On the 51st Anniversary of Roe

On January 22, 2013, along with so many in my community, I celebrated the 40th anniversary of Roe v Wade. At the time, we had an incredible president, a relatively sane Supreme Court, and the momentum of millions of women who benefited from Roe over 40 years. Hard far right conservatives were (generally) laughed off the country’s political stage as the dangerous whack jobs they are. We were progressing as a nation, keeping pace with the vast majority of the world regarding abortion rights. No one would have ever thought with any seriousness that a narcissistic, sociopathic fascist wannabe would or could become the President of the United States and change the course and meaning of our Supreme Court and constitution for a generation.

Here we are. Eleven years later. Marking the 51st anniversary of one of the most important decisions in the lives of women and families that was ripped out from under us. Instead of celebrating, we’re mourning the lives of thousands of women who have already died due to anti-abortion laws and the tens of thousands more who will continue to be negatively impacted with the decision in Dobbs v Jackson Women’s Health overturning Roe.

In a country that already had the highest maternal mortality rate in the developed world, overturning Roe has resulted in an increase in maternal mortality. Women in states with anti-abortion laws are three times more likely to die during pregnancy, child birth, or soon after giving birth than are women in other states. Even before Roe was overturned, maternal mortality rates were 62 percent higher in states with anti-abortion laws than in other states. Women of color are three times more likely than white women to die. In addition, in a survey of OB-GYNs, 70 percent of respondents said that overturning Roe has worsened racial and ethnic inequalities in women’s healthcare.

Not only do anti-abortion laws increase maternal mortality, they also increase infant mortality. Since Roe was overturned, there has been a sharp spike in infant mortality after rates had been decreasing for nearly a decade. Babies born in states with anti-abortion laws are 30 percent more likely to die in their first month of life than are those born in other states, according to research by the Gender Equity Policy Institute.

In Texas alone, more than 2,000 infants died in 2022, an 11.5 percent increase from 2021. And while about 10 percent of Americans live in Texas, about 14 percent of all maternal deaths have been in the state. In fact, the infant mortality rate of Texas is higher than the overall infant mortality rate in the country as a whole. It’s likely no coincidence that Texas purposefully delayed its annual maternal mortality review report that was scheduled for early 2022. (Separately, Idaho disbanded its maternal mortality review committee altogether!)

Alternately, maternal and infant mortality rates have been improving in states that support comprehensive reproductive health, including abortion.

States with anti-abortion laws also have twice as many teen pregnancies as do other states. This is likely because states that ban abortions are also states that ban comprehensive sex education. In addition, states with anti-abortion laws have twice as many single mothers who are uninsured as do other states. Health insurance has been shown to reduce maternal mortality.

The lack of abortion access is not the only reason women and infants are dying. Forty percent of OB-GYNs in states with anti-abortion laws surveyed said they faced constraints in caring for patients experiencing miscarriages and other pregnancy-related emergencies. More than half said their ability to practice within the standard of care has become worse since Roe was overturned. Nearly two-thirds of all OB-GYNs surveyed believe that overturning Roe has worsened maternal mortality. More than half also believe the decision has inhibited the ability to attract new doctors to the field. New OB-GYNs in training also may not receive the required training to get licensed. Nearly half of accredited programs now operate in a state with a anti-abortion laws. Of those already in the field, many have or are planning to leave states with anti-abortion laws to go to other states that protect abortion rights. A survey of medical school students, residents, and faculty revealed that 82 percent want to train and work in states that have abortion access; more than three-quarters of all respondents would refuse to apply in states with anti-abortion laws. When narrowed to the practice of obstetrics, 99 percent said they want to work where abortion is legal. The first round of residency program applications after Roe was overturned showed a ten percent reduction in applications in states with anti-abortion laws compared to the previous year.

More than a third of U.S. counties across the country already have no obstetrics providers, in addition to having no hospital or birthing center with OB-GYNs. This is particularly dangerous for women in rural areas.

According to the Centers for Disease Control and Prevention, 80 percent of all pregnancy-related deaths in the United States are preventable.

So much for being “pro-life.”

The Dobbs decision overturning Roe will have broader, generational impacts. A poll of women ages 18 to 39 found that more than a third — regardless of where they live — said they or someone they know has “decided not to get pregnant due to concerns about managing pregnancy-related medical emergencies” after the Dobbs decision. Women are afraid to get pregnant because of the anti-abortion laws that have swept the country. Planned Parenthood CEO Alexis McGill Johnson summed up the problem succinctly: “Abortion bans make pregnancy less safe, and women are acutely aware of the consequence of restricting access to reproductive health care in their own lives.” With the already declining birth rates, this could have long-term impacts.

As one author stated, “It is time to recognize the ethical implications of this decision for people with and children of unwanted pregnancy.” Indeed. It is time. I hope that voters realize that and show up to vote.

With so much damage and danger the Dobbs decision caused, marking the anniversary this year is more bitter than sweet.