The latest dispatch in the war on women comes from Texas, where a report just released by the University of Texas at Austin finds that as many as 240,000 women have attempted to self-abort using medication or time-tested — and ineffective — methods like excessive drinking. The findings are shocking and horrific, and many are pointing to them as yet another example of the dangers presented by targeted regulation of abortion providers (TRAP) laws, which are designed to limit abortion access. Are we going to be thrown back to a pre-Roe era, with patients and abortion providers alike working underground to seek access, since we already know that outlawing abortion doesn't eliminate need?
Just the contrary: We're already there.
Roe v. Wade was a landmark Supreme Court decision, extending the right to privacy to include the medical decisions of abortion patients. It immediately improved the climate for patients who need abortions. Before 1973, an estimated 5,000 patients died every year in the pursuit of pregnancy termination as a result of unsafe conditions, procedures performed later in pregnancy, and unscrupulous abortionists. Today, 0.06 patients die for every 100,000 abortions, and the procedure is substantially safer than giving birth.
Ever since Roe, abortion opponents have been working to reverse it directly in the courts and via legislation, while also hacking away at abortion access across the country. Earlier this month, the Supreme Court announced that it would be reviewing two abortion-related cases which could potentially shift the nature of abortion in the United States yet again. The news has many advocates understandably concerned, as they fear for the welfare of patients across the country. With good reason — pre-Roe horror stories about illegal abortions are chilling to read.
As we talk about a return to pre-Roe and the era of initiatives like Jane, a Chicago organization which connected patients with providers and ultimately trained members to perform abortions to ensure access, much of the conversation casts this in a threatening future tense. However, what's going on in Texas shows us that pre-Roe conditions aren't something that could happen if we can't defend abortion rights. They show us that they're already happening, and the question is not so much how we can retain the rights we have and slowly claw back horrific legislation, but how we can reclaim abortion access.
The stance that we are in danger of full-out pre-Roe conditions might actually be conservative, which is a terrifying thought.
Abortion is functionally illegal and/or inaccessible in multiple U.S. states as a result of TRAP laws, making the number of abortion clinics dwindle away to nearly nothing. When combined with continuous terrorist attacks against abortion clinics, providers and patients alike are terrified to be involved with abortion services. The EMW Women's Surgical Center in Kentucky, for example, has been vandalized twice already in November, and in September, a clinic in Washington State was firebombed.
Lack of access to abortion may not be the same thing as outlawing it, but it has a similar effect. When abortion is unilaterally illegal, patients are forced underground if they want to terminate pregnancies. When women cannot access legal abortions due to TRAP laws, terrorism, or other barriers, they likewise go underground. Whether they see providers who risk their licenses to offer abortions in safe settings, descend into charnel houses like Kermit Gosnell's, or try to abort on their own with medications from across the border, those patients are already living a pre-Roe experience. This isn't a hypothetical. It's reality.
We already know that what is happening is bad — it doesn't take a rocket scientist to understand that legislation infringing on abortion rights is a problem — but the issue of how bad it really is might be up for debate. The stance that we are in danger of full-out pre-Roe conditions might actually be conservative, which is a terrifying thought. Roe hasn't come and been begged to stay; it's already gone.
Yes, conditions in the United States are clearly better than they were pre-Roe. Many patients can still access abortions, and the number of deaths associated with illegal abortion isn't in any way comparable to the thousands who died in the '50s and '60s. In fact, the CDC reports that it doesn't know of any illegal-abortion-related deaths between 2011 and 2014. In part, that's because better antibiotics and patient care are available to help people suffering complications from illegal abortions gone wrong.
But it's hard to argue with the results from Texas. That's just one state; how many others face the same situation? A perfect storm is gathering, and the stage is set for us to see radical changes. If Roe isn't respected in one state, it's possible for every other state to argue that it doesn't apply to them, either. The issue isn't necessarily whether Roe is in a state of erosion, but whether the new cases hitting the Supreme Court can affirm abortion rights, reiterating what the court said in 1973. Roe is still a valuable and important part of U.S. case law, but when laws aren't upheld, they lose their punch.
This doesn't mean that we've lost or that we should give up, however. As long as there are people who need abortions — which there always will be, though better public health initiatives and better access to reproductive care would likely reduce their numbers — it's critical to fight for access. For the possibly hundreds of thousands of Texas patients endangering themselves, for the growing number of pregnant teens in the South, for mothers who know that their families would be better served by recognizing that now is not the time for another child.
What does that fight look like when these things are being decided by judicial bodies and in seemingly inaccessible houses of legislature? It means contributing to groups that will be submitting amicus briefs in cases like these: Planned Parenthood, the ACLU, the Center for Reproductive Rights, NARAL, and the Southern Poverty Law Center. You might not be a high-powered attorney with years of experience in the field, but you can help an organization hire one. (And if you are, go you!)
It means writing your legislators to firmly state your opinion on proposed bills. Find your Congressperson here, and your Senator here. Do the same for your state representatives and senators. Also, keep an eye on what's up at your State House as well as at Congress, so you don't find out about legislation when it's already escaped committee and hit the floor — you can search their website with keywords like "abortion" to find legislation in Committee or slated for debate and voting.
It means voting, and participating in "get out the vote" campaigns, and educating friends, family, and anyone you can pin down long enough about which candidates have a good voting record on reproductive rights (many state Planned Parenthoods maintain report cards, like this one in New York). It means taking to the streets to tell the world that you want your right to medical privacy restored — or that you stand in solidarity with people demanding that right, even if you can't get pregnant yourself.
It means never surrendering.
Image: Steve Rhodes /Flickr