Why restrict an already safe abortion procedure?
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Tanya came to me for an abortion. She has two children and despite working two jobs, has the means to raise one and is pregnant with a third.
She is a resilient woman, but this additional pregnancy is one too many. She feels stigma and shame walking into the abortion clinic, but this is actually more a commentary on our ethics and morality as society than on the “immorality” and shame of Tanya and thousands of American women like her.
By failing to provide adequate access to affordable contraception, by failing to offer enough jobs that pay a living wage, by failing to address health disparities, we have failed poor women, many of whom are women of color.
They come to me to take care of the pregnancy, so they can find a better paying job, finish their education or training, and try to scrape by and hopefully scrape up a better life.
Women need access to safe and legal abortion. Only this health service has become marginalized in our health care system. Increasingly, it is subject to “safety” restrictions that have nothing to do with the health and safety of women who need the service and everything to do with restricting access to abortion.
Abortion is at its root a public health and safety issue. Strikingly, the numbers of abortions were fairly constant before and after the Roe v. Wade decision, at roughly one million per year.
The difference legality has made is in safety, for all women and especially for poor women of color.
Pre-Roe, middle class and wealthy women could usually find a doctor who would walk them through the hospital’s review board process and help them make their case for mental health or other dispensation. It was often poor women who were driven to the clandestine back alley abortionists, at risk to their health and even their lives. It is estimated that about 5,000 US women died per year pre-legalization in the years leading up to the US Supreme Court’s Roe v. Wade decision.
Today, 88 percent of abortions are performed in the first 12 weeks when complications are exceedingly rare (0.5 percent) and most of the complications that occur can be handled in the physician’s office or clinic.
Our goal should not be to eliminate abortion but to address circumstances that lead a woman to choose abortion, and then to make sure that safe, legal abortion is there as a backup because we are not able to reduce all risk.
Under the auspices of increasing abortion’s safety, legislatures across the country have passed more than 200 restrictions on abortions in the past four years. In reality, these new laws only create burdensome restrictions on abortion providers because legal, induced abortion is already safe. Like mandatory waiting periods and forced ultrasounds, their sole purpose is to make abortion harder, even impossible, to get. When practicing in Mississippi, I am forced to lie to women and tell them abortions may cause breast cancer — a lie which has been scientifically disproven.
All of these restrictions have led to this: the latest data available shows that in 2011, 89 percent of US counties lacked an abortion clinic. With the proliferation of new abortion restrictions, there is reason to believe that the number of providers will continue to fall. We are closer than at any time post-Roe to the specter of nowhere to get a safe, legal abortion. That is the real shame.
Parker, MD, MPH, MSc, is a Physician and Reproductive Justice Advocate and Board Member, Physicians for Reproductive Health. Copyright: American Forum.
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