We Need More Than Roe v. Wade to Protect The “Right to Choose”
For millions of people with uteruses in the United States, the “freedom to choose” is already long gone.
The recent addition of Amy Coney Barrett to the Supreme Court has sparked many fearful conversations about what could happen to Roe v. Wade. As I listen, I can’t help but feel that we’re missing the bigger picture. These conversations neglect all the ways our freedom to choose has already been lost. The Supreme Court doesn’t need to overturn Roe v. Wade in order to make it nearly impossible for women to access abortions. It’s happening right now. Over 1,300 new provisions intended to restrict access were introduced across the country in 2020 alone. We need more than Roe v. Wade to protect the so-called “right to choose.”
The reality is that even with Roe in place, millions of women already face incredible obstacles intended to prevent them from obtaining the abortion care they need. These are multilayered barriers to access, at the state and federal levels. The women affected by these laws are women you know. They’re mothers, sisters, friends and colleagues. They’re women like Dr. Valerie Peterson, who lived in Texas. She needed an abortion at 16 weeks after she learned her unborn son was diagnosed with a lethal fetal anomaly and would not survive. Her only options were to wait to miscarry or end the pregnancy. Dr. Peterson had just learned the sex of her baby, and was excited for her two daughters to have a younger brother. Losing the pregnancy was a traumatic event on its own, and waiting would be too excruciating to bear. For her mental health, Dr. Peterson knew her only real option was to terminate the pregnancy. Then she learned her doctor would not be able to administer the procedure. She would need to be referred to Planned Parenthood instead. She remembers thinking, “Wow, why can’t my doctor take care of me?”
It gets worse. There was a 3–4 week waitlist at Planned Parenthood. There is a shortage of clinics in Texas because the state has laws requiring abortion providers to meet unnecessary standards in terms of their building, equipment, and staffing. Many clinics have been forced to close. In 2017, 96% of Texas counties did not have an abortion provider.
“I lost it. I didn’t understand why I would have to be subjected to what I felt was extra trauma.”
Even if Dr. Peterson could get an earlier appointment, she would have to wait several more days before she could legally have the procedure. This additional delay is due to the mandatory 24 hour waiting period, mandatory counseling, and ultrasound. This would mean two separate appointments and a very long day. On top of that, the nurse told Dr. Peterson there was no guarantee these separate appointments would happen on consecutive days. “I lost it. I didn’t understand why I would have to be subjected to what I felt was extra trauma.” Dr. Peterson recalls, explaining how these unnecessary restrictions adversely affected her mental health. There was another looming deadline, too — abortion is banned altogether at 20 weeks in Texas.
This is not reproductive freedom, this is a bureaucratic nightmare.
Dr. Peterson paid $5,000 out of her own pocket to fly to Florida and have the procedure done there — but many women do not have the resources to pursue an alternative option like this. Traveling is expensive, and taking time off work costs money too. There’s also the cost of the abortion to worry about and insurance coverage is only available to a privileged few. There are laws in place to make sure of that.
The Hyde Amendment, implemented in 1977, currently bans the use of federal dollars for abortion coverage (except in extremely limited cases like rape, incest, or life endangerment). This means that millions of women insured by Medicaid or CHIP are forced to pay for the procedure entirely out of their own pocket. In 2015, over 7 million women of reproductive age in the United States did not have abortion coverage. This policy disproportionately affects low-income women and women of color, groups that already face an increased risk of unintended pregnancy.
This is the bind our legal system places women in. States continue to implement laws that ban abortion after an arbitrary number of weeks, while simultaneously enforcing medically unnecessary restrictions designed to make women wait for care. Targeted regulation of abortion providers — TRAP laws — force clinics to close by holding them to burdensome standards. This leads to a shortage of clinics and lengthy waitlists. Women are denied insurance coverage and must waste more valuable time raising the funds themselves. In states like Texas that ban abortion at 20 weeks, by the time they raise the money, it is likely too late. Their freedom to “choose” is all but obliterated.
All of these obstacles exist even with Roe v. Wade in place.
We need more comprehensive legislation to ensure genuine access to abortion. We eliminate these obstacles by passing the Women’s Health Protection Act and the Equal Access to Abortion Coverage in Health Insurance Act (EACH Woman Act).
The Women’s Health Protection Act will protect abortion access by prohibiting medically unnecessary restrictions at the federal level. By creating a federal standard, this bill will eliminate the arbitrary waiting periods, mandatory counseling, misinformation, and unnecessary ultrasounds intended to delay access and shame women. It will stop 6-week and 20-week bans and allow clinics to provide access without being shut down by unreasonable standards. Dr. Peterson would have been able to access her abortion in her home state, at the time she needed it.
But what good is abortion access without a way to pay for it? This is why we need the EACH Woman Act just as much. This is about ensuring access for all women, not just a privileged few. The EACH Woman Act will restore abortion coverage for women insured by Medicaid and other federal programs. It will also prohibit political interference with private insurance coverage of abortion, granting equal access for all women.
Proponents of anti-abortion legislation typically argue that abortion hurts women. Those who want to restrict access suggest abortion poses medical risks, or say women who have abortions will suffer a dramatic loss of self-esteem. While these arguments are certainly emotionally evocative, they are not backed by research. Statistically, abortion is very safe. It is safer than common procedures like wisdom tooth removal or tonsillectomy. Only 0.3% of abortion patients experience complications that lead to hospitalization. It is safer than childbirth.
As for the claims about a loss of self-esteem, Diana Greene Foster, author of The Turnaway Study, looked into it. She interviewed 1000 women over the course of ten years. Some of these women had an abortion at the start of the study, while the others sought out an abortion but were turned away. Foster found that women who were denied an abortion suffered from higher anxiety, lower self-esteem, and lower life satisfaction than women who had one. There were also significant differences in the women’s ability to hold a job and pay for necessities like food, housing, and transportation. Again, women who accessed an abortion fared better. Contrary to popular anti-abortion arguments, the results of this study indicate that women themselves are best suited to make decisions for their own lives.
“If we want abortions to happen earlier in pregnancy, then many restrictions should be taken off the books because they don’t improve women’s health. And they cause abortions to happen later.”
Foster is also a professor of obstetrics, gynecology, and reproductive sciences at the University of California, San Francisco. While presenting her research, she has directly addressed the contradictory logic behind legislation restricting abortion access. She told NPR, “If we want abortions to happen earlier in pregnancy, then many restrictions should be taken off the books because they don’t improve women’s health. And they cause abortions to happen later. For example, the one that would have the biggest effect in making abortions happen sooner would be to drop the Hyde Amendment.” The EACH Woman Act would do exactly that.
It’s time to look beyond Roe v. Wade. If Amy Coney Barrett’s Supreme Court seat stresses you out, call and email your local representatives. Tell them the Women’s Health Protection Act and the EACH Woman Act are important to you. Educate your friends and family about the reproductive injustices happening in this country right now. The freedom to choose should be available to everyone. It’s time to fight for what is already lost.
I linked up with Dr. Valerie Peterson through the amazing storytelling platform, We Testify, created by Renee Bracey Sherman. I owe a thank you to both of them for making this piece possible. If you liked this article, please consider supporting their work.