The Supreme Court’s decision to overturn the landmark Roe v. Wade case is a crushing disappointment on several levels, not the least of which is that it will set women back financially, academically, and professionally. No amount of justification will ever get around that reality.
In health care, we often talk about the paradox of how one’s zip code defines their life expectancy. We have recognized the absurdity of this, and health care providers are working hard to mitigate the effect of local environment on health. The overturning of Roe v Wade doubles down on the impact of zip code on health and well-being – in this case just for women, particularly low-income women, and their right to define their future.
The reversal will return women to the 1970’s when safe abortion was only available to young women with means or access to a provider who would perform such a procedure out of their scope of practice. This decision will not limit safe and effective abortions for those women; it will limit abortions for low income or isolated women living in the 26 states that now have the legal freedom to ban abortions. These are women who don’t have the money to travel to a state where abortion is legal or the emotional resources to make that trip.
Fifty years ago, when abortion became legal, women’s lives were dramatically changed for the better. Abortion care came out of the back rooms and was delivered in safe and supportive environments. Women were free to follow their life goals and aspirations without the lifetime burden of an unwanted and unplanned pregnancy.
The economic toll on women (not the male partner) with such a pregnancy has been clearly defined. Consider the following:
- In a study of 1,000 pregnant women over five years, women unable to get an abortion had financial challenges including a 78 percent increase in unpaid bills and an 81 percent increase in issues like bankruptcies and evictions, compared with the women who were able to get an abortion (Advancing New Standards in Reproductive Health program at University of California San Francisco)
- Abortion restrictions already on the books in states reduce the number of working women and cost the nation’s economy an estimated $105 billion a year (Institute for Women’s Policy Research)
As a young public health nurse, one of my professors shared a poem about a community whose residents kept falling off a small cliff and getting hurt. Instead of building a fence at the cliff to prevent people from falling, town leaders decided to put an ambulance at the bottom of the cliff to take people who fell to the hospital. I tend to look at health care problems from a lens of prevention. What can we do so that we don’t have the problem to solve?
Repealing a woman’s right to choose is hardly the answer.
We need to help, support, and empower young women to have easy access to birth control. We need to support pharmaceutical research on birth control methods that don’t have side effects - and that can be the responsibility of both men and women.
All women who find themselves in this most vulnerable position need access to abortions provided by health care providers in safe and supportive environments. When a woman finds she has an unwanted pregnancy, we need structures and models to help her decide thoughtfully and quickly, so she avoids the emotional trauma of late-term abortions.
We need to recognize a women’s right to choose her path in life is absolute and that includes her right to choose her reproductive path. We must continue to advocate for full reproductive rights in all states and for all women, not just for those who have the economic resources to define their future.