Beyond Abortion
Abortions bans create a chilling effect, curtailing every facet of women's lives
“We won’t go back” has become one of the most popular rallying cries of the pro-choice movement. Popularized by Planned Parenthood, it’s a nod to the dark days womankind experienced before Roe vs. Wade and a promise that women will fight tooth and nail to never be debased and exploited like that again. Now that the Supreme Court has toppled Roe vs. Wade, and close to half of all states have nearly banned abortion1, the truth is we aren’t going back.
Many people know the time before Roe was dire, even if most don’t know exact details, which leaves most of us unaware and unprepared for the unprecedented horrors a post-Roe America is beginning to usher in. When one thinks back to the time before Roe, the homes for unwed mothers and needless deaths from back-alley abortions come to mind. While these events were obviously shameful in their own right and must be remembered, it’s now more important to focus on the imminent future: the ways in which the healthcare system, modern day technology, the judicial system, and American culture in general will be shaped by abortion bans, making America a much worse place than we could have ever imagined for all women.
The American healthcare system is already known for it’s extreme negligence when it comes to women, especially pregnant women. The maternal mortality rate in America “has risen steadily over the last 25 years” from 1990 to 2015. “This means that compared with their own mothers, American women today are 50% more likely to die in childbirth.”2 The issue hasn’t been getting better since 2015 either; rates increased sharply during the pandemic3 while “across the country, from suburban San Diego to rural Connecticut, maternity wards have been shutting down for good during the Covid-19 pandemic” which “could make birth even more dangerous in the US.”4 This troubling, dangerous trend was noted in a time before over a dozen states effectively banned abortion. Estimates of a post-Roe America put the maternal mortality rate 20% higher.5
Yet abortion bans will complicate our understanding - and ability to address - the maternal mortality rate as it relates to abortion access. It’s easy to track and count the women who will die after being refused an abortion in medical emergencies, but what about the women who fall through the cracks? The women who wanted an abortion, and would've gotten one if they weren't prevented by the state, and subsequently died due to pregnancy or childbirth complications. These are deaths caused by abortion bans yet they won’t be counted as such; our understanding of the death toll will be under-counted and the grave outcomes of abortion bans will be downplayed.
The healthcare system isn’t alone in failing pregnant women. Male violence has become such a prevalent yet unaddressed issue that “homicide during pregnancy or within 42 days of the end of pregnancy exceeded all the leading causes of maternal mortality by more than twofold.” This discovery from the same study is chilling when considering the implications of the state forcing women, and especially young girls, to keep unwanted pregnancies: “Pregnancy was associated with a significantly elevated homicide risk in the Black population and among girls and younger women (age 10-24 years) across racial and ethnic subgroups.”6
The reality is girls will bear a large proportion of the brunt of abortion bans. Eleven states have already banned abortion without exceptions for rape or incest7, forcing young victims of rape to become young mothers, while the CDC recently reported that rape perpetrated against teenage girls has skyrocketed, up 27% since 2019. These are girls who will be forced to miss weeks or months of school - or quitting entirely - due to pregnancy, birth, and young motherhood; teenage pregnancy is a significant contributor to high school dropout rates, with only half of teenage mothers receiving their high school degree8. This leads to a life of poverty and financial disadvantage.
Biases about women in the workplace have been pushing women out for years, with the most concerted push occurring during COVID - with women experiencing greater job losses9 while men who work from home were three times more likely to be promoted10 - and the end of Roe will see an acceleration of this. Women are less likely to be promoted because of the bias they will focus more on their families or leave the workforce entirely after having children. Abortion bans confirm and further entrench that bias, making women an implicit liability to an employer because at any point she could become pregnant and her only option is to become a mother. She will need accommodations and time off to give birth; even if the company refuses to pay for any leave, employers count that as a loss of labor. Employers will invest in women even less.
Women already experience elderly poverty at higher rates than men11 and now that will be intensified by the lag of women's participation in the workforce compounded with the financial distress caused by abortion bans: "Being denied an abortion has large and persistent negative effects on a woman’s financial well-being. … The impact of being denied an abortion on collections is as large as the effect of being evicted (Humphries et al., 2019) and the impact on unpaid bills is several times larger than the effect of losing health insurance (Argys et al., 2019). ... Denying a woman an abortion reduces her credit score by more than the impact of a health shock resulting in a hospitalization (Dobkin et al., 2018) or being exposed to high levels of flooding following Hurricane Harvey (Billings et al., 2019).”12
Although the forced-birth camp relies heavily on the altruistic idea of adoption, the reality is that, when given a choice, adoption was a rare choice even before Roe: “the Centers for Disease Control and Prevention reports that among never-married women, about 9 percent chose adoption before 1973, when Roe v. Wade legalized abortion. By the mid-1980s, the figure had dropped to 2 percent, and it was just 1 percent by 2002, the last year the CDC data captured.” Without abortion, girls and women will be forced into motherhood and into a lifetime of financial instability and subsequently elderly poverty. Considering all of this, is it any wonder restricting abortion access is linked to increased suicide risk for women?13
Before Roe sexual education was rarely taught, contraceptives weren’t common knowledge and were hard to come by, and emergency contraception was in it’s infancy; it wasn’t until the late 90’s that the FDA began working on emergency contraception.14 Thanks in large part to the internet, women now have more knowledge about preventing and ending pregnancy than before Roe, but that is tied to an ever growing surveillance state propagated by technology.
While women have become the fastest growing prison population, growing “834% over nearly 40 years — more than double the pace of the growth among men”15, the cases of pregnant women being punished for miscarriages and abortions has simultaneously been on the rise: “From 1973-2020, NAPW [National Advocates for Pregnant Women] has recorded 1,600 such cases [of "forcible intervention" against pregnant women], with about 1,200 occurring in the last 15 years alone.”16 Technological surveillance is now one of the main drivers behind this horrifying trend: “In 2017, an online search for the abortion medication misoprostol was used to charge one woman with second-degree murder. In 2015, a series of text messages with a friend about getting an abortion helped convict another of feticide and child neglect. That same year, activists used surveillance technology to target anti-abortion ads at women visiting abortion clinics.”17 And the chilling extent of women’s technological surveillance continues to be exposed: data brokers selling the location data of women who visit abortion clinics18, period tracking apps selling identifiable data to app developers and marketers.19 With the end of Roe women will be subject to severe technological surveillance in the hopes of penalizing them with an emboldened judicial system.
The surveillance of women goes beyond technology and the state; as we've seen in the past two years, the responsibility of surveillance is being placed on private citizens. In their aggressive push to restrict abortion as much as possible, forced-birth extremists have introduced a law that rewards vigilantism against women: Texas’ SB8.20 Oklahoma has followed in Texas’ footsteps nine months later with SB1503.21 These laws operate by rewarding private citizens for suing other private citizens who help a woman get an abortion. While they absolve the state of any complicity in surveilling women by placing the responsibility of surveillance on private citizens, they rely on the complicity of the state in punishing women. These laws turn every woman into a prospective criminal deserving of heightened surveillance by her friends, family, coworkers, and strangers she might happen to interact with.
Nearly twenty years ago the CDC published a guideline asking “all females capable of conceiving a baby to treat themselves -- and to be treated by the health care system -- as pre-pregnant, regardless of whether they plan to get pregnant anytime soon.”22 While we know the healthcare system has been treating women this way for years, especially Catholic hospitals23, it's become an even more pressing issue. Prescriptions, wholly unrelated to abortion, are already being withheld from women with long term health issues like rheumatoid arthritis and cancer on the basis of abortion bans. This analysis24 found that “limitations and barriers to these treatments will have a disproportionate impact on women, beyond limiting the availability of abortions to terminate pregnancies.” It seems the state has taken this ideal to heart and is now planning to treat all women as pre-pregnant through any means necessary - technological surveillance, the judicial system, and even private citizens. And while the CDC’s intentions were good - to improve the rate of unhealthy pregnancies - one has to believe placing women under constant surveillance wasn’t meant to be the intended outcome.
When society treats all women as pre-pregnant, only valuing their fertility and ability to give birth, the result is academics suggesting “that 'brain dead women' could have their bodies used to house surrogate pregnancies for those unable, or unwilling, to carry a baby of their own.”25 Even with the veneer of consent that suggestion is chilling, but it becomes a stark reality with the knowledge that most American women don't have the right to consent to how their bodies are used once pregnant and on life support: "At least 31 states have adopted laws restricting the ability of doctors to end life support for terminally ill pregnant women, regardless of the wishes of the patient or the family."26 Compounded with the knowledge that the vast majority of women living in those states also don't have the ability to choose whether or not they're pregnant, it becomes clear the state has done everything possible to secure women's position as, what Professor Anna Smajdor suggested, "whole body gestational donors."
Abortion is inextricably linked to the quality of a woman’s life - shaping not only her sexual and reproductive life, but more importantly her social life, her educational and work life, her access to healthcare in general, and most importantly her basic ability to participate in society. In the words of Moira Donegan27:
The real story is about thousands of these women, not just now but for decades to come – the women , whose lives will be made smaller and less dignified by unplanned and unchosen pregnancies, the women whose health will be endangered by the long and grueling physical process of pregnancy; the women, and others, who will have to forgo dreams, end educations, curtail careers, stretch their finances beyond the breaking point, and subvert their own wills to someone else’s.
The real story is in the counterfactuals – the books that will go unwritten, the trips untaken, the hopes not pursued, and jokes not told, and the friends not met, because the people who could have lived the full, expansive, diverse lives that abortions would allow will instead be forced to live other lives, lives that are lesser precisely because they are not chosen.
The real story is the millions of women, and others, who now know that they are less free than men are – less free in the functioning of their own bodies, less free in the paths of their own lives, less free in the formation of their own families.
The real story is not this order; the real story is these people’s unfreedom – the pain it will inflict and the joy it will steal. The real story is women, and the real story is the impossible question: how can we ever grieve enough for them?
Elizabeth Nash and Isabel Guarnieri. “Six Months Post-Roe, 24 US States Have Banned Abortion or Are Likely to Do so: A Roundup.” https://www.guttmacher.org/2023/01/six-months-post-roe-24-us-states-have-banned-abortion-or-are-likely-do-so-roundup
Neel Shah. “A soaring maternal mortality rate: What does it mean for you?” https://www.health.harvard.edu/blog/a-soaring-maternal-mortality-rate-what-does-it-mean-for-you-2018101614914
Donna L. Hoyert. “Maternal Mortality Rates in the United States, 2020” https://www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/maternal-mortality-rates-2020.htm#Table
Dylan Scott. “Maternity wards are shuttering across the US during the pandemic” https://www.vox.com/22923432/maternity-wards-hospitals-covid-19-pandemic
Jaime Ducharme. “Without Roe v. Wade, U.S. Maternal Mortality Rates May Get Even Worse” chttps://time.com/6192697/roe-v-wade-maternal-mortality/
Maeve Wallace, Veronica Gillispie-Bell, Kiara Cruz, Kelly Davis, Dovile Vilda. “Homicide During Pregnancy and the Postpartum Period in the United States, 2018-2019” https://pubmed.ncbi.nlm.nih.gov/34619735/
Stephanie Kirchgaessner. “No-exception laws, once too harsh even for anti-abortion Republicans, gain traction across US” https://www.theguardian.com/world/2022/may/06/no-exception-rape-incest-anti-abortion-laws-republicans-us
CDC. “About Teen Pregnancy” https://www.cdc.gov/teenpregnancy/about/index.htm#:~:text=The%20Importance%20of%20Prevention&text=Pregnancy%20and%20birth%20are%20significant,adolescence%20graduate%20from%20high%20school.
Richard Fry. “Some gender disparities widened in the U.S. workforce during the pandemic” https://www.pewresearch.org/fact-tank/2022/01/14/some-gender-disparities-widened-in-the-u-s-workforce-during-the-pandemic/
Michelle Fox. “Men have been promoted 3 times more than women during the pandemic, study finds” https://www.cnbc.com/2020/10/13/pandemic-fallout-men-got-3-times-more-promotions-than-women.html
Monique Morrissey. “Women over 65 are more likely to be poor than men, regardless of race, educational background, and marital status” https://www.epi.org/publication/women-over-65-are-more-likely-to-in-poverty-than-men/#:~:text=As%20women%20get%20older%2C%20they,percent%20and%2017%20percent%2C%20respectively.
Sarah Miller, Laura R. Wherry, Diana Greene Foster. “The Economic Consequences of Being Denied an Abortion” https://www.nber.org/papers/w26662
Ran Barzilay, Jonathan Zandberg, Rebecca Waller. “Restricted abortion access linked to increased suicide risk in young women” https://penntoday.upenn.edu/news/restricted-abortion-access-linked-increased-suicide-risk-young-women
Dawn Stacey. “The History of Emergency Contraception” https://www.verywellhealth.com/the-history-of-emergency-contraception-906714
Wendy Sawyer. “The Gender Divide: Tracking Women's State Prison Growth” https://www.prisonpolicy.org/reports/women_overtime.html
Robin Levinson-King. “US women are being jailed for having miscarriages” https://www.bbc.com/news/world-us-canada-59214544
Sarah Emerson, Emily Baker-White. “In A Post-Roe America, Googling "Abortion" Could Put You At Risk. Here’s How To Protect Yourself.” https://www.buzzfeednews.com/article/sarahemerson/abortion-digital-privacy-guide
Joseph Cox. “Data Broker Is Selling Location Data of People Who Visit Abortion Clinics” https://www.vice.com/en/article/m7vzjb/location-data-abortion-clinics-safegraph-planned-parenthood
Maria Ricapito. “Forget Tracking Your Period—Your Period (App) Is Tracking You” https://www.marieclaire.com/health-fitness/a33897772/period-pregnancy-tracker-risks/
Marie Solis. “Texas abortion vigilantes: how the ban empowers anti-choice citizens to sue” https://www.theguardian.com/world/2021/sep/08/texas-abortion-vigilantes-sb8-citizens-sue
Center for Reproductive Rights. “Vigilante Abortion Ban Takes Effect in Oklahoma” https://reproductiverights.org/vigilante-abortion-ban-takes-effect-in-oklahoma/
January W. Payne. “Forever Pregnant” https://www.washingtonpost.com/wp-dyn/content/article/2006/05/15/AR2006051500875.html
ACLU. “Healthcare Denied” https://www.aclu.org/issues/reproductive-freedom/religion-and-reproductive-rights/health-care-denied
Brittni Frederiksen, Matthew Rae, Tatyana Roberts, Alina Salganicoff. “Abortion Bans May Limit Essential Medications for Women with Chronic Conditions” https://www.kff.org/womens-health-policy/issue-brief/abortion-bans-may-limit-essential-medications-for-women-with-chronic-conditions/
Jennifer Savin. “Professor sparks backlash after suggesting 'brain dead' women could have their bodies used to carry babies” https://www.cosmopolitan.com/uk/body/health/a42771871/brain-dead-women-surrogate/
Manny Fernandez, Erik Eckholm. “Pregnant, and Forced to Stay on Life Support” https://www.nytimes.com/2014/01/08/us/pregnant-and-forced-to-stay-on-life-support.html
Moira Donegan. “Roe v Wade has been overturned. Here’s what this will mean” https://www.theguardian.com/commentisfree/2022/jun/24/overturning-roe-story-is-women-unfreedom