A lot. On June 24th, the U.S. Supreme Court ruled 6-3 to overturn Roe v. Wade, which had protected the federal right to an abortion for almost 50 years. The Supreme Court ruled in Dobbs vs. Jackson Women’s Health Organization that the Mississippi state law that bans most abortions after 15 weeks could stand. Instead of allowing women to make their own decisions about whether to have an abortion, that decision-making power now rests with state governments. 

Your ability to get an abortion is now dependent on where you live and what you can afford.  When Roe fell thirteen states had pre-existing “trigger laws”, intended to ban or restrict abortion if Roe was overturned. Other states had abortion laws on the books that were so old, they were written before women could vote. And many other states like Indiana and West Virginia moved quickly to enact new legislation.

Currently, 14 states have a full ban on abortion: Alabama, Arizona, Arkansas, Idaho, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, South Dakota, Tennessee, Texas, West Virginia and Wisconsin. Georgia, Florida, Utah and North Carolina have partial bans, with some starting as early as 6 weeks. An additional 8 states have abortion bans that are currently blocked by the courts, but this can change at any time. The blocked bans are: Indiana, Iowa, North Dakota, Michigan, Montana, Ohio, South Carolina and Wyoming. Many of these bans make no exception for rape, incest or the health of the mother. A majority of the states with bans are in the southeast or midwest, making it very challenging to get abortion care in these parts of the country.

In 15 states abortion access is protected by the state constitution or state law. An additional 9 states plus Washington, D.C. have legalized abortion but the right is not protected, so changes in state government could affect reproductive rights in these states.

Less than three months after the fall of Roe, Republicans revealed their plans for a national ban. Initially, many Republicans claimed that abortion laws should be left up to the states, but in September Senator Lindsey Graham introduced a federal ban on abortions at 15 weeks, promising to pass the legislation if Republicans take over Congress.

That is a great question. A whopping 80% of Americans support a woman’s right to choose, however a small minority used the power of the court to overturn Roe. Abortion can be a complex and emotional issue for some people and special interests have spent years and billions of dollars to try to exploit those emotions and divide us. Most Americans agree, abortion is a deeply personal choice between a woman and her doctor and should not be dictated by the government. Recent polling shows that regardless of whether someone aligns as pro-choice or pro-life, over two thirds of Americans want the government out of this decision. Americans overwhelmingly support reproductive freedom.

A quick look at our history will tell you that eliminating access to abortion does not reduce the number of abortions, it just eliminates the number of safe abortions. In fact what is proven to reduce the number of abortions is easy access to birth control and affordable healthcare.

When Roe became law in 1973, illegal abortions were considered to be a public health crisis due to the number of women who were harmed and even killed from their prohibition. The legalization of abortion provided women a safe option in their reproductive healthcare.

So why now? Who the hell knows, but it is certainly not about reducing the number of abortions, which have been declining for years.

On September 13th Republican Senator Lindsey Graham introduced legislation for a national abortion ban. Although Graham was unable to answer specifics about his legislation, it would effectively ban abortion at 15 weeks of pregnancy, throughout the United States. A federal ban would supersede any state laws or protections of abortion access. However, the law would allow states to continue to enact stricter abortion bans, including full bans. Graham made it clear that if Republicans won the Senate and the House, they would vote on this legislation. They did not take the Senate majority and their majority in the House is slim, so it remains to be seen what next steps they will take.

Women most affected by a 15-week abortion ban are those carrying a non-viable pregnancy due to fetal abnormalities that are often not discovered until the 20-week anatomy scan. Every day we hear stories of women who desperately wanted their pregnancy but found out that their fetus was not compatible with life. During the most painful of times, women need access to all of their reproductive choices to make the best decision for their family. The government should not be making decisions about women’s access to safe reproductive healthcare.

Throughout the spring and summer, Republican politicians claimed that the Supreme Court ruling in Dobbs would not result in a federal ban on abortion. They repeatedly stated that elected officials in each state would have the right to make laws protecting or banning abortion. The federal abortion ban is in direct violation of their previous statements and shows they cannot be trusted. Republicans all across the country removed any mention of abortion bans from their websites. They know that their ideas are too extreme for the majority of Americans. The announcement of the proposed federal ban reminds us that extremist politicians are trying to take away our freedom. They think they can fool us by changing their websites, but suburban women know better. 

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Yes! Voters overwhelmingly turned out in support of reproductive rights in 2022, securing protections in every state where it was on the ballot. An early sign of support came during the primary elections in Kansas, when voters rejected a proposed amendment to their state constitution that would have removed the right to abortion. That success was repeated in five more states in November. In Kentucky and Montana, voters defeated similar ballot measures that would have limited abortion rights in their states. In California, Michigan, and Vermont, voters approved measures to enshrine reproductive rights in their state constitutions through constitutional amendments. Candidates who supported abortion bans were also defeated in important Governor races in Arizona, Michigan, Pennsylvania, and Wisconsin. These successes show us that our movement is strong and if we organize and stay active, we can protect reproductive freedom in more states.

Several recent studies show a correlation between restrictions on abortion care and maternal mortality rates. From 2015 to 2018 there was a 7% increase in maternal mortality in states with significant restrictions on abortion. Before the fall of Roe, the United States already had a high maternal mortality rate for a first-world nation. We are one of the only countries with an increasing maternal mortality rate. Now as states continue to pass extreme legislative bans on abortion care, the medical community is warning that maternal mortality will continue to increase nationwide. To put it bluntly, more women will die due to pregnancy and childbirth complications and the inability to get the medical care they need.

In addition, black women are already 3-4 times more likely to die during childbirth than white women in the U.S. Roughly 60% of these deaths are preventable but restricting maternal healthcare with abortion bans will only further limit what doctors can do to save the lives of mothers. 

A common misconception is that abortions are mostly used as a form of birth control by young, unmarried women. But in reality, more than half of the women who get abortions report using contraception. We also know that the majority of abortions performed in the U.S. are on women who are already mothers. In fact, concern for their children is a motivating factor, with nearly half of the women reporting that providing for the children they already have is their reason for seeking an abortion. 75% of women who get abortions live at or below the federal poverty level.

Despite what extremists want you to believe, almost all abortions occur within the first trimester, and the majority of those happen shortly after someone discovers they are pregnant. Only 1% of abortions are performed after 20 weeks and those are almost exclusively due to fetal abnormalities that are not consistent with life, or to save the life of the mother. Abortions performed later in pregnancy are often women who want to be mothers but discover their fetus will not be able to live outside the womb. 

Approximately 1 in 4 women will have an abortion in their lifetime, which means you probably know and love someone who has had one.

An estimated 1 in 4 pregnancies end in miscarriage, which is the natural loss of a pregnancy. Did you know that a miscarriage is also called a spontaneous abortion? After a miscarriage, medical treatment may include surgical or medical interventions to save the life of the mother. The surgical option is called Dilation and Curettage (D&C). The medical option includes the use of the drugs mifepristone and misoprostol. 

D&C, mifepristone, and misoprostol are also the surgical and medical options for abortions. Because the same procedures are used for both abortions and miscarriage treatment, many women and doctors are now calling attention to the fact that the healthcare procedures are the same, and that new abortion restrictions may have harmful consequences on women experiencing miscarriage. Keep reading to learn more about surgical and medical abortions and miscarriages.

Dilation and Curettage (D&C) is a surgical procedure that removes uterine lining and tissue from a woman’s uterus. It is a necessary clinical intervention to clear the uterus of all remaining tissue and prevent bleeding, hemorrhaging, infections, sepsis, and other potentially fatal complications. D&C is also the clinical intervention used to end a pregnancy during a surgical abortion. So, the exact same clinical treatment used for surgical abortions is also used for miscarriage treatment. It’s the same procedure, with the same doctors, the same instruments are used, and it’s the same in the eyes of medical insurance companies. 

A medical abortion is when a pregnancy is ended using medicine (as opposed to surgery). The drugs mifepristone and misoprostol are used to end pregnancies. The drug methotrexate is used to end ectopic pregnancies, which are when the fertilized egg has implanted itself outside of the woman’s uterus. Ectopic pregnancies are never viable and can be fatal to the mother if untreated. Mifepristone and misoprostol can also be used as medical interventions in natural miscarriages. So again, the medical treatment for miscarriages is the same as for medical abortions.  

Because the surgical and medical treatments for abortions and miscarriages are the same, any bans on abortion care may also impact miscarriage care. Doctors and patients all over the country are already sharing stories where this has happened. Laws that restrict abortions could also apply to miscarriages. Doctors and hospital lawyers are sounding the alarm on this issue, noting that recent abortion laws are intentionally vague and difficult to interpret. With some laws not only restricting abortions, but also criminalizing medical treatment and actions, a lot is at stake for patients and providers. Meanwhile, while they struggle to figure it all out, patients are experiencing delayed care, or worse, not getting the healthcare they need at all.

Without medical intervention, miscarriages can take days, weeks, and even months to occur. During this time, dangerous, life-threatening health complications may arise. Not to mention the mental toll it takes on the mother, adding to her trauma. To ask a woman to endure this when there are proven, safe medical interventions available is harmful and unfair. These interventions, which are safe and have become standard practices of care in medicine, should be available for all women, regardless of why they need them.

Contraception – After the fall of Roe, 195 Republicans in the house voted against protecting the individual right to access contraception and the right for medical providers to prescribe it. In some states, legislators are moving to criminalize abortion, including certain methods of contraception that stop a fertilized egg from implanting, like an IUD or intrauterine device. If laws that classify abortion as a homicide are passed, then women could even face prison time or criminal charges for an IUD, a spontaneous miscarriage, or for treatment of an ectopic pregnancy. There is also concern that if the right to privacy falls, our right to contraception will be tested in court. 

Miscarriage – As stated above, the medical treatment for miscarriage is the same treatment for abortion care. We are already seeing situations in Texas and other states with bans, where women who naturally experience a miscarriage are being denied medical help. In some instances, doctors are consulting lawyers and waiting for the situation to be fatal, before providing life saving care to the woman. Pharmacies are refusing to fill prescriptions for women who need this medicine as well. There are also reports of women being questioned about what medications they took prior to their miscarriage to prove it was natural and spontaneous.   

IVF – Going against modern science, some state legislatures have decided to define the start of life as the moment of fertilization, when an egg and sperm meet. Under this ideology, an embryo created for IVF would be considered a human life. Families who go through IVF often have multiple embryos created which are frozen or discarded. It is currently unknown if state governments will try to force implantation of these embryos but many parents are rushing to store their embryos in states that protect the rights of the parents.   

Ectopic Pregnancy – An ectopic pregnancy is an incredibly dangerous situation that can result in the death of the mother if left untreated. An ectopic pregnancy occurs when a fertilized egg implants outside of the uterus and, despite what some politicians have said, it CANNOT be re-implanted into a uterus. It is a non-viable pregnancy and must be treated immediately to save the mother’s life. There is concern that some state legislatures will move to deny medical care for women experiencing an ectopic pregnancy, which could mean death for the mother.

The medicines that are used to treat miscarriages and abortions also have other uses. Misoprostol can be used to treat stomach ulcers and arthritis symptoms. It also helps open a cervix for other procedures, like IUD insertion, and to induce labor. Mifepristone is used to treat high blood sugar (hyperglycemia) in patients with Cushing’s disease and type 2 diabetes. Methotrexate, used to end ectopic pregnancies, is also the “gold standard” treatment for several common autoimmune disorders including: rheumatoid arthritis, juvenile arthritis, inflammatory bowel disease, ulcerative colitis, Crohn’s disease, Multiple Sclerosis, lupus, psoriasis, and many cancers. If restrictions are placed on prescribing these medications for abortion or miscarriages, it can also impact patients who need them for all these other conditions. In fact, many patients across the country are starting to report challenges with getting their methotrexate prescriptions because of recently introduced abortion bans.

Abortion bans affect all women in the United States. As you read above, many medications used to treat abortion and miscarriage are being denied to patients using them for other healthcare reasons. All across America, women are experiencing greater difficulty getting medication that treats  auto-immune diseases, cancer and a variety of different health issues. Some women have also reported trouble filling their birth control prescriptions. 

For women seeking abortions, the bans will force them to travel hundreds of miles, across many state lines to access safe abortion. They will need to take time off work, look for child care, and pay for travel expenses in addition to the cost of an abortion. The costs rise considerably as less options for safe care are available. 

We all know that banning abortions does NOT stop abortions from happening, it just leads to unsafe, back-alley abortions. Women with the financial ability to travel out of state, take time off work, and provide for childcare will have an easier time accessing a safe abortion in states that are protecting women’s rights. Women of color will be disproportionately affected by state bans on abortion and women who live in poverty may be unable to afford the increased expense of an abortion. Women who live in the south and mid-west will have longer distances to travel to find access to abortion care.

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Studies have shown that when a woman is denied an abortion, she suffers economic harm both immediately, and in years following. 

Having a baby is expensive. One study found that the average cost of having a baby is close to $3,000 if the mother has private insurance through a large employer. That’s what the mom ends up paying out of an average billing just under $19,000. And these are just costs related to the pregnancy, birth, and immediate postpartum care. This doesn’t include earlier prenatal care or other expenses related to pregnancy like over-the-counter pain meds, comfort care, maternity clothes, or psychiatric needs. 

 The $3,000 estimated cost also doesn’t account for higher risk pregnancies that require more healthcare services at additional cost. The Turnaway Study showed that women who were denied an abortion had more life-threatening complications during their pregnancy and more long-term health issues, all of which adds personal financial burden.  

Many people do not have this kind of cash readily available. A study found that 45% of single person households, and about ⅓ of multi-person households, don’t have more than $2,000 available to pay for medical bills.  

Raising a child is also expensive. The costs don’t end once a baby is born. In fact, they are just beginning. First, there may be lost income if the mother doesn’t have paid parental leave from her employer. Then there is the cost of infant and child healthcare, and all the other non-medical costs like child care and support over the years as the child grows up. These expenses increase the odds of the parents taking on new debt, medical or otherwise, which compounds over time. 

This all equates to economic harm. The Turnaway study found that women who were denied an abortion are four times more likely to live below the Federal Poverty Level than counterparts who sought and did have an abortion. 72% of women who couldn’t get an abortion lived in poverty, compared to 55% of women who were able to get an abortion. For years following, the women who had children were more likely than the women who had abortions to not have enough money to cover their living expenses. They were also more likely to be late paying their bills, had lower credit scores, and saw those scores decline. They saw their debts increase and experienced more negative events like bankruptcies, evictions, and tax liens. All of these factors mean that women who are unable to get an abortion when they want one are more likely to have decreased financial security and less stable economic conditions in which to support their family.    

Roe v. Wade has guaranteed your right to an abortion for almost 50 years.  It all started with Jane Roe, a mother in Texas who sued the state because it denied her the right to terminate a pregnancy.  In 1973 the Supreme Court ruled 7-2 in favor of Roe, declaring that the due process clause of the 14th amendment guaranteed a “right to privacy” (more on this below) that protects a woman’s right to choose whether to have an abortion. 

Through a variety of Supreme Court cases, it has been determined that Americans have an inherent right to privacy, protected by the 1st, 3rd, 4th, 5th, 9th and 14th Amendments of the Constitution. Our right to privacy protects us from government interference. This right to privacy is also the basis for other rights, like same-sex marriage and access to contraception. There is real concern that the fall of Roe could result in other rights being re-litigated and taken away. That’s why Democratic leaders in Congress acted quickly to pass the Respect for Marriage Act. Even if you don’t think you’ll be personally affected by the right to choose when and if you have a family, this is absolutely the time to act and speak up for all our rights.

The short answer is no. Roe cannot be reinstated. But there are other ways that abortion rights can be protected through legislation at both state and federal levels. Remember, Republicans made it clear that they wanted to pass a federal ban if they took control of Congress. We must pass federal legislation to protect reproductive freedom. We must also work to enshrine reproductive rights at the state level.

When people say we must codify Roe, they are asking their state and federal legislators to pass laws that will protect a woman’s right to abortion. Some states such as California and Colorado have already passed legislation to protect a woman’s right to choose. Federally we do not currently have the votes to pass such legislation because of the filibuster in the U.S. Senate. 

To pass federal legislation that would protect abortion access we need a majority of the House of Representatives and 60 Senators to vote in support of the law. Without that, the Republicans can filibuster to stop or delay the vote.