Let’s look ahead. What if the landmark Roe v. Wade decision is gutted or overturned? My first thoughts go to my teen daughter, Caroline; my nieces, Haley and Isabelle; and all their girlfriends.
The recent ideological shift on the U.S. Supreme Court has put many of us on high alert, ready for a fight we didn’t ask for, but ready to do what is necessary to ensure abortion care remains safe and available. If abortion rights are weakened or rescinded by the Court, Caroline, Haley, and Isabelle would, thankfully, not be returning to a pre-1973 world where, in many states, obtaining an abortion meant risking one’s health or even death. But, they would face obstacles to getting care, and even possible prosecution.
With the advent of medication that safely ends an early pregnancy, even in a post-Roe world, if my gals need an abortion they’ll have options other than facing risky procedures in shady settings performed by someone with questionable credentials.
Medication abortion in the U.S. relies on a two-pill combination: mifepristone and misoprostol. After more than 15 years of use in the U.S. and more than 30 years elsewhere, doctors know it is extremely safe and effective. Right now, about 45 percent of American women obtaining abortion during the first nine weeks of pregnancy choose pills rather than a medical procedure.
I can imagine that if my super-independent Caroline ever needs abortion care, she might well go the medication route, inducing her own miscarriage, instead of a surgical procedure. She’s one to appreciate the autonomy that comes with managing her own care.
The availability of abortion pills has cut the rate of unsafe abortions around the world, particularly in countries where abortion is illegal or heavily restricted. In Brazil, for example, where it’s banned, treatment rates for severe complications from abortion declined by 76 percent since 1992 as more Brazilians have turned to medication to end pregnancies.
Abortion medications are on the World Health Organization’s (WHO) list of essential medicines, the definitive directory of effective and safe medicines needed in a nation’s health system. And WHO has a published protocol for women to use the drugs to self-manage abortion, without direct provider supervision.
International medical providers, like Aid Access, provide medication abortion via telemedicine to women who cannot otherwise access abortion care. Undoubtedly, if Roe is overturned, American women, just like their sisters around the world living where abortion is illegal, will turn to medication abortion, ordering it from overseas suppliers if necessary, to manage abortion at home.
Still, although she will not be risking her health or life, I do worry that if my daughter lives in a state that criminalizes abortion post-Roe, she may face legal risks if she chooses this route. No one, including Caroline, should fear jail for ending her pregnancy or for seeking medical help, if needed. As a person of color and an immigrant, she would face disproportionate risk of prosecution. If medical assistance is sought after an abortion, I hope my girl finds doctors who actively reduce harm to make sure she can safely receive care and who create safe places where women will not face risk of arrest.
Women throughout history have needed to end pregnancies. In our age, my daughter, my nieces, and my friends should be able to decide, with dignity, on the care that best meets their needs.
If an extremist majority on the U.S. Supreme Court deny us that right, we can rest at least somewhat assured that, unlike times past, medication exists that will make obtaining an abortion less risky health-wise, even though legal risk will continue. Because of that, we all must remain vigilant in protecting policies that positively impact the health and lives of women like Caroline, Haley, and Isabelle, vigorously defending against the criminalization of abortion at every turn.
Amy Weintraub is the Reproductive Rights Program Director for Progress Florida, a statewide organization dedicated to winning a more progressive Florida – www.ProgressFlorida.org