clear where the threshold lies below which the fetus is favored to the detriment of the mother’s life. Laws restricting abortion practices and laws supposed to ensure the quality of obstetric care overlap and sometimes contradict each other.
In states with the strictest bans, it is unclear at what point doctors can intervene when a woman has, for example, a miscarriage. When in doubt, health care workers refrain. As a result, some women are forced to endure the sometimes serious yet treatable consequences of pregnancy complications. Horror stories abound: women sent home to miscarry, hospitalized after several days after losing dangerous amounts of blood. Women forced to carry pregnancies to term when it is known that the fetus will not survive after birth…
We also observe a disturbing trend towards the judicialization of pregnancy. At the beginning of June, the organization Repro Legal Helpline, created in 2018 to offer legal information related to pregnancy (already, the existence of this service speaks volumes), reported having seen its number of calls received explode since 2022. Around a third of calls received annually, it is noted, are made by people under the age of 18.
By subjecting the gestation process to severe legal constraints, concludes Repro Legal Helpline, the demands related to health care have been downgraded by the carceral function of the health system. Obviously, the judicialization of reproductive health disproportionately affects women, and even more so poor and racialized women.
We do not yet understand the full extent of the restriction of women’s rights and autonomy triggered by Dobbs. This decision has opened a Pandora’s box; all possible retreats are now on the table. The assaults are numerous, the offensive is financed and organized. However, it would be naive to believe that this trend will stop at our border.
A columnist specializing in environmental justice issues, Aurélie Lanctôt is a doctoral student in law at McGill University.