tag:theconversation.com,2011:/fr/topics/reproductive-rights-3801/articlesReproductive rights – The Conversation2024-03-26T20:54:50Ztag:theconversation.com,2011:article/2266702024-03-26T20:54:50Z2024-03-26T20:54:50ZAbortion drug access could be limited by Supreme Court − if the court decides anti-abortion doctors can, in fact, challenge the FDA<figure><img src="https://images.theconversation.com/files/584450/original/file-20240326-30-a29mv8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Pro-abortion rights activists rally in front of the Supreme Court on March 26, 2024, the day justices heard oral arguments about the use of mifepristone.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/abortion-rights-activist-rally-in-front-of-the-us-supreme-news-photo/2107843451?adppopup=true">Drew Angerer/AFP via Getty Images </a></span></figcaption></figure><p><em>Who has the legal right to challenge decisions by the U.S. Food and Drug Administration? And should the moral umbrage of a group of anti-abortion rights doctors shift policy across the country, limiting women’s ability to get the widely used abortion drug mifepristone?</em></p>
<p><em>These are a few of the central questions that the <a href="https://www.cbsnews.com/news/supreme-court-abortion-pill-arguments-mifepristone/">Supreme Court fielded on March 26, 2024</a>, during the oral arguments in <a href="https://www.scotusblog.com/case-files/cases/food-and-drug-administration-v-alliance-for-hippocratic-medicine-2/">FDA v. Alliance for Hippocratic Medicine</a>. A group of doctors is challenging the FDA, saying that the federal agency’s decision allowing people to get mifepristone via telehealth, at up to 10 weeks of pregnancy, is causing some medical professionals harm.</em></p>
<p><em>Amy Lieberman, politics and society editor at The Conversation U.S., spoke with family law and reproductive justice scholars <a href="https://scholar.google.com/citations?user=gCJEShUAAAAJ&hl=en">Naomi Cahn</a> and <a href="https://www.law.gwu.edu/sonia-m-suter">Sonia Suter</a> to better understand what’s behind the oral arguments before the Supreme Court – and how the court’s eventual decision, expected in June, could affect people’s ability to get abortions by using mifepristone, one of two drugs used for medication abortion.</em> </p>
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<a href="https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="White boxes of Mifepristone are seen stacked in a shelf." src="https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=900&fit=crop&dpr=1 600w, https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=900&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=900&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=1131&fit=crop&dpr=1 754w, https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=1131&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/584469/original/file-20240326-26-9qpi95.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=1131&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">A cabinet holds mifepristone at a health clinic in Casper, Wyo., in June 2023.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/cabinet-containing-mifepristone-seen-in-wellspring-health-news-photo/1258730531?adppopup=true">Rachel Woolf for The Washington Post via Getty Images</a></span>
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<p><strong>What is this case about?</strong></p>
<p><strong>Sonia Suter:</strong> It’s about whether the FDA’s regulations for the use of <a href="https://www.fda.gov/drugs/postmarket-drug-safety-information-patients-and-providers/questions-and-answers-mifepristone-medical-termination-pregnancy-through-ten-weeks-gestation">mifepristone were appropriately loosened in 2016 and 2021</a>. These changes generally make mifepristone more accessible by allowing people to have the medication prescribed via a telehealth visit and then getting the pill in the mail.</p>
<p><strong>Naomi Cahn:</strong> That 2016 regulation also extended the time during which mifepristone could be prescribed, increasing it from seven to 10 weeks gestation. Medication abortions accounted for <a href="https://www.guttmacher.org/2024/03/medication-abortion-accounted-63-all-us-abortions-2023-increase-53-2020">63% of all abortions</a> that occurred in the U.S. in 2023. This percentage has increased since the Supreme Court overturned the constitutional right to an abortion in 2022.</p>
<p><strong>Why are these guidelines being challenged?</strong></p>
<p><strong>Suter:</strong> A group of doctors and medical associations that oppose abortion <a href="https://www.nytimes.com/2024/03/26/us/erin-hawley-abortion-pill-supreme-court.html">are challenging these guidelines</a> and using this court case as a way, we believe, to limit the ability to get an abortion by using medication. </p>
<p>They challenged the drug’s initial approval by the FDA and the relaxed restrictions on how it is used. They claimed that the FDA exceeded its authority, did not rely on proper data and did not have adequate support from scientific studies for its decision that mifepristone could be safely prescribed. Their initial arguments, which the lower court accepted, would have banned mifepristone. But that decision was not upheld by the <a href="https://www.ca5.uscourts.gov/opinions/pub/23/23-10362-CV1.pdf">5th Circuit Court</a>. </p>
<p>Instead, the issues before the Supreme Court focus on whether the FDA should have expanded the use of mifepristone. Virtually all studies have shown that <a href="https://www.nytimes.com/interactive/2023/04/01/health/abortion-pill-safety.html">mifepristone is not dangerous</a>, even with the relaxed conditions on its use. </p>
<p><strong>What is the federal government’s central argument against these claims?</strong></p>
<p><strong>Cahn:</strong> The government is stating that the FDA appropriately reviewed all of the evidence and its decision was appropriate. </p>
<p>Indeed, the attorney representing the mifepristone manufacturer, <a href="https://www.supremecourt.gov/oral_arguments/argument_transcripts/2023/23-235_p8k0.pdf">Jessica Ellsworth</a>, pointed out that <a href="https://apnews.com/article/abortion-pill-mifepristone-redacted-studies-supreme-court-ebd60519fd44dc69c5ac213580d1c1ba#:%7E:text=A%20medical%20journal%20has%20retracted,and%20flaws%20in%20their%20research.">the studies cited by the challengers have either been</a> discredited <a href="https://www.npr.org/sections/health-shots/2024/02/09/1230175305/abortion-pill-mifepristone-retraction-supreme-court">or withdrawn because they were unreliable</a>. </p>
<p>Another critical issue, as <a href="https://www.nytimes.com/live/2024/03/26/us/abortion-pill-supreme-court">U.S. Solicitor General Elizabeth Prelogar said to the justices today</a>, is whether the organization challenging this ruling actually has legal standing – the right to sue – to bring a lawsuit against the FDA. </p>
<p><strong>Why is the question of who can sue the FDA important here?</strong></p>
<p><strong>Suter:</strong> Under U.S. law, you cannot succeed in court every time you are unhappy. The Supreme Court has ruled that the Constitution requires parties who bring suit in federal court to <a href="https://www.law.cornell.edu/constitution-conan/article-3/section-2/clause-1/standing-requirement-overview">have “standing.”</a> This means parties have to show that they have been injured in some tangible way or threatened with such an injury by the acts that are the basis of the lawsuit. In this case, a group of doctors morally opposed to abortion are saying they have been injured. Their claim is that with the changes in the FDA’s regulation of mifepristone prescriptions, patients will come to them in the emergency room, requiring medical care that violates these religious beliefs and causes them stress. </p>
<p>The government’s response is that the FDA is not making them do anything, including prescribe these pills or treat these patients. And <a href="https://www.hhs.gov/conscience/conscience-protections/index.html">there are conscience laws</a> that say if the treatment is against a health care provider’s beliefs, they do not need to provide that care. So the government asks: How are the doctors harmed here?</p>
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<a href="https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A line of people in formal clothing are seen behind barricades outside the Supreme Court on a grey day." src="https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/584543/original/file-20240326-18-ohf6hs.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">People wait outside the Supreme Court to hear oral arguments on mifepristone on March 26, 2024.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/people-wait-in-line-outside-us-supreme-court-to-hear-oral-news-photo/2107843290?adppopup=true">Drew Angerer/AFP via Getty Images</a></span>
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<p><strong>What is your impression from the justices, listening to these arguments?</strong></p>
<p><strong>Cahn:</strong> I was surprised by how much time the justices spent asking about legal standing and whether there was a direct enough connection between the plaintiffs and the FDA’s guidance. </p>
<p><strong>What’s the potential impact of the court’s eventual ruling on this case?</strong></p>
<p><strong>Cahn:</strong> The court’s decision has implications for the whole FDA approval process as well as access to medication abortion, including through telehealth and the mail. If the court rules for the doctors challenging the FDA, mifepristone would still be available, but access to it would be severely limited because people would need an in-person visit before they could get it.</p><img src="https://counter.theconversation.com/content/226670/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Two legal scholars who study abortion-related laws explain what happened at the Supreme Court in a case that could make it harder to get an abortion.Naomi Cahn, Professor of Law, University of VirginiaSonia Suter, Professor of Law, George Washington UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2265282024-03-25T17:08:27Z2024-03-25T17:08:27ZImmaculate: how a nunsploitation film tunes into women’s anger over misogyny and oppression<p><em>Warning: this article contains spoilers</em></p>
<p>Camp, provocative and often kitsch, the “nunsploitation” subgenre rose to prominence in 1970s European cinema. Exemplifying this trend were films including Ken Russell’s <a href="https://www.imdb.com/title/tt0066993/">The Devils</a> (1971) – which received an “X” (18) rating in the UK and the US due to its explicit sexual and violent scenes – and pornographic Italian films <a href="https://www.imdb.com/title/tt0165325/">Images in a Convent</a> (Joe D'Amato, 1979) and <a href="https://www.imdb.com/title/tt0070404/?ref_=fn_al_tt_4">The Nun and the Devil</a> (Domenico Paolella, 1973).</p>
<p>Many film critics have been labelling <a href="https://www.theguardian.com/film/2024/mar/20/immaculate-sydney-sweeney-review#:%7E:text=Immaculate%20isn't%20above%20the,be%20both%20laughable%20and%20refreshing.">Immaculate</a>, the new horror film from Michael Mohan (The Voyeurs, 2021), as nunsploitation, but I believe it offers a greater level of sophistication than this label suggests, reflecting recent political events in America that have profoundly affected women’s freedoms when it comes to their own bodies. </p>
<p>The film acknowledges the prevalent cinematic stereotype of the “sexy nun”. When Sister Cecilia (Sydney Sweeney) is initially introduced, she is en route to Italy from her previous post in Michigan. She draws the attention of two male border agents who make sexist comments in Italian. Despite not understanding the language, Cecilia senses their meaning. This experience reflects the discomfort many women feel when being harassed or objectified in public spaces.</p>
<p>This early scene hints at the film’s potential to challenge expectations associated with nunsploitation films and address more culturally relevant themes. With lead actress Sydney Sweeney also serving as a producer, the film gains a unique feminist perspective that interrogates the disturbing and increasingly relevant topic of <a href="https://www.weforum.org/agenda/2022/03/what-is-bodily-autonomy-and-why-does-it-matter-for-women/">women’s bodily autonomy</a> – a woman’s power and agency over her own body.</p>
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<p>Sweeney plays Sister Cecilia, a devout young woman who is invited to take her vows at an Italian countryside convent dedicated to caring for elderly nuns in their final years. Cecilia is summoned to a meeting with the convent’s leaders and asked to confirm that she has honoured her vow of chastity.</p>
<p>A subsequent scan reveals her unexpected pregnancy. While the nuns view this as a miracle heralding the second coming of Christ, a sequence of unsettling nightmares and mysterious events hints at a darker force at work.</p>
<p>From satanic cults in <a href="https://www.theguardian.com/film/2010/oct/22/rosemarys-baby-polanksi-horror">Rosemary’s Baby</a> to murderous offspring in <a href="https://www.theguardian.com/film/2017/feb/12/prevenge-review-alice-lowe-sightseers">Prevenge</a>, numerous films have shown that horror can be a powerful genre for exploring anxieties surrounding motherhood. Immaculate exemplifies this, fitting into what journalist Jordan Crucchiola describes as <a href="https://www.vulture.com/2017/03/prevenge-is-proof-we-need-more-horror-movies-about-pregnancy.html">“pregnancy horror”</a>“.</p>
<h2>Reproductive rites</h2>
<p>The film speaks to ongoing concerns about women’s reproductive rights. In 2022 the US Supreme Court <a href="https://www.bbc.co.uk/news/world-us-canada-65956103#:%7E:text=On%252024%2520June%252C%25202022%252C%2520America's,which%2520is%2520about%252024%2520weeks.">overturned Roe v Wade</a>, the pivotal 1973 ruling that established women’s constitutional right to abortion. Since then, <a href="https://www.theguardian.com/us-news/ng-interactive/2023/nov/10/state-abortion-laws-us">14 states have implemented near-total abortion bans</a>.</p>
<p>The overturning of Roe v Wade reflects the growing influence of conservative religious groups on political agendas. Even the self-proclaimed misogynist influencer <a href="https://www.bbc.co.uk/news/uk-64125045">Andrew Tate</a> has <a href="https://www.msnbc.com/opinion/msnbc-opinion/andrew-tates-muslim-conversion-cant-hide-misogyny-rcna64707">used religious rhetoric</a> to spread his extremist ideology.</p>
<p>Just as Margaret Atwood’s dystopian novel <a href="https://www.britannica.com/topic/The-Handmaids-Tale-by-Atwood">The Handmaid’s Tale</a> warned, when far-right politics, male dominance and religious beliefs align, women’s bodies become state property and are subjected to inhumane restrictions.</p>
<p>The shadow of post-Roe America looms over Immaculate. The fact that Cecilia – the sole American nun in the film – finds herself ensnared in an oppressive religious institution controlled by a dangerous patriarch intent on exploiting women’s bodies, speaks volumes.</p>
<p>The nuns insist on treating the pregnant Cecilia like a religious idol, at one point even dressing her to resemble the Virgin Mary. A poignant close-up shot reveals Cecilia’s inner turmoil as she stands motionless, teary-eyed and trapped in circumstances she never consented to.</p>
<p>Despite being worshipped, Cecilia is denied access to proper medical care. She resorts to faking a miscarriage in the hope of being taken to a hospital. Reflecting the sentiments of the post-Roe landscape, the wellbeing of Cecilia’s unborn child is prioritised over her own.</p>
<h2>Women’s bodies and Hollywood</h2>
<p>Sweeney’s role in Immaculate forms a dialogue with her Hollywood star image, especially in light of her remarks in interviews about how her body is perceived by the public.</p>
<p>In a recent <a href="https://variety.com/2024/film/news/sydney-sweeney-immaculate-glen-powell-euphoria-season-3-1235943028/">sit-down with Variety</a>, she reflected on the media’s tendency to objectify her physique, stating: "People feel … free to speak about me in whatever way they want, because they believe that I’ve signed my life away. That I’m not on a human level any more, because I’m an actor”.</p>
<p>Canada’s <a href="https://nationalpost.com/opinion/amy-hamm-wokeness-is-no-match-for-sydney-sweeneys-undeniable-beauty">National Post</a> recently ran a story doing just that, asking: “Are Sydney Sweeney’s breasts double-D harbingers of the death of woke?”.</p>
<p>The themes of bodily autonomy and ownership of women’s bodies explored in Immaculate extend beyond reproductive rights. They also resonate in celebrity culture, where women in the public eye have long battled sexual objectification and intrusive scrutiny of their physical appearances.</p>
<p>From her breakthrough role in <a href="https://www.imdb.com/title/tt8772296/">Euphoria</a> to her powerful leading role in Immaculate, Sweeney has proved herself to be a daring and dynamic actress who deserves to be praised for her talent rather than objectified for her looks.</p>
<p>Cecilia fights back against the patriarchal and religious forces attempting to dictate her bodily autonomy. The film’s climactic act is a bloody and visceral outpouring of female rage. Cecilia’s cries convey not only her personal anguish but resonate as a wider expression of women’s collective anger.</p><img src="https://counter.theconversation.com/content/226528/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Harriet Fletcher does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The increasing misogyny and oppression against women is reflected in this new horror, elevating it to something more than a mere nunsploitation movie.Harriet Fletcher, Lecturer in Media and Communication, Anglia Ruskin UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2251262024-03-11T12:24:14Z2024-03-11T12:24:14ZI’m a political scientist, and the Alabama Supreme Court’s IVF ruling turned me into a reproductive-rights refugee<figure><img src="https://images.theconversation.com/files/580509/original/file-20240307-26-mc43ro.jpg?ixlib=rb-1.1.0&rect=1095%2C1199%2C1403%2C1892&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Spencer and Gabby Goidel hadn't planned to become activists.</span> <span class="attribution"><span class="source">Spencer and Gabby Goidel</span>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span></figcaption></figure><p>The day before the Alabama Supreme Court ruled that <a href="https://apnews.com/article/alabama-supreme-court-from-embryos-161390f0758b04a7638e2ddea20df7ca">frozen embryos created and used for in vitro fertilization</a> are children, my wife, Gabby, and I were greenlighted by our doctors to begin the IVF process. We live in Alabama.</p>
<p>That Friday evening, Feb. 16, 2024, unaware of the ruling, Gabby started taking her stimulation medications, worth roughly US$4,000 in total. We didn’t hear about the decision until Sunday morning, Feb. 18. By then, she had taken four injections – or two doses – of each of the stimulation medications.</p>
<p>For those who don’t know, the <a href="https://theconversation.com/what-is-ivf-a-nurse-explains-the-evolving-science-and-legality-of-in-vitro-fertilization-224476">IVF process is a winding journey</a> full of tests, bloodwork and bills. An IVF patient takes hormones for eight to 14 days to stimulate their ovaries to produce many mature eggs. The mature eggs are then retrieved via a minor surgical procedure and fertilized with sperm in a lab. The newly created embryos are monitored, sometimes biopsied and frozen for genetic testing, and then implanted, usually one at a time, in the uterus. From injection to implantation, one round of IVF takes four to eight weeks. </p>
<p>IVF can be as stressful as it is exciting. However, the potential of having a successful pregnancy and our own child at the end of the process, we hoped, would make it all worth it. The decision by the Alabama Supreme Court threw our dreams up in the air.</p>
<p>I <a href="https://scholar.google.com/citations?user=ow6DhIQAAAAJ&hl=en&oi=ao">study politics</a> – I don’t practice it. I’m not involved in state or local government. I’m a scholar, not an activist or an advocate. But now one of the most intimate, personal events of our lives had been turned into a political event by the state’s highest court. As a result, I became something else, too, which I had not been before: an activist.</p>
<h2>Making sense of the ruling</h2>
<p>Throughout the process of creating, growing and testing embryos in a lab, as many as <a href="https://www.illumefertility.com/fertility-blog/ivf-attrition-rate">50% to 70%</a> of embryos <a href="https://theconversation.com/most-human-embryos-naturally-die-after-conception-restrictive-abortion-laws-fail-to-take-this-embryo-loss-into-account-187904">can be lost</a>. Similarly, in the preimplantation stage of natural pregnancies, <a href="https://doi.org/10.12688%2Ff1000research.22655.1">many embryos don’t survive</a>.</p>
<p>If embryos are children, as the court ruled, then fertility clinics and patients would be exposed to an immense amount of potential legal liability. Under this new framework, patients would be able to bring wrongful death suits against doctors for the normal failures of embryos in the testing or implantation phase. Doctors would either have to charge more for an already expensive procedure to cover massive legal-insurance costs or avoid IVF altogether.</p>
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<a href="https://images.theconversation.com/files/580233/original/file-20240306-30-vi57hp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A screen shows a microscope's view of a needle and cells." src="https://images.theconversation.com/files/580233/original/file-20240306-30-vi57hp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/580233/original/file-20240306-30-vi57hp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/580233/original/file-20240306-30-vi57hp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/580233/original/file-20240306-30-vi57hp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/580233/original/file-20240306-30-vi57hp.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/580233/original/file-20240306-30-vi57hp.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/580233/original/file-20240306-30-vi57hp.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Lab staff at an in vitro fertilization lab extract cells from embryos that are then checked for viability.</span>
<span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/FrozenEmbryos/ebbb52ebd68b4ab691798f90b3319f05/photo">AP Photo/Michael Wyke</a></span>
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<p>The decision and its implication – that IVF could not continue in the state of Alabama – felt like a personal affront to us. We were infuriated to have this uncertainty injected into the process three days into injecting IVF medication. </p>
<p>While the decision clearly imperiled the future of IVF in Alabama, it was not clear to us whether we would be allowed to continue the process we had begun. We were left completely in the dark for the next four days. Gabby and I had no choice but to continue daily life and IVF as though nothing was happening. </p>
<p>For me, that meant teaching my <a href="https://bulletin.auburn.edu/coursesofinstruction/poli/">political participation course at Auburn University</a>.</p>
<h2>Teaching politics when it gets personal</h2>
<p>I’ll never forget walking into class on Monday, Feb. 19, and telling the students about the court’s ruling and how it – maybe? – was going to jeopardize Gabby’s and my IVF process. </p>
<p>Before starting IVF, Gabby and I had gone through three miscarriages together.</p>
<p>IVF doesn’t always work. Approximately <a href="https://nccd.cdc.gov/drh_art/rdPage.aspx?rdReport=DRH_ART.ClinicInfo&rdRequestForward=True&ClinicId=9999&ShowNational=1">55% of IVF patients</a> under the age of 35 – Gabby is 26 – have a successful pregnancy after one egg retrieval. We couldn’t imagine the pain of telling friends and family that our attempt at having a child had once again failed. So we had agreed we were going to tell as few people as possible about starting IVF. </p>
<p>Yet, here I was now, telling my entire class what we were going through and how the Alabama Supreme Court ruling could affect us. </p>
<p>I wasn’t alone in sharing our story. The night before my Monday morning class, Gabby published an <a href="https://www.al.com/opinion/2024/02/guest-opinion-alabama-supreme-court-embryo-ruling-may-make-it-difficult-for-us-to-have-children.html">opinion column</a> on our local news site about the ruling and our resulting fears and anxieties, which really resonated with people.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/578418/original/file-20240227-26-7ak5sq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Clear batches of containers of eggs and embryos in a large, frozen circular container" src="https://images.theconversation.com/files/578418/original/file-20240227-26-7ak5sq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/578418/original/file-20240227-26-7ak5sq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=360&fit=crop&dpr=1 600w, https://images.theconversation.com/files/578418/original/file-20240227-26-7ak5sq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=360&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/578418/original/file-20240227-26-7ak5sq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=360&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/578418/original/file-20240227-26-7ak5sq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=452&fit=crop&dpr=1 754w, https://images.theconversation.com/files/578418/original/file-20240227-26-7ak5sq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=452&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/578418/original/file-20240227-26-7ak5sq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=452&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Cryopreservation gives prospective parents more time to pursue pregnancy.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/frozen-embryos-and-eggs-in-nitrogen-cooled-royalty-free-image/520157312">Ted Horowitz Photography/The Image Bank via Getty Images</a></span>
</figcaption>
</figure>
<p>I was, that day and throughout the next few weeks, fixated on the conceptual gulf between the court’s ruling and public opinion. I wondered aloud, “Who’s against IVF? Surely, only 5% to 10% of the public agrees with this ruling.”</p>
<p>The actual numbers aren’t far off my in-class guess. <a href="https://d3nkl3psvxxpe9.cloudfront.net/documents/econTabReport_XLG2Z6p.pdf">Only 8% of Americans</a> say that IVF is immoral or should be illegal. But the story is more nuanced than that. Approximately <a href="https://www.ipsos.com/sites/default/files/ct/news/documents/2024-02/Axios%20Ipsos%20Alabama%20IVF%20Topline%20PDF%202.28.24.pdf">31% of Americans and 49% of Republicans</a> support “considering frozen embryos as people and holding those who destroy them legally responsible.” </p>
<p>In an attempt to tie our personal political experience into the class topic, I remarked that this court decision was a surefire way to get people involved in politics. I had no clue at the time how prophetic my comment would be.</p>
<h2>Fleeing to Texas for reproductive rights?</h2>
<p>On Wednesday, Feb. 21, the <a href="https://www.al.com/news/2024/02/uab-pauses-in-vitro-fertilization-due-to-fear-of-prosecution-officials-say.html">University of Alabama Birmingham’s fertility clinic</a> paused IVF treatments. That wasn’t our clinic, but the move sent us into a total panic. Our clinic’s closure seemed inevitable – and within 24 hours <a href="https://www.nbcnews.com/health/health-news/university-alabama-pauses-ivf-services-court-rules-embryos-are-childre-rcna139846">it had paused IVF treatments as well</a>. </p>
<p>We didn’t know what we were going to do, but we knew we were likely leaving the state to continue IVF. I needed to tell my department chair what was going on.</p>
<p>I was walking out of my department chair’s office when my phone rang. Gabby told me, “We got in, we’re going to Temple.” I ran back into my department chair’s office, told her we were going to Temple, Texas, and then rushed home. </p>
<p><a href="https://www.cnn.com/2024/02/22/us/alabama-embryos-ruling-ivf-treatment-leaving-state/index.html">A reporter from CNN</a> beat me there. It was one of <a href="https://www.washingtonpost.com/nation/2024/02/24/alabama-ivf-treatment-ruling-abortion/">several</a> <a href="https://www.nbcnews.com/health/health-news/ivf-doctors-patients-fearful-alabama-court-rules-embryos-are-children-rcna139636">interviews</a> with <a href="https://apnews.com/video/alabama-assisted-reproductive-technology-courts-legislation-gabby-goidel-8990ee5efaab450b940da1e6a39bf8d1">major</a> <a href="https://www.msnbc.com/katy-tur/watch/-thoughtless-ivf-patients-speak-out-on-alabama-embryo-decision-204655173631">media</a> <a href="https://www.theguardian.com/us-news/2024/feb/22/alabama-fertility-pause-ivf-embryo-ruling">outlets</a> Gabby did in the wake of her opinion column. After the interview, we threw clothes in a suitcase, dropped our dogs off at the vet and drove to the Atlanta airport. We flew to Texas that night.</p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/9MCbgW7i2I0?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">One of the Goidels’ many media interviews in the wake of the Alabama ruling.</span></figcaption>
</figure>
<p>The thought of not completing the egg retrieval never seriously entered our minds. We were confident that we could get in with another IVF clinic somewhere, anywhere. But we’re affluent. We’re privileged. What if we weren’t so well off? We wouldn’t have wanted to give up, but we wouldn’t have been able to afford the fight.</p>
<p>We spent exactly one week at my parents’ house in Texas. Thankfully, my parents live an hour and a half away from the Temple clinic. We met our new doctor, <a href="https://www.bswhealth.com/physician/gordon-bates">Dr. Gordon Wright Bates</a>, and were immediately reassured. His cool expertise and confidence were calming to a stressed-out couple. The Alabama Supreme Court may have upended our lives, but we felt weirdly lucky to be in such a comfortable place.</p>
<p>The egg retrieval was Wednesday morning, Feb. 28. By all indications, it went well. IVF, however, is full of uncertainties. Now we are waiting on the results from preimplantation genetic testing. After that, there’s implantation and hoping the embryo continues to grow. We’re not in the clear: IVF is a stressful process even without a state court getting in the way. But today we are in a situation more like an average couple going through IVF than we have been in the past few weeks.</p>
<p>Late Wednesday night, March 6, <a href="https://www.nytimes.com/2024/03/06/us/politics/alabama-ivf-law.html">Alabama Gov. Kay Ivey signed into law a bill</a> providing legal protection to IVF clinics in the state. Gabby and I rejoiced at the news. Hopefully, we’re the last Alabamian couple to flee the state for IVF.</p>
<h2>A mobilizing moment</h2>
<p>When state politics directly interferes with your life, it feels like a gut punch, as if the community that you love is saying you’re not loved back. It’s easy to see how such an experience could either discourage or motivate you. Research shows that traumatic events, for the most part, <a href="https://doi.org/10.1017/S0003055422001010">depress voter turnout</a> in the following presidential election. By contrast, families and friends of 9/11 victims <a href="https://doi.org/10.1073/pnas.1315043110">became and remained more politically engaged</a> than their peers. </p>
<p>In this case, the Alabama Supreme Court ruling mobilized Gabby and <a href="https://www.democracynow.org/2024/3/4/alabama_ivf_patients_warning_to_others">other</a> <a href="https://www.today.com/health/news/alabama-ivf-ruling-embryo-transfer-canceled-rcna140029">women</a> going through the IVF process. For better or worse, the women, couples and families mobilized by this decision will likely always be more engaged because of it.</p>
<p>“Oh, God,” I remarked to my dad, “we’re going to be activists now, aren’t we?”</p>
<p>“So?” he asked.</p>
<p>“No one likes activists,” I responded in jest. But if we’re going to have and raise the family we want, this is just the first of many decisions we’re going to make that someone’s not going to like.</p><img src="https://counter.theconversation.com/content/225126/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Spencer Goidel does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>I’m a scholar, not an activist or an advocate. But now one of the most intimate, personal events of our lives had been turned into a political event by the state’s highest court.Spencer Goidel, Assistant Professor of Political Science, Auburn UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2208322024-02-07T20:46:33Z2024-02-07T20:46:33ZDemography and reproductive rights are environmental issues: Insights from sub-Saharan Africa<p>Sub-Saharan Africa’s population is growing <a href="https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/wpp2022_summary_of_results.pdf">three times faster</a> than the rest of the world with an average of 4.6 births per woman in 2021. By comparison, <a href="https://www150.statcan.gc.ca/n1/pub/91f0015m/91f0015m2024001-eng.htm">the fertility rate in Canada was 1.3 births per woman in 2022</a>. </p>
<p>The region is projected to continue to be the fastest growing in the world, with a population increasing from 1.2 billion in 2021 to 2.1 billion in 2050. </p>
<p>Sustained and rapid population growth has deep implications for development, <a href="https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/undesa_pd_2022_policy_brief_population_growth.pdf">exacerbating social, economic and environmental challenges</a> from food insecurity and gender inequity to environmental degradation. </p>
<p>At the same time, Sub-Saharan Africa also has a <a href="https://www.populationinstitute.org/wp-content/uploads/2023/07/Population-and-Climate-Change-Vulnerability.pdf">disproportionate vulnerability to climate change and environmental degradation</a>. </p>
<p>It is critical that population dynamics and reproductive health be at the forefront of ongoing environmental discussions.</p>
<h2>Population dynamics and environment</h2>
<p>There are <a href="https://doi.org/10.1126/science.aat8680">many just and humane ways to slow the pace of rapid population growth while also respecting human rights and the need for economic development</a>. Key to this goal is advancing reproductive rights, gender equity and education. </p>
<p>Advancing reproductive autonomy by ensuring that individuals have the means to choose the timing and frequency of childbearing carries significant benefits for climate change resilience and environmental sustainability. </p>
<p>As individuals are given the means to choose the number, timing and spacing of their children, <a href="https://doi.org/10.1002/sd.2470">they tend to have fewer children</a>. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/africas-groundbreaking-womens-rights-treaty-turns-20-the-hits-and-misses-of-the-maputo-protocol-209607">Africa's groundbreaking women's rights treaty turns 20 - the hits and misses of the Maputo protocol</a>
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</em>
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<p>It is estimated that if the United Nations’ <a href="https://sdgs.un.org/">Sustainable Development Goals</a> target for contraceptive use and education are met, global population size would decline from today’s 8 billion to <a href="https://doi.org/10.1016/s0140-6736(20)30677-2">6.29 billion in 2100</a>. If not, then the United Nations medium <a href="https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/wpp2022_summary_of_results.pdf">projection of 10.3 billion appears more likely</a>. </p>
<p>Yet, despite their far-ranging implications for environmental sustainability, demographic trajectories are largely omitted or regarded as set in stone by the development and environmental communities. This makes for a missed opportunity for transformative change. </p>
<p>Discussions that highlight the negative impacts of global population growth are also often marginalized and perceived as <a href="https://doi.org/10.1080/10042857.2016.1149296">unwarranted, alarmist, coercive and racist</a>. At the same time, it is important to remember that high birth rates should not carry the stigma of blame but instead be seen within the lens of wider socio-economic issues.</p>
<p>We live in a demographically divided world. Some regions of the planet are experiencing sustained population growth, while others are witnessing relative stability and even decline. </p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/drc-has-one-of-the-fastest-growing-populations-in-the-world-why-this-isnt-good-news-209420">DRC has one of the fastest growing populations in the world – why this isn't good news</a>
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<p>In this context concerns about population growth can appear to have limited global application, making it more challenging to express alarm over increasing human numbers in relation to population declines elsewhere </p>
<p>However, this does not mean that exponential human growth cannot pose concerns in some regions.</p>
<h2>Sub-Saharan perspectives</h2>
<p>As a <a href="https://uniweb.uottawa.ca/members/4481">researcher</a> in the emerging field of planetary health, I study the nexus of reproductive rights, population dynamics and environmental sustainability. </p>
<p>In collaboration with <a href="https://www.ug.edu.gh/economics/people/staff-faculty/nkechi-s-owoo">Nkechi S. Owoo</a>, from the University of Ghana, we set out to <a href="https://doi.org/10.3197/JPS.63772236595233">explore stakeholder perceptions</a> around these issues. We were surprised to learn that sub-Saharan Africans perspectives had not been individually documented, despite their unique relevance. </p>
<p>Our study included a survey and follow-up interviews with 402 participants from 42 countries in sub-Saharan Africa. The results would surprise many observers who may doubt that population growth is a concern in Africa.</p>
<p>While there were geographic and gender limitations in our sample size — and more research will be required to further explore this topic — we nevertheless feel that <a href="https://doi.org/10.3390/world4040048">our findings</a> provide useful insights into wide-ranging public concern for population growth. Respondents overwhelmingly perceived population growth as a phenomenon representing challenges to environmental sustainability, economic and social goals, peace and security. </p>
<p>Many participants expressed the view that population dynamics ought to be integrated in policies and discussions aimed at improving or preserving the quality of the environment. One respondent in particular stated that </p>
<blockquote>
<p>“population dynamics should always be put at the forefront whenever climate and the environment are being discussed”. </p>
</blockquote>
<p>A small number of participants argued that population growth was not a driver of environmental degradation and climate change, which was attributed to the excessive consumption habits and disproportionate responsibility of the Global North.</p>
<p>The large majority of our respondents, however, held a different view. They felt that the disproportionate role of consumption did not preclude acknowledging the role of population growth in generating environmental degradation. </p>
<p>A survey participant from South Africa, for example, stated that: </p>
<blockquote>
<p>“The cumulative impact of 1 billion low per-capita footprints still equals a high impact. This is not to discount the high impact of people that may have lower fertility rates and higher per-capita footprints — who are as important to address.”</p>
</blockquote>
<p>Participants overwhelmingly felt reproductive health and rights, alongside education and women empowerment considerations, ought to be integrated in environmental sustainability discussions and policies. </p>
<p>They agreed with the notion that contraception and family planning services can have a positive impact on environmental sustainability. They also agreed that integrating family planning as an environmental policy would contribute to accelerating much needed progress on reproductive rights and sustainability. </p>
<h2>It is time to discuss demography</h2>
<p>This study presents surprising evidence that rebuts common assumptions about the sensitivity of discussing population trends in developing countries. </p>
<p>Our survey suggests that a majority of those working in a field that is related to economic, social, or environmental development in sub-Saharan Africa consider the topic of population growth important. </p>
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<figcaption><span class="caption">‘What will it take to achieve the UN Sustainable Development Goals?’ Produced by the United Nations.</span></figcaption>
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<p>Our study also supports the importance of amplifying the voices of people among those most exposed to rapid population growth and most vulnerable to climate change and environmental degradation. These individuals, more often than not, live in places where gender equity and access to family planning face <a href="https://doi.org/10.1186/s40834-022-00198-5">significant challenges</a>.</p>
<p>Most of our research respondents are concerned by population growth because of its negative environmental and social implications, and wish to integrate demographic and reproductive rights and gender equity considerations in environmental discourses and policies. </p>
<p><a href="https://mahb.stanford.edu/wp-content/uploads/2023/11/biad080.pdf">Similar calls to stabilize and gradually decrease the human population by supporting reproductive autonomy and gender equity</a> are regularly issued by leading environmental scientists, and must be prioritized to achieve the transformative change needed for sustainability.</p><img src="https://counter.theconversation.com/content/220832/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Céline Delacroix is a Senior Fellow with the Population Institute (USA), which provided financial support to pursue this research project by offering a fellowship to its authors.</span></em></p>Environmental policymakers and scholars must listen to sub-Saharan Africans’ voices and recognize the importance of population for achieving sustainable development goals.Céline Delacroix, Adjunct Professor and Senior Fellow, School of Health Sciences, L’Université d’Ottawa/University of OttawaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2194952024-01-31T19:09:33Z2024-01-31T19:09:33ZWill abortion be the issue that swings the 2024 US presidential election?<p>Abortion is shaping up to be a central issue for both parties in the 2024 US presidential and Congressional elections.</p>
<p>Nearly two years ago, the US Supreme Court overturned the landmark Roe v. Wade decision, finding there was no constitutional right to abortion and returning regulation to the states.</p>
<p>Since that decision (a case known as Dobbs v. Jackson), <a href="https://www.nytimes.com/interactive/2022/us/abortion-laws-roe-v-wade.html">14 states</a> now ban abortion in almost all circumstances and ten have imposed restrictions, some of which have been blocked by the courts. <a href="https://apnews.com/article/abortion-dobbs-anniversary-state-laws-51c2a83899f133556e715342abfcface">One in three</a> women of reproductive age now live in states that have either banned or restricted abortion.</p>
<p>Abortion remains legal and protected in 26 states, plus the District of Columbia. </p>
<p>For decades, abortion has been central to partisan politics in the United States. Republicans made opposition to abortion a core part of their identity and voter mobilisation strategies. They pumped out so-called “<a href="https://www.nytimes.com/2024/01/12/us/politics/house-republicans-abortion-ban.html">messaging bills</a>” (dramatic legislation with little chance of passing or being upheld, such as the <a href="https://www.paul.senate.gov/news-sen-rand-paul-introduces-life-conception-act/">Life At Conception bill</a>), while <a href="https://link.springer.com/content/pdf/10.1007/978-3-030-01707-1.pdf">pledging</a> to end Roe v Wade.</p>
<p>Yet, abortion was not a make-or-break electoral cause. In 2018, sociologist <a href="https://www.wiley.com/en-au/Abortion+Politics-p-9780745688787">Ziad Munson</a> concluded</p>
<blockquote>
<p>[…] for the vast majority of the public, abortion is simply not a key issue they consider when deciding their vote.</p>
</blockquote>
<h2>Most Americans still support abortion rights</h2>
<p>Dobbs v. Jackson, however, transformed the political landscape. Support for abortion is now at a <a href="https://news.gallup.com/poll/506759/broader-support-abortion-rights-continues-post-dobbs.aspx">record high</a> among Americans, with 69% believing abortion should be legal in the first three months of pregnancy and 61% believing that overturning Roe v. Wade was a “bad thing”. </p>
<p>Women and young people have <a href="https://www.vox.com/policy-and-politics/2022/9/4/23333329/roe-voter-registration-dobbs-midterms-democrats">rushed</a> to register as new voters. And 21% of registered voters describe abortion as the issue they would be <a href="https://fivethirtyeight.com/features/abortion-was-always-going-to-impact-the-midterms/">unwilling to compromise on</a>, a sentiment most pronounced among Democrats and independents. </p>
<p>In the 2022 midterm elections in the US, voter anger over Dobbs v. Jackson was <a href="https://www.npr.org/2022/11/25/1139040227/abortion-midterm-elections-2022-republicans-democrats-roe-dobbs">widely</a> <a href="https://fivethirtyeight.com/features/abortion-was-always-going-to-impact-the-midterms/">credited</a> with stopping the expected “<a href="https://www.politico.com/news/2022/11/09/abortion-votes-2022-election-results-00065983">red wave</a>” in Congress and state races, even as President Joe Biden’s <a href="https://www.pewresearch.org/politics/2023/12/14/assessments-of-joe-biden/pp_2023-12-14_gop_2-01/">approval rating</a> hovered around 40%. </p>
<p>Abortion was also central to Democrats <a href="https://www.theguardian.com/us-news/2023/dec/20/democrats-virginia-abortion-strategy-roe-v-wade-2024-election">gaining control</a> of the Virginia state legislature in 2023.</p>
<p>Seven states have voted on abortion referendums since the Dobbs v. Jackson decision. All were <a href="https://www.politico.com/news/2023/11/09/abortion-rights-elections-red-states-00126225">decisive victories for reproductive rights</a>, including in <a href="https://www.washingtonpost.com/politics/2023/11/07/ohio-issue-1-election-results/">traditionally red</a> states such as Kansas, Kentucky and Ohio. In Ohio, one in five Republicans voted to constitutionally <a href="https://www.theguardian.com/us-news/2023/nov/17/ohio-abortion-rights-republicans-overturn">protect</a> abortion access in the state.</p>
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<h2>Democrats have an issue to rally support</h2>
<p>All of this points to abortion being a major issue in the presidential election later this year.</p>
<p>Biden, a practising Catholic, is an unlikely pro-choice ally. In 1973, he believed the Supreme Court went “<a href="https://www.nytimes.com/2019/03/29/us/politics/biden-abortion-rights.html">too far</a>” in the Roe v. Wade decision. During his decades in the Senate, his views <a href="https://www.nbcnews.com/politics/2020-election/biden-s-long-evolution-abortion-rights-still-holds-surprises-n1013846">evolved</a> and he now believes Roe v. Wade “<a href="https://www.cbsnews.com/news/joe-biden-abortion-catholic-faith-roe-v-wade-got-it-right/">got it right</a>.”</p>
<p>Initially, the Biden administration was slow to respond to the <a href="https://theconversation.com/what-would-amy-coney-barrett-trumps-pick-for-the-supreme-court-mean-for-abortion-rights-in-the-us-146931">palpable threat</a> to reproductive rights in the lead-up to Dobbs v. Jackson. It took Biden <a href="https://didbidensayabortionyet.org/">468 days</a> to publicly say the word abortion as president, and he still <a href="https://www.politico.com/news/2023/06/22/biden-abortion-2024-campaign-reelection-00103158">rarely</a> uses the term. </p>
<p>After Dobbs v. Jackson, however, both Biden and Vice President Kamala Harris became assertive in defence of abortion rights. Legislatively hamstrung, the administration used the <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2023/01/22/fact-sheet-president-biden-to-sign-presidential-memorandum-on-ensuring-safe-access-to-medication-abortion/">Food and Drug Administration</a>, the <a href="https://www.justice.gov/opa/pr/attorney-general-merrick-b-garland-statement-supreme-court-ruling-dobbs-v-jackson-women-s">Justice Department</a>, and <a href="https://www.whitehouse.gov/briefing-room/statements-releases/2023/06/23/fact-sheet-biden-harris-administration-highlights-commitment-to-defending-reproductive-rights-and-actions-to-protect-access-to-reproductive-health-care-one-year-after-overturning-of-roe-v-wade/">executive orders</a> to try to protect and expand access to abortion and contraception across the country.</p>
<p>And abortion will be “<a href="https://www.politico.com/news/2023/06/22/biden-abortion-2024-campaign-reelection-00103158">front and centre</a>” for Democrats in the 2024 elections.</p>
<p>In <a href="https://www.nytimes.com/2023/11/08/us/politics/abortion-ads-democrats-election.html">advertisements</a>, <a href="https://www.youtube.com/watch?v=yGnc8JkaUII">Senate briefings</a>, <a href="https://www.whitehouse.gov/briefing-room/speeches-remarks/2023/04/25/remarks-by-vice-president-harris-at-a-political-event-on-reproductive-rights/">campaign events</a>, and <a href="https://www.reuters.com/world/us/biden-harris-begin-abortion-rights-campaign-roe-v-wade-anniversary-2024-01-18/">television appearances</a>, Democrats emphasise the suffering caused by what they call “<a href="https://abcnews.go.com/Health/wireStory/bidens-campaign-pushes-abortion-rights-2024-battle-republicans-106483145">draconian</a>” Republican abortion bans and the advocacy work of doctors and reproductive rights groups.</p>
<p>To drive home the point, the Biden-Harris team made their first joint campaign appearance of the year in late January at a <a href="https://edition.cnn.com/2024/01/23/politics/biden-harris-abortion-rights/index.html">reproductive rights rally</a> in Virginia, a day after what would have been the 51st anniversary of the Roe v. Wade decision. </p>
<h2>For Republicans, it’s complicated</h2>
<p>Dobbs v. Jackson was the fulfilment of a Republican promise decades in the making. Publicly, Republicans celebrated. Privately, some believed the party was “<a href="https://www.politico.com/news/2022/06/25/the-dog-that-caught-the-car-republicans-brace-for-the-impact-of-reversing-roe-00042387">the dog that caught the car</a>”.</p>
<p>Anti-abortionists have always viewed overturning Roe v. Wade as merely a first step, with the ultimate goal being an end to legal abortion nationwide. Since Dobbs v. Jackson, anti-abortion groups have pushed for: </p>
<ul>
<li><p>a <a href="https://www.nytimes.com/2023/04/20/us/politics/trump-abortion-susan-b-anthony.html">federal abortion ban at 15 weeks and beyond</a> </p></li>
<li><p>state bills to outlaw <a href="https://www.washingtonpost.com/politics/2022/08/14/medicated-abortions-drugs-students-for-life/">abortion-inducing drugs</a> (now the most common type of abortion method) </p></li>
<li><p>“<a href="https://time.com/6191886/fetal-personhood-laws-roe-abortion/">foetal personhood</a>” laws that would extend legal rights to foetuses or embryos from the <a href="https://www.nytimes.com/2022/08/21/us/abortion-anti-fetus-person.html">moment of fertilisation</a>, with likely consequences for in vitro fertilisation and some forms of contraception.</p></li>
</ul>
<p>Since the Republican primary campaigns began last year, however, <a href="https://apnews.com/article/iowa-republicans-presidential-candidates-abortion-55dd7067d626c4add1f1270c03e33655">the silence among prospective candidates</a> has been striking. </p>
<p>Most presidential aspirants have preferred to talk generically about “<a href="https://www.npr.org/2023/11/16/1213006071/republican-candidates-abortion-rights">protecting life</a>.” Nikki Haley, the only candidate remaining to challenge frontrunner Donald Trump, has spoken vaguely of the need for “<a href="https://www.washingtonpost.com/politics/2024/01/23/haley-abortion-new-hampshire/">consensus</a>” on abortion at the federal level.</p>
<p>As for Trump, he ran <a href="https://democrats.org/news/donald-trump-brags-about-his-role-in-overturning-roe-in-new-ads/">Facebook advertisements</a> before the Iowa caucuses last month calling himself “THE MOST Pro-Life President in history.” Yet, simultaneously, Trump is positioning himself as an abortion <a href="https://www.rollingstone.com/politics/politics-features/donald-trump-abortion-moderate-run-2024-election-1234893936/">moderate</a>. </p>
<p>Trump’s cynical about-face should come as no surprise. In 1999, Trump claimed to be “<a href="https://www.nbcnews.com/meet-the-press/video/trump-in-1999-i-am-very-pro-choice-480297539914">very pro-choice</a>.” By the 2016 Republican primaries, he had become much more <a href="https://www.washingtonpost.com/news/wonk/wp/2016/10/20/rip-the-baby-out-of-the-womb-what-donald-trump-got-wrong-about-abortion-in-america/">extreme</a> and <a href="https://edition.cnn.com/2016/03/30/politics/donald-trump-abortion-town-hall/index.html">controversial</a> in his rhetorical opposition to abortion.</p>
<p>Trump has repeatedly dodged questions about whether he supports a federal law, refusing to support the idea of a 15-week ban <a href="https://www.bbc.com/news/world-us-canada-66003915">championed</a> by his former vice president, Mike Pence. </p>
<p>In September, he described Florida Governor Ron DeSantis’ signing of a six-week abortion ban in his state as “<a href="https://www.pbs.org/newshour/politics/trump-labels-desantis-abortion-ban-a-terrible-mistake-riling-some-republicans">a terrible thing and a terrible mistake</a>.” Then, in January, Trump told a Fox News town hall audience that on abortion, “there has to be a little bit of a <a href="https://slate.com/news-and-politics/2024/01/donald-trump-abortion-bans-fox-news-town-hall.html">concession</a>.”</p>
<p>Initially, anti-abortion activists condemned Trump, even picketing one of his Miami rallies with signs declaring “<a href="https://www.rollingstone.com/politics/politics-features/anti-abortion-activists-protest-donald-trump-rally-florida-1234873608/">Make Trump Pro-Life Again</a>”. However, with Trump widely expected to be the Republican candidate, these groups are now <a href="https://www.washingtonpost.com/politics/2024/01/05/trump-abortion/">falling in line</a>. Ultimately, they need him far more than he needs them.</p>
<p><div data-react-class="Tweet" data-react-props="{"tweetId":"1752088518602400182"}"></div></p>
<p>The new Republican timidity about abortion does not mean that conservatives have had a fundamental change of heart. As Trump put it, “<a href="https://abcnews.go.com/Politics/trump-boasts-role-ending-roe-wade-abortion-regulations/story?id=106280890">you got to win elections</a>.” If they win the presidency and majorities in both houses of Congress in November, Republicans will most likely continue their assault on abortion and reproductive rights.</p>
<p>In January, Biden’s job approval rating hit <a href="https://abcnews.go.com/Politics/trump-tops-opponents-biden-hits-new-low-approval/story?id=106335244">record lows</a> at a time of historic inflation levels. Even though abortion has been political poison for Republicans, it <a href="https://time.com/6561898/donald-trump-voters-2024/">may not be enough</a> to help Democrats hold onto the White House.</p><img src="https://counter.theconversation.com/content/219495/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Prudence Flowers has received funding from the South Australian Department of Human Services. She is a member of the South Australian Abortion Action Coalition. </span></em></p>Democrats now have an issue to mobilise voters. For Republicans, however, it’s more complicated.Prudence Flowers, Senior Lecturer in US History, College of Humanities, Arts, and Social Sciences, Flinders UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2172492023-11-09T18:48:39Z2023-11-09T18:48:39ZAbortion rights victories show this issue is unlikely to fade in 2024 elections − 3 things to know<figure><img src="https://images.theconversation.com/files/558413/original/file-20231108-17-safd3t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Abortion rights supporters celebrate Issue 1 passing in Ohio on Nov. 7, 2023.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/abortion-rights-supporters-celebrate-winning-the-referendum-news-photo/1769771636?adppopup=true">Megan Jelinger/AFP via Getty Images </a></span></figcaption></figure><p>Abortion rights advocates <a href="https://www.npr.org/2023/11/08/1211429268/abortion-rights-2023-election-ohio-virginia-kentucky">won major victories</a> in several state elections on Nov. 7, 2023, signaling that abortion laws are likely to continue to play an important role in the 2024 elections. </p>
<p>In Ohio, the only state where abortion was directly on the ballot, more than <a href="https://www.washingtonpost.com/politics/2023/11/07/abortion-ohio-kentucky-virginia-elecitons/">56% of voters in the conservative-leaning</a> state approved a measure called Issue 1. </p>
<p>This <a href="https://apnews.com/article/ohio-abortion-amendment-election-2023-fe3e06747b616507d8ca21ea26485270">constitutional amendment protects people’s right</a> to <a href="https://www.ohioattorneygeneral.gov/getattachment/cf27c10f-b153-4731-ae9e-e3555a326ed9/The-Right-to-Reproductive-Freedom-with-Protections-for-Health-and-Safety.aspx">have an abortion</a> in Ohio, as well as to get contraception and receive treatment for fertility issues and miscarriages.</p>
<p>Virginia Democrats, who campaigned on preserving abortion rights, maintained control of the state Senate and <a href="https://apnews.com/article/virginia-legislature-election-2023-79f9337731c25decc83b83eeb4d3e00e">took control of Virginia’s House of Delegates</a> from Republicans. While <a href="https://lis.virginia.gov/cgi-bin/legp604.exe?231+sum+SB1483">abortion is legal</a> in Virginia until the 26th week of pregnancy, Republican Gov. Glenn Youngkin has said he wanted the legislature to enact <a href="https://www.washingtonpost.com/dc-md-va/2023/11/08/virginia-senate-house-election-results-2023/">a ban on abortion</a> after 15 weeks of pregnancy. </p>
<p>And in Kentucky, Gov. <a href="https://www.washingtonpost.com/politics/2023/11/07/kentucky-governor-election-results-2023/">Andy Beshear, a Democrat, won reelection</a>. During his campaign, Beshear promised to protect abortion rights and highlighted Republican opponent Daniel Cameron’s support for Kentucky’s <a href="https://theconversation.com/in-first-nationwide-election-since-roe-was-overturned-voters-opt-to-protect-abortion-access-194140">near-total ban on abortion</a>. </p>
<p>We are <a href="https://scholar.google.com/citations?user=CcAfO1UAAAAJ&hl=en">scholars of law,</a> <a href="https://scholar.google.com/citations?user=4bgaJCQAAAAJ&hl=en">gender and health</a> and co-direct Boston University’s Program on Reproductive Justice.</p>
<p>We wrote last year that new constitutional amendments protecting a right to abortion in states usually considered “red,” like Kansas, <a href="https://theconversation.com/in-first-nationwide-election-since-roe-was-overturned-voters-opt-to-protect-abortion-access-194140">were not flukes</a>. Rather, such wins, which have happened in <a href="https://ballotpedia.org/2023_and_2024_abortion-related_ballot_measures">six other states</a> since 2022, affirm a broader trend. The majority of U.S. voters support laws protecting access to abortion and other reproductive care. </p>
<p>Here are three important things to know about the election results.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/558418/original/file-20231108-21-dsckc0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A woman closes her eyes and appears to be crying, surrounded by other people." src="https://images.theconversation.com/files/558418/original/file-20231108-21-dsckc0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/558418/original/file-20231108-21-dsckc0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/558418/original/file-20231108-21-dsckc0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/558418/original/file-20231108-21-dsckc0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/558418/original/file-20231108-21-dsckc0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/558418/original/file-20231108-21-dsckc0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/558418/original/file-20231108-21-dsckc0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Abortion rights supporters in Columbus, Ohio, celebrate winning the right to enshrine abortion in the state’s constitution.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/abortion-rights-supporters-celebrate-winning-the-referendum-news-photo/1769779581?adppopup=true">Megan Jelinger/AFP via Getty Images</a></span>
</figcaption>
</figure>
<h2>1. Votes amending state constitutions are key to protecting abortion rights</h2>
<p>Ohio voted for former President Donald Trump in 2016 and in 2020. In recent years, it has been considered a toss-up state that is turning “red.” </p>
<p>In the days leading up to the 2023 election, <a href="https://www.politico.com/news/2023/10/11/conservatives-ohio-abortion-referendums-00120837">some conservative commentators observed</a> that “anti-abortion groups are banking on Ohio to end the movement’s run of state-level losses and create a blueprint for battles in 2024 and beyond.”</p>
<p>Instead, most Democratic and independent voters, and some Republican voters, <a href="https://www.msn.com/en-us/news/politics/exit-poll-results-from-ohio-issue-1-ballot-measure-on-abortion-rights/ar-AA1jyKvR">cast their ballots in favor of Issue 1,</a> rejecting Ohio’s law that bans abortion after six weeks.</p>
<p>This followed on the heels of a recent high-profile case in which a 10-year-old Ohio girl had to travel to Indiana to <a href="https://www.nbcnews.com/health/health-news/indiana-doctor-gave-10-year-old-girl-abortion-disciplinary-hearing-rcna86214">have an abortion after she was raped</a> and could not have the procedure in Ohio. Notably, physicians <a href="https://twitter.com/OURR2023/status/1719345494130885114?s=20">vocally opposed</a> <a href="https://drive.google.com/file/d/1-hgtRAaGszSvdZy7krZ_FZrMKSgZqHSg/view">Ohio’s restrictive laws</a>.</p>
<p>This new constitutional amendment means that <a href="https://www.dispatch.com/story/news/2022/07/02/roe-v-wade-abortion-supreme-court-ohio-dewine-heartbeat-bill/7767433001/">Ohio’s 2019 law</a> that prohibited abortion as soon as fetal cardiac activity could be detected – as early as six weeks into pregnancy – will not be allowed to take effect. A lower state court stopped enforcement of the six-week ban, but the case was making its way to the Ohio Supreme Court, whose seven members are mostly Republicans that have publicly <a href="https://www.npr.org/2023/11/07/1209092670/2023-results-key-ohio-elections">opposed abortion rights</a>.</p>
<p>Now, the Republican-controlled Ohio legislature <a href="https://www.ohiosos.gov/legislation-and-ballot-issues/putting-an-issue-on-the-ballot/citizen-initiated-constitutional-amendment/">does not have the power</a> to amend or stop the new constitutional amendment or to enforce the six-week ban. </p>
<p>Lawmakers may still campaign to repeal Issue 1, but this change would require voters to first approve a different ballot initiative.</p>
<p>While state constitutions are amended much more frequently than the U.S. Constitution, a majority of voters in Ohio showed they support abortion rights, so another ballot measure seems unlikely. </p>
<h2>2. Reframing abortion restrictions does not fool voters</h2>
<p>In Virginia, Democratic candidates campaigned on preserving abortion rights, while Republican candidates <a href="https://abcnews.go.com/Politics/democrats-republicans-release-dueling-abortion-ads-high-stakes/story?id=103598015">charged Democrats</a> with being obsessed with abortion. </p>
<p>Some Republican candidates also denied that they supported an abortion ban. Instead, they attempted to describe Youngkin’s <a href="https://www.nytimes.com/2023/11/04/us/politics/abortion-ohio-kentucky-virginia-election.html">proposed 15-week ban</a> as “legislation that reflects compassionate common sense.”</p>
<p>The election results suggest that a majority of Virginia voters effectively rejected this proposed ban on abortion after 15 weeks.</p>
<p>Instead, they elected Democratic candidates who pledged to protect abortion rights in the one Southern state that had not enacted new <a href="https://www.forbes.com/sites/alisondurkee/2023/11/08/abortion-rights-victories-continue-here-are-all-the-wins-in-major-elections-since-the-supreme-court-overturned-roe/?sh=5825d21026ad">restrictive abortion laws</a> since the Supreme Court overturned Roe v. Wade in 2022.</p>
<p>With Democrats controlling both legislative chambers in Virginia, new bills will stall, and the legislative majority can counter other restrictive measures that are proposed. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/558422/original/file-20231108-23-ys1tah.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Andy Beshear stands in a dark blue suit at a podium that has his name on it, surrounded by three women on a stage." src="https://images.theconversation.com/files/558422/original/file-20231108-23-ys1tah.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/558422/original/file-20231108-23-ys1tah.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/558422/original/file-20231108-23-ys1tah.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/558422/original/file-20231108-23-ys1tah.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/558422/original/file-20231108-23-ys1tah.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/558422/original/file-20231108-23-ys1tah.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/558422/original/file-20231108-23-ys1tah.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Kentucky Gov. Andy Beshear, who campaigned on abortion rights, delivered his victory speech on Nov. 7, 2023.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/kentucky-incumbent-democratic-gov-andy-beshear-is-joined-by-news-photo/1781193061?adppopup=true">Stephen Cohen/Getty Images</a></span>
</figcaption>
</figure>
<h2>3. Abortion rights matter up and down the ballot</h2>
<p>Beshear placed abortion at the center of his campaign for governor in Kentucky, even though the state has a <a href="https://apnews.com/article/abortion-kentucky-governor-campaign-ec767bf7802852d48ea150b7118fc90c">near-total ban</a> on all abortions and does not have any exceptions for cases of incest or rape. </p>
<p>His win, as well as the <a href="https://www.inquirer.com/politics/election/pennsylvania-supreme-court-election-results-2023-20231107.html">Pennsylvania Supreme Court election</a> that resulted in one more Democrat joining the court and creating a majority, suggests that highlighting abortion rights in election campaigns can be an <a href="https://apnews.com/article/kentucky-primary-governors-race-election-2023-e8df45cd3978ce5a1691ba447c84bafc">effective way to draw in voters</a>. </p>
<p>While Kentucky voters said the economy is a top issue for them, they have also said <a href="https://www.kentucky.com/news/politics-government/election/article281536793.html">abortion and other basic rights </a> are important, too. </p>
<p>Beshear’s campaign <a href="https://www.youtube.com/watch?v=BQ_qeTQz_Es">ran an unusual advertisement</a> featuring Hadley Duvall, a Kentucky resident who was raped by her stepfather at age 12. She became pregnant but later miscarried. Duvall, now 20 years old, appeared in the television advertisement and challenged Cameron’s <a href="https://www.aclu.org/wp-content/uploads/2023/02/SCOKY-Opinion-Feb-16-2023.pdf">support for Kentucky’s law</a>, which allows an abortion only in order to save the life of a pregnant woman – while instructing doctors to try to save the fetus, too.</p>
<p>The ad <a href="https://www.cincinnati.com/story/news/local/northern-ky/2023/10/05/kentucky-abortion-debate-hadley-duvall-commercial-daniel-cameron-andy-beshear/71077318007/">resonated with voters</a>, even in a state that now <a href="https://www.axios.com/2022/04/14/kentucky-abortion-clinics-stop-provider-law-ban">has no abortion clinics</a>.</p>
<p>Beshear’s reelection shows that politicians can effectively push for laws that walk back from near-total abortion bans, such as making exceptions in cases of rape or incest. In 2022, Kentucky voters already <a href="https://www.pbs.org/newshour/politics/kentucky-voters-reject-constitutional-amendment-on-abortion">rejected a state constitutional amendment</a> that would have prevented recognizing a right to abortion in the state. </p>
<p>These different state elections point in one clear direction.</p>
<p>Abortion <a href="https://www.kff.org/womens-health-policy/press-release/abortion-access-rises-as-a-voting-issue-and-motivator-especially-among-democrats-and-reproductive-age-women-but-inflation-continues-to-dominate-as-americans-worry-about-bills/">increasingly matters to voters</a>. And most voters do not want laws <a href="https://news.gallup.com/poll/321143/americans-stand-abortion.aspx">severely restricting abortion</a> and other kinds of reproductive health care. </p>
<p>The 2023 election outcomes also suggest that Democratic candidates can effectively use abortion as a campaign issue. This will be critical for the general elections in 2024.</p><img src="https://counter.theconversation.com/content/217249/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The new constitutional amendment to protect the right to abortion in Ohio − as well as other wins for Democrats − shows the importance of ballot initiatives and focusing on abortion in elections.Nicole Huberfeld, Professor of Health Law and Professor of Law, Boston UniversityLinda C. McClain, Professor of Law, Boston UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2154082023-11-06T13:34:33Z2023-11-06T13:34:33ZAs Ohio and other states decide on abortion, anti-abortion activists look to rebrand themselves as not religious<figure><img src="https://images.theconversation.com/files/557473/original/file-20231103-20-fp6fav.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Roman Catholic nuns pray with anti-abortion activists across the street from a Planned Parenthood clinic in New York in September 2023.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/roman-catholic-nuns-pray-with-a-group-of-anti-abortion-news-photo/1655599179?adppopup=true">Robert Nickelsberg/Getty Images</a></span></figcaption></figure><p>Abortion has become an increasingly polarized, political issue in the United States since 2022, when the <a href="https://www.oyez.org/cases/2021/19-1392">Supreme Court overturned</a> <a href="https://www.oyez.org/cases/1971/70-18">Roe v. Wade</a>, which guaranteed the constitutional right to an abortion. This decision threw the question of abortion rights back to states. </p>
<p><a href="https://www.dispatch.com/story/news/politics/elections/2023/08/24/ohio-abortion-issue-on-the-november-7-2023-ballot-election-results/70672454007/">Ohio voters</a> will cast ballots on Nov. 7, 2023, to determine abortion rules in their state, joining <a href="https://www.nytimes.com/2023/09/12/magazine/abortion-laws-states.html">six other states</a> that have put the decisions before voters in ballot initiatives since 2022. </p>
<p>Currently, Ohio’s constitution does not mention abortion. Ohio residents will <a href="https://www.npr.org/2023/10/31/1209593353/abortion-ohio-issue-1-vote-election-roe-dobbs">vote on “Issue 1,”</a> which would amend the state constitution to explicitly protect an individual’s right to get an abortion. The amendment would still allow the state to prohibit abortion after a <a href="https://www.acog.org/advocacy/facts-are-important/understanding-and-navigating-viability">fetus is considered viable</a>, with an exception when the health of the pregnant person is at stake. </p>
<p>The initiative is supported by a coalition of abortion-rights organizations, collectively called <a href="https://ohioansunitedforreproductiverights.win/">Ohioans United for Reproductive Justice</a>. </p>
<p>Some anti-abortion activists in Ohio <a href="https://www.ncregister.com/cna/ohio-abortion-supporters-outraise-pro-life-side-3-to-1-ahead-of-november-referendum">have said that Issue 1</a> is “too radical” for the state. But an October 2023 <a href="https://www.bw.edu/news/2023/fall/10-bw-ohio-pulse-poll-shows-ohio-voters-favor-issues-1-and-2">survey showed</a> that 58% of likely Ohio voters support Issue 1.</p>
<p>I am an <a href="https://annewhitesell.com">American politics scholar</a> who focuses on how groups outside of government attempt to influence policy. </p>
<p>Since the <a href="https://www.oyez.org/cases/2021/19-1392">Supreme Court overturned</a> the federal right to get an abortion, I have interviewed 45 anti-abortion activists across the country and collected Facebook data from approximately 190 organizations. I wanted to better understand how anti-abortion groups are working in a post-Roe v. Wade world to ban abortion.</p>
<p>Prominent anti-abortion groups continue to reference religion, and specifically Christianity, in their arguments against abortion. But I found that these activists also recognize that framing abortion as a human rights issue may appeal to a broader audience. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/557476/original/file-20231103-21-jr0953.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A woman wearing a yellow shirt holds a rosary around her neck and appears to pray with her eyes closed." src="https://images.theconversation.com/files/557476/original/file-20231103-21-jr0953.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/557476/original/file-20231103-21-jr0953.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/557476/original/file-20231103-21-jr0953.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/557476/original/file-20231103-21-jr0953.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/557476/original/file-20231103-21-jr0953.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/557476/original/file-20231103-21-jr0953.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/557476/original/file-20231103-21-jr0953.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Anti-abortion activists pray in New York in August 2022 outside a Planned Parenthood clinic.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/anti-abortion-activists-pray-in-front-of-the-planned-news-photo/1413322749?adppopup=true">Robert Nickelsberg/Getty Images</a></span>
</figcaption>
</figure>
<h2>Perceptions of the anti-abortion movement</h2>
<p>Religious objections to abortion center around the sanctity of human life and the belief that humans are made in God’s image. To end a human life, including the life of a fetus, is to play God.</p>
<p>According to a <a href="https://apnorc.org/wp-content/uploads/2020/02/December-Topline-with-MIP-final.pdf">2019 poll</a>, 77% of Americans believe religion has some or a lot of influence on U.S. abortion policy. </p>
<p>In my interviews, anti-abortion rights activists said they understood that the public views <a href="https://www.press.uillinois.edu/books/?id=p082467">their movement</a> as anti-woman and driven by conservative Christians. More recently, the movement has adopted <a href="https://www.tandfonline.com/doi/full/10.1080/1554477X.2021.1925478">pro-woman messaging</a> to counter the perception that they do not support women. </p>
<p>These organizations are increasingly choosing to speak less about religion and more about human rights and science to combat the narrative that the <a href="https://www.cambridge.org/us/universitypress/subjects/sociology/sociology-general-interest/pro-life-activists-america-meaning-motivation-and-direct-action?format=HB&isbn=9780521660440">anti-abortion movement</a> is solely a Christian movement.</p>
<p>This movement does have a religious history – the <a href="https://www.jstor.org/stable/23052569">U.S. Conference of Catholic Bishops</a> created the predecessor of one of the most well-known anti-abortion organizations, the <a href="https://www.nrlc.org/">National Right to Life Committee</a>, in 1966. </p>
<p>In the 1980s, <a href="https://www.operationrescue.org/">Operation Rescue</a>, which blockaded abortion clinics and had thousands of their activists arrested, brought an evangelical religious fervor to the anti-abortion movement. </p>
<p>Stopping abortion was seen as a <a href="https://doi.org/10.5744/florida/9780813044972.003.0009">Christian duty</a>, even if it meant resorting <a href="https://press.umich.edu/Books/O/Opposition-and-Intimidation2">to violence</a>.</p>
<h2>The changing role of religion</h2>
<p>The religious environment in the U.S. has changed in recent decades, however. </p>
<p>While evangelicals remain a <a href="https://news.gallup.com/opinion/polling-matters/324410/religious-group-voting-2020-election.aspx">powerful voting bloc for Republicans</a>, the percentage of Americans identifying as Christian has declined over the <a href="https://www.pewresearch.org/religion/2022/09/13/how-u-s-religious-composition-has-changed-in-recent-decades/">past 50 years</a> from 90% to 63%. At the same time, the percentage of Americans who identify as religiously unaffiliated has increased from 5% to 29%. </p>
<p>In 2020, <a href="https://news.gallup.com/poll/341963/church-membership-falls-below-majority-first-time.aspx">less than half of Americans</a> belonged to a church, synagogue or mosque – marking an all-time low in affiliation with a religious institution since 1940. </p>
<p>For anti-abortion activists, this means fewer people may connect to their religious appeals. One activist I interviewed put it bluntly: “Why talk the Bible to people, many people, who say the Bible is a fairy tale?”</p>
<h2>What anti-abortion organizations say</h2>
<p>My research shows that anti-abortion organizations in the U.S. fall into one of three camps. Some are openly religious. Others may have religious staff, but refrain from using religion in their advocacy. A small proportion outright reject the use of religion.</p>
<p>I analyzed how anti-abortion organizations use Facebook to promote their work. At least on this social media platform, most anti-abortion organizations do not use religious language.</p>
<p>Between June 2022 and September 2023, 193 anti-abortion groups posted 44,639 times on Facebook. Approximately 11% of these Facebook posts made explicit religious references, ranging from Bible verses to prayer requests. </p>
<p>Some organizations use religious references in nearly all of their Facebook posts, while other groups make only passing references to religion. </p>
<p>Texas Right to Life, for example, posted 770 times between June 2022 and September 2023, and 50% of its posts mentioned religion. In contrast, the group Ohio Right to Life posted 586 times in the same time period. Only 8.7% of their posts mention religion.</p>
<p>More than 15% of the 193 anti-abortion organizations in my sample, however, make no religious references in their Facebook posts from June 2022 through September 2023. </p>
<p>Indeed, the majority of the 45 activists from anti-abortion groups I spoke with said they kept their religious beliefs separate from their activism.</p>
<p>As one anti-abortion activist told me, when someone finds out “you believe that all life is created in the image of God, they completely dismiss you.”</p>
<h2>Other findings</h2>
<p>Most of the activists I interviewed said their organization does not have a formal stance on religion. Approximately one-quarter of the 45 activists I interviewed, however, said their organizations are explicitly Christian. </p>
<p>When asked about the choice to frame anti-abortion arguments around faith, one advocate said, “We 100% present the faith and the theological argument of things. Yeah, part of our culture is being Catholic.”</p>
<p>This advocate continued: “We understand that we also have a responsibility before God on these subjects, so we’re not going to shy away from that.” </p>
<p>A few interviewees stressed that they are not religious. One described herself as an “atheist, vegan pro-lifer.”</p>
<p>Instead of using religion to bolster their arguments against abortion, <a href="https://www.democratsforlife.org/index.php">these activists</a> frame abortion as a <a href="https://www.nbcnews.com/nbc-out/out-news/anti-abortion-lgbtq-groups-roes-reversal-human-rights-victory-rcna35716">human rights issue</a>. For them, any loss of human life is tragic, whether it is from abortion, war or the death penalty.</p>
<p>This kind of framing could help the anti-abortion movement shift conversations about abortion away from religious beliefs.</p>
<h2>Ohio’s vote</h2>
<p>People in all six states that have voted on abortion since 2022 have affirmed broader abortion rights. But <a href="https://www.nytimes.com/2023/11/02/us/abortion-ballot-ohio-vote.html">Ohio is the first red state</a> to vote on adding a right to abortion to the state’s constitution.</p>
<p>Local anti-abortion groups like Cincinnati Right to Life are pushing back <a href="https://www.facebook.com/100064698580681/posts/697161332450480">against Issue 1,</a> saying, for example, that the amendment is too wide-reaching, and that “Issue One will only hurt women & children and not help them.” </p>
<p>Ohio Right to Life has framed Issue 1 as a matter of safety in their <a href="https://www.facebook.com/100064601747509/posts/689319569898095">Facebook posts</a>. </p>
<p>Ohio voters will be the ones to decide which way to move the issue forward.</p><img src="https://counter.theconversation.com/content/215408/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Anne Whitesell does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>An analysis of anti-abortion rights groups in the US shows that while some specifically turn to Christianity to explain their positions, others are looking at broader, human rights arguments.Anne Whitesell, Assistant Professor, Political Science, Miami UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2067062023-09-01T12:42:46Z2023-09-01T12:42:46ZWhite men have controlled women’s reproductive rights throughout American history – the post-Dobbs era is no different<figure><img src="https://images.theconversation.com/files/545354/original/file-20230829-23-mvx2g4.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5964%2C3952&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">U.S. Rep. Cori Bush, a Democrat from Missouri, after participating in an abortion rights sit-in on July 19, 2022, in Washington.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/rep-cori-bush-leaves-a-processing-area-after-being-arrested-news-photo/1409761529?adppopup=true">Anna Moneymaker/Getty Images</a></span></figcaption></figure><p>More than a year after the Supreme Court ended federal protection for abortion rights in the United States, disagreements over abortion bans continue to reverberate around the country. <a href="https://www.youtube.com/watch?v=_brdDBHOT5E">Candidates sparred over the idea of a federal abortion ban</a> during the Aug. 23, 2023, Republican presidential debate. And abortion is likely to figure prominently in the November 2023 <a href="https://www.politico.com/news/2023/08/27/pennsylvania-supreme-court-abortion-00113074">contest for a seat on the Pennsylvania Supreme Court</a>.</p>
<p>When the U.S. Supreme Court overturned <a href="https://www.oyez.org/cases/2021/19-1392">Roe v. Wade</a> in June 2022, removing women’s federal constitutional right to get abortions and giving states the power to pass laws about the legality of the procedure, the 6-3 vote was by a four white men, one Black man and a white woman majority.</p>
<p>Since that decision – <a href="https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf">Dobbs v. Jackson Women’s Health Organization</a> – more than <a href="https://www.theguardian.com/us-news/ng-interactive/2023/jun/22/abortion-ban-politicians-who-voted-for-restrictions-who-are-they-men-women">1,500 state legislators, who are overwhelmingly white men</a>, have voted for full or partial abortion bans. </p>
<p>This is not the first period in U.S. history when white men have exercised control over women’s right to bear – or not bear – children, including during slavery. Then, it was a matter of numbers. The more people they enslaved, the more money white male enslavers could earn either from <a href="https://www.vox.com/identities/2019/8/16/20806069/slavery-economy-capitalism-violence-cotton-edward-baptist">selling the enslaved or from the forced labor</a> of the enslaved. <a href="https://doi.org/10.1093/acrefore/9780199329175.013.430">White men controlled people’s reproductive rights during the 20th century</a>, too, with the <a href="https://www.genome.gov/about-genomics/fact-sheets/Eugenics-and-Scientific-Racism">American eugenics movement</a>. </p>
<p>From the late 1800s until the 2000s, white proponents of eugenics – the selective breeding of people – tried to determine who was fit or unfit to have children. While the American eugenics movement affected people of other races and ethnic backgrounds, as well as men, it was particularly harmful to Black women who, data from 1950 to 1966 shows, were sterilized at “<a href="https://theconversation.com/forced-sterilization-policies-in-the-us-targeted-minorities-and-those-with-disabilities-and-lasted-into-the-21st-century-143144">three times the rate of white women and more than 12 times the rate of white men</a>.” </p>
<p>During both periods, <a href="https://doi.org/10.1089/heq.2017.0045">Black women and their health bore the brunt of the consequences</a> of white men’s control.</p>
<p>As a researcher who specializes in the <a href="https://scholar.google.com/citations?user=566DVVQAAAAJ&hl=en">history of race and racism in the U.S.</a>, I study historical issues related to race, gender and social justice.</p>
<h2>Enslaved women forced to reproduce</h2>
<p><a href="https://www.jstor.org/stable/45129363">African midwives</a>, imported and enslaved as early as the 1600s, attended to the birthing needs of the <a href="https://www.hup.harvard.edu/catalog.php?isbn=9780674008526">enslaved and enslavers</a> until the beginning of the 19th century.</p>
<p>But, after 1808, enslavers in the United States <a href="https://www.archives.gov/education/lessons/slave-trade.html">could no longer legally import</a> enslaved people. With this shift, enslavers stepped up the <a href="https://www.google.com/books/edition/The_American_Slave_Coast/iwCKCgAAQBAJ?hl=en&gbpv=1&dq=slave+masters+forced+breeding+of+slaves+1808&pg=PT11&printsec=frontcover">forced breeding of enslaved women</a>. White men raped the Black women and <a href="https://ldhi.library.cofc.edu/exhibits/show/hidden-voices/enslaved-women-and-slaveholder/sexual-violence">girls they enslaved</a>, and then enslaved the children born from those rapes. White men also <a href="https://notchesblog.com/2020/10/27/the-rape-of-rufus-sexual-violence-against-enslaved-men/">forced the Black women and Black men they enslaved to have sex </a> with one another to generate more babies, who would be born into slavery.</p>
<p><a href="https://www.haymarketbooks.org/books/736-how-capitalism-underdeveloped-black-america">This was a systemic way </a> of ensuring enslaved women <a href="https://www.penguinrandomhouse.com/books/155575/killing-the-black-body-by-dorothy-roberts/">bore more children, which would increase profits</a> for their enslavers. </p>
<p>Because <a href="https://www.google.com/books/edition/More_Than_Chattel/td2yIa7X6H4C?hl=en&gbpv=1&bsq=midwives">the Black midwives and enslaved women often were blamed for or suspected</a> of using birth control and abortions to resist forced pregnancy and the enslavement of their offspring, enslavers turned increasingly away from midwives and to <a href="https://www.google.com/books/edition/Birthing_a_Slave/ZussEAAAQBAJ?hl=en&gbpv=1&pg=PP1&printsec=frontcover">white male doctors</a> to figure out why nearly half of enslaved infants were stillborn or died within their first year of life and why so many enslaved women were infertile. <a href="https://doi.org/10.2105/AJPH.2019.305243">These doctors also helped with difficult births</a>. </p>
<p>In the two decades after 1810, the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7716878/">population growth rate of the enslaved averaged about 30%</a>, despite the ban on slave importation. This was just under the 1800 to 1809 average of 31.6% which was a century high. </p>
<p>In the 1800s, as the slave population increased, <a href="https://www.vox.com/identities/2019/8/16/20806069/slavery-economy-capitalism-violence-cotton-edward-baptist">profits in cotton did too</a>. And after the legal importation of slaves ended, the <a href="https://ir.vanderbilt.edu/xmlui/bitstream/handle/1803/15814/vu06-w24.pdf?sequence=1&isAllowed=y">value of Black women of childbearing age increased</a> significantly. The forced breeding of these enslaved women was <a href="https://scholarlycommons.law.wlu.edu/crsj/vol7/iss1/4">linked to the profitability of southern economies</a>. </p>
<h2>Eugenics and control over women’s bodies</h2>
<p>Eugenicists believed that <a href="https://theconversation.com/forced-sterilization-policies-in-the-us-targeted-minorities-and-those-with-disabilities-and-lasted-into-the-21st-century-143144">increased breeding by white people</a>, whom they assumed had high IQs, would benefit American society. But people who did not embody their idea of racial perfection, such as Black people, Native Americans, certain immigrants, poor white people and people with disabilities, should be sterilized – typically via <a href="https://www.rutgersuniversitypress.org/fit-to-be-tied/9780813578910">tubal ligation and vasectomy</a>.</p>
<figure class="align-center ">
<img alt="A Black woman, surrounded by large plants, sits with both hands resting on her crossed legs as she stares ahead." src="https://images.theconversation.com/files/545356/original/file-20230829-17-nfjc7f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/545356/original/file-20230829-17-nfjc7f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/545356/original/file-20230829-17-nfjc7f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/545356/original/file-20230829-17-nfjc7f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/545356/original/file-20230829-17-nfjc7f.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/545356/original/file-20230829-17-nfjc7f.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/545356/original/file-20230829-17-nfjc7f.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Elaine Riddick, pictured at her home in Marietta, Ga., on July 15, 2022, was sterilized without her consent when she was 14, in North Carolina.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/elaine-riddick-at-her-home-in-marietta-georgia-on-july-15-news-photo/1242045819?adppopup=true">Tami Chappell for The Washington Post via Getty Images</a></span>
</figcaption>
</figure>
<p>In this <a href="https://www.genome.gov/about-genomics/fact-sheets/Eugenics-and-Scientific-Racism">debunked pseudo-science</a>, eugenicists often <a href="https://via.library.depaul.edu/cgi/viewcontent.cgi?article=1270&context=law-review">used intelligence tests</a> to determine who was fit or unfit to reproduce and to predict who would commit crimes, end up in poverty or have children who were mentally ill or intellectually disabled. And they worked to incorporate their ideas into state laws. </p>
<p><a href="https://www.sciencedirect.com/science/article/pii/S1098360021025909">Thirty-two states</a>, between 1907 and 1937, enacted forced sterilization mandates to prevent births by people eugenicists considered socially inadequate. </p>
<p>State-mandated procedures resulted in the <a href="https://theconversation.com/forced-sterilization-policies-in-the-us-targeted-minorities-and-those-with-disabilities-and-lasted-into-the-21st-century-143144">coerced sterilization of women</a>, particularly <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/bioe.12977">African American, Native American and Hispanic American women</a>, and <a href="https://doi.org/10.1089/gyn.2021.0102">those from Southern and Eastern Europe</a>.</p>
<p><a href="https://library.law.howard.edu/civilrightshistory/blackrights/desegregation">Beginning in 1948</a> with President Harry Truman’s executive order to integrate the military, which extended to other areas, including education, employment and commerce, <a href="https://theconversation.com/forced-sterilization-policies-in-the-us-targeted-minorities-and-those-with-disabilities-and-lasted-into-the-21st-century-143144">sterilization rates for Black women increased</a>. For example, in North Carolina, which had the country’s third-highest sterilization rate, far more women than men were forcibly sterilized. And in the 1960s, <a href="https://socialequity.duke.edu/wp-content/uploads/2020/06/BreedingOutVol15No1-1.pdf">Black women in the state made up 65% of the women sterilized</a>, while only making up 25% of the population. </p>
<figure class="align-center ">
<img alt="With people standing around her, a woman wearing a shirt that reads, " src="https://images.theconversation.com/files/545359/original/file-20230829-23-1c4xtj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/545359/original/file-20230829-23-1c4xtj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/545359/original/file-20230829-23-1c4xtj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/545359/original/file-20230829-23-1c4xtj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/545359/original/file-20230829-23-1c4xtj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/545359/original/file-20230829-23-1c4xtj.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/545359/original/file-20230829-23-1c4xtj.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Abortion-rights activists counter-demonstrate as anti-abortion demonstrators gather for a rally in Federal Building Plaza on June 24, 2023, in Chicago to mark the first anniversary of the Dobbs v Jackson Women’s Health Organization Supreme Court decision.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/abortion-rights-activists-counter-demonstrate-as-anti-news-photo/1501196070?adppopup=true">Scott Olson/Getty Images</a></span>
</figcaption>
</figure>
<p><a href="https://bpr.berkeley.edu/2020/11/04/americas-forgotten-history-of-forced-sterilization/">Between 1930 and 1970</a>, close to 33% of the women in Puerto Rico, a U.S. territory, were forcibly sterilized. In California, between 1997 and 2003, 1,400 female inmates, <a href="https://www.insider.com/inside-forced-sterilizations-california-womens-prisons-documentary-2020-11">mostly Black, were forcibly sterilized</a>. </p>
<h2>The post-Dobbs era</h2>
<p>White nationalists and some right-wing politicians in the U.S. see the nation’s demographic changes as dangerous. The Census Bureau <a href="https://www.census.gov/content/dam/Census/library/publications/2020/demo/p25-1144.pdf">projects that in the 2040s</a>, non-Hispanic white people will no longer make up a majority of the U.S. population. The nation’s racial and ethnic makeup will then be what some call “<a href="https://www.nytimes.com/2021/08/24/opinion/us-census-majority-minority.html">majority-minority</a>.” Those projections scare racists, <a href="https://fivethirtyeight.com/features/the-twisted-logic-behind-the-rights-great-replacement-arguments/">who believe in a conspiracy about white people being destroyed</a>, which they label the <a href="https://doi.org/10.1080/1369118X.2022.2077654">great replacement theory</a> because they fear losing social, political and economic power.</p>
<p>There is no way to know if this theory factored into the majority’s votes in the Dobbs decision, but the argument that <a href="https://fivethirtyeight.com/features/how-the-fight-to-ban-abortion-is-rooted-in-the-great-replacement-theory/">not enough white people are being born</a> has been a <a href="https://www.theguardian.com/books/2022/jul/23/body-politics">common historical thread</a> in the American anti-abortion movement.</p>
<p>But, while believers in the great replacement conspiracy want white women to have more babies, actual anti-abortion decisions like the Dobbs ruling <a href="https://www.reuters.com/world/us/roe-v-wade-ruling-disproportionately-hurts-black-women-experts-say-2022-06-27/">harm Black women more</a> than any other group. <a href="https://theconversation.com/a-year-after-supreme-courts-dobbs-decision-black-women-still-struggle-for-access-to-reproductive-health-care-206369">Black women represent 39% of the country’s abortion patients</a>, but many live in communities that have limited access to <a href="https://doi.org/10.1017/S1743923X2100009X">family planning clinics</a>. And they have <a href="https://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-in-maternal-and-infant-health-current-status-and-efforts-to-address-them/">disproportionately</a> higher rates of complications during pregnancy.</p>
<p>As a result, Black women – who experience <a href="https://www.liebertpub.com/doi/full/10.1089/jwh.2020.8868">higher maternal complications</a> and mortality rates – <a href="https://www.whijournal.com/article/S1049-3867(23)00098-1/fulltext">will be forced to give birth to more babies</a>. </p>
<p>This is another period in the country in which the reproductive health decisions made by mostly white men will harm Black women.</p>
<img src="https://counter.theconversation.com/content/206706/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rodney Coates does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>In the US, white men have long had the power to make decisions about women’s reproductive health care. Those decisions have often been especially harmful to Black women.Rodney Coates, Professor of Critical Race and Ethnic Studies, Miami UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2111672023-08-29T12:38:13Z2023-08-29T12:38:13ZWith ‘Goodbye Mary,’ Molly Tuttle extends country music’s lineage of reproductive rights songs to the post-Roe era<figure><img src="https://images.theconversation.com/files/544834/original/file-20230825-29-42xgcb.jpg?ixlib=rb-1.1.0&rect=0%2C11%2C3872%2C2562&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Molly Tuttle is a rising star in American roots music.</span> <span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/2023BonnarooMusicandArtsFestival-DayOne/c1e9d71f78c141cdb07b816d58d78934/photo">Amy Harris/Invision/AP</a></span></figcaption></figure><p>Jason Aldean’s song “<a href="https://dulerecord.bandcamp.com/track/jason-aldean-try-that-in-a-small-town">Try That In A Small Town</a>” extols small towns as bastions of conservative values standing up against a litany of violent big-city bogeymen. The song, and the <a href="https://www.npr.org/2023/07/20/1188966935/jason-aldean-try-that-in-a-small-town-song-video">backlash against it</a>, threatens to strengthen popular conceptions about the inherent <a href="https://www.npr.org/transcripts/7484160">conservatism of country music</a>.</p>
<p>As an <a href="https://www.middlebury.edu/college/people/william-nash">American Studies professor</a> who teaches courses on country music, I am interested in the <a href="https://www.npr.org/sections/therecord/2018/03/20/594043497/think-politics-is-gone-from-country-music-listen-closer">genre’s competing “liberal” lineage</a>. For example, I have written about <a href="https://theconversation.com/barbara-kingsolvers-demon-copperhead-and-the-enduring-devastation-of-the-opioid-crisis-205378">country musicians’ compassionate responses to the opioid crisis</a>.</p>
<p>Another group of songs casts light on abortion rights, a newly pressing issue in the wake of <a href="https://www.oyez.org/cases/2021/19-1392">2022’s Dobbs v. Jackson Women’s Health Organization</a> Supreme Court decision overturning the constitutional right to abortion. Rather than resort to angry polemics or pronouncements about morality, however, these country – and, more broadly, Americana – songs create intimate portraits of the women and men engaged in the painful realities of daily life. This helps maintain compassion and empathy in discussions of reproductive freedom.</p>
<h2>Stories in post-Roe America</h2>
<p>Perhaps the most striking of the new “abortion songs” comes from acoustic guitar wizard <a href="https://www.mollytuttlemusic.com/">Molly Tuttle</a>, a bluegrass musician and rising star in the American roots music scene. With “<a href="https://mollytuttle.bandcamp.com/track/goodbye-mary">Goodbye Mary</a>,” a track from her new album, “<a href="https://mollytuttle.bandcamp.com/album/city-of-gold">City of Gold</a>,” Tuttle creates <a href="https://thebluegrasssituation.com/read/the-inspirations-and-issues-behind-molly-tuttles-city-of-gold/">an intimate portrait of a woman’s struggle for bodily autonomy</a> that captures the potential terrors of a post-Roe America.</p>
<iframe style="border-radius:12px" src="https://open.spotify.com/embed/playlist/0cONwQ7rzk0BLszUUcMIuP?utm_source=generator" width="100%" height="352" frameborder="0" allowfullscreen="" allow="autoplay; clipboard-write; encrypted-media; fullscreen; picture-in-picture" loading="lazy"></iframe>
<p>The story chronicles the aftermath of a love affair between Thomas and Mary, whose language marks them as country folk. The song recounts Thomas’ abandoning the pregnant Mary, who chides him for failing to keep his promise to “build a cradle soon”; sending her directions on where to find an abortionist, who refuses to perform the procedure because “the baby’s too far ‘long”; encouraging Mary to fling herself down the stairs or “ride careless down a rocky road”; and saying that he “prays for her soul” after she finds and uses a “wire” in “the old tool shed” to abort the fetus. In the final verse, she asks him, from the confines of her jail cell, to “place pretty flowers on her grave.” </p>
<p>This last twist shifts the narrative from being solely a tale about the tragic failure of the man to own his part in the conception and destruction of their fetus. The story becomes a more layered statement about a woman’s grief when she is pushed to unbearable choices, and her need to balance control of her own body with the legal and psychological guilt imposed by society when she takes the only means of control open to her. </p>
<p>The result is an intimate portrait of a woman navigating a complex landscape made more perilous by the erasure of her rights. The agency left to her, in a world where male doctors can refuse her care and absentee partners can advocate for dangerous solutions, is self-destructive and scarring.</p>
<h2>Women’s voices</h2>
<p>With “Goodbye Mary,” Tuttle joins a line of female artists who have used country, folk or roots music <a href="https://www.thinkglobalhealth.org/article/loretta-lynn-and-beyond-reproductive-rights-country-and-folk-music">to emphasize women’s reproductive rights</a>. Perhaps the most famous example is Loretta Lynn’s “<a href="https://time.com/6219550/loretta-lynn-dies-the-pill-legacy/">The Pill</a>,” a song so controversial that it was effectively banned by country radio programmers after its 1975 release. Despite the resistance to the song, its message resonated so strongly with country listeners that it became one of Lynn’s biggest hits.
</p><blockquote>You wined me and dined me when I was your girl<br>
Promised if I’d be your wife, you’d show me the world<br>
But all I’ve seen of this old world is a bed and a doctor bill<br>
I’m tearing down your brooder house ‘cause now I’ve got the pill</blockquote><p></p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/5xrjIsLmT0c?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Loretta Lynn’s song ‘The Pill’ became popular despite the country music industry’s efforts to stifle it.</span></figcaption>
</figure>
<p>Another well-known chronicler of women’s struggles is <a href="https://dollyparton.com">Dolly Parton</a>, whose 1970 track “<a href="https://www.lyrics.com/lyric/944906/Dolly+Parton/Down+from+Dover">Down from Dover</a>” chronicles the sufferings of an abandoned teenage mother who feels relief and grief when her baby is stillborn. Less well-known by the mainstream but no less critically important in this history is <a href="https://www.malvinareynolds.com">Malvina Reynolds</a>, whose 1973 “<a href="http://people.wku.edu/charles.smith/MALVINA/mr144.htm">Rosie Jane</a>” supported the Supreme Court’s <a href="https://www.oyez.org/cases/1971/70-18">1973 Roe v. Wade ruling</a> and whose 1978 “<a href="http://people.wku.edu/charles.smith/MALVINA/mr007.htm">Back Alley Surgery</a>” responded to <a href="https://www.cambridge.org/core/books/abs/abortion-and-the-law-in-america/hyde-amendment-and-its-aftermath/D0AF40D286D3AAD2DC617DEB5010947A">efforts to restrict Medicaid funding of abortion</a>. </p>
<p>There’s also a small but important history of male artists taking up these issues. Among the most moving of <a href="https://www.johnprine.com">John Prine’s</a> songs is “<a href="https://genius.com/John-prine-unwed-fathers-lyrics">Unwed Fathers</a>,” a pointed tale of Appalachian men who “can’t be bothered” with unwanted pregnancies and pursue personal and cultural freedoms that elude the women they have impregnated. </p>
<p>But not all the men in these situations are carefree. In “<a href="https://genius.com/Jason-isbell-and-the-400-unit-white-beretta-lyrics">White Beretta</a>,” a song from his “Weathervanes” album, <a href="https://www.jasonisbell.com">Jason Isbell</a> chronicles the retrospective grief and agony of a rural man who, when a teenager, failed to do more than the minimum for his pregnant girlfriend. The protagonist of the song does take her to have an abortion, but he offers her little empathy and sends her “in that room alone.” He does not regret the decision, thanking his former partner for her “grace/For the dreams we got to chase” because of her choice.</p>
<h2>Multidimensional portraits</h2>
<p>In the final analysis, both Tuttle and Isbell have created intimate, intricate portraits of people making decisions that cause them grief and bring them relief. Neither oversimplifies the issues at hand, just as neither artist wavers from the belief in the rightness of the decisions their respective characters make.</p>
<p>Put another way, these songs succeed in putting human faces on issues that have been depersonalized for political ends. Tuttle and Isbell remind their listeners that there’s more than one side to small-town life.</p><img src="https://counter.theconversation.com/content/211167/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>William Nash does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>From the pre-Roe years to today, country musicians have written about the realities of life with restrictions on reproductive rights.William Nash, Professor of American Studies and English and American Literatures, MiddleburyLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2071012023-06-21T21:54:27Z2023-06-21T21:54:27ZAbortion is a workplace issue: How managers can support employee access to reproductive health care<figure><img src="https://images.theconversation.com/files/531174/original/file-20230609-29-cvtxut.jpg?ixlib=rb-1.1.0&rect=0%2C8%2C5579%2C3705&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Protesters cheer during a Planned Parenthood rally in support of abortion access outside the Supreme Court on April 15, 2023, in Washington.</span> <span class="attribution"><span class="source">(AP Photo/Nathan Howard)</span></span></figcaption></figure><p>June 24 marks the one-year anniversary of <a href="https://theconversation.com/roe-v-wade-overturned-will-more-americans-travel-to-canada-and-mexico-for-abortions-185563">the United States Supreme Court overturning <em>Roe v. Wade</em></a> — the landmark decision that, for nearly 50 years, had guaranteed abortion care access in the U.S. </p>
<p>As of June 16, <a href="https://www.nytimes.com/interactive/2022/us/abortion-laws-roe-v-wade.html">20 states have banned or heavily restricted access</a> to abortion. At best, these bans require women who need abortions to travel hours, or even days out-of-state, often at a significant cost.</p>
<p>In response to this legislative change, <a href="https://www.nytimes.com/article/abortion-companies-travel-expenses.html">many companies in the U.S.</a> — including Goldman Sachs, the Bank of America, Dick’s Sporting Goods and Meta — introduced benefits to support employees needing abortions and <a href="https://www.nbcnews.com/news/us-news/companies-that-will-protect-employee-access-to-abortions-rcna35265">other reproductive health care</a> (e.g., birth control and genetic testing).</p>
<p><a href="https://www.bankingdive.com/news/jpmorgan-chase-goldman-sachs-bank-of-america-jefferies-amex-deutsche-employee-abortion-travel-citi/626134/">JPMorgan Chase</a>, for example, is covering costs for employees who must travel more than 50 miles. <a href="https://www.reuters.com/business/retail-consumer/amazon-reimburse-us-employees-who-travel-treatments-including-abortions-2022-05-02/">Amazon is offering up to US$4,000</a> in travel expenses each year for medical treatments. By offering such benefits, employers are prioritizing employee health and safety, even when the law may not.</p>
<h2>Dark side of workplace health benefits</h2>
<p>Unfortunately, workplace health and safety initiatives have historically demonstrated that even the most well-intentioned benefits can have a dark side. For example, some <a href="https://doi.org/10.3389/fpsyg.2018.02206">health promotion programs have led to weight-based discrimination</a> in the workplace.</p>
<p>Similarly, workplaces that adopt anti-harassment policies, but fail to have appropriate training, <a href="https://hbr.org/2020/05/why-sexual-harassment-programs-backfire">risk unintentionally causing backlash against women</a> in the workplace. </p>
<p>If implemented poorly, health and safety benefits related to abortion may have similar unintended consequences, potentially putting already vulnerable employees at risk of being discriminated against at work. The mere presence of inclusive health and safety benefits is not enough. Authentic, consistent organizational support is critical. </p>
<figure class="align-center ">
<img alt="A woman in a suit speaks into a microphone while holding up a map of the United States" src="https://images.theconversation.com/files/531000/original/file-20230608-11102-d9owk7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/531000/original/file-20230608-11102-d9owk7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/531000/original/file-20230608-11102-d9owk7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/531000/original/file-20230608-11102-d9owk7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/531000/original/file-20230608-11102-d9owk7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/531000/original/file-20230608-11102-d9owk7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/531000/original/file-20230608-11102-d9owk7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Vice President Kamala Harris holds up a map of the United States showing different states’ abortion laws while speaking in Los Angeles in October 2022.</span>
<span class="attribution"><span class="source">(David Crane/The Orange County Register via AP)</span></span>
</figcaption>
</figure>
<p>Our research on related topics, including <a href="https://hbr.org/2022/01/5-ways-managers-can-support-pregnant-employees">pregnancy</a>, <a href="https://doi.org/10.1016/j.jvb.2023.103848">pregnancy loss</a>, <a href="https://doi.org/10.1146/annurev-orgpsych-120920-050527">mental health</a> and <a href="https://doi.org/10.1037/ocp0000287">grief</a>, provides actionable, evidence-based insight for employers and managers.</p>
<h2>Build awareness of benefits</h2>
<p>Many employees don’t access benefits because they don’t know the benefits exist. Employees often have low levels of awareness about the policies, programs and benefits their employer offers, particularly when those benefits are not discussed openly. </p>
<p>To build awareness, employers should share information about reproductive health-care benefits widely, freely and frequently. All messaging should be clear and use non-judgmental language.</p>
<p>Employers should also offer additional, but complementary benefits and resources, such as inclusive mental health (e.g., counselling) and physical health (e.g., physical therapy) support.</p>
<h2>Improve access to benefits</h2>
<p>Even when employees are aware of benefits, they may be unsure about how to access them. Bureaucratic red tape, such as paperwork or complicated human resource websites, can discourage, limit and prevent the use of benefits. To improve access to abortion care benefits, employers can do a number of things.</p>
<p>First, employers should ensure employees can safely and confidentially access abortion-related benefits. Employers should protect their employees’ privacy and dignity.</p>
<figure class="align-center ">
<img alt="A pair of hands pushes a white, round pill out of a blister packet into another person's waiting hand." src="https://images.theconversation.com/files/531173/original/file-20230609-27-4z3i88.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/531173/original/file-20230609-27-4z3i88.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/531173/original/file-20230609-27-4z3i88.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/531173/original/file-20230609-27-4z3i88.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/531173/original/file-20230609-27-4z3i88.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/531173/original/file-20230609-27-4z3i88.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/531173/original/file-20230609-27-4z3i88.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A doctor gives their patient the first of two pills taken for a medical abortion during a visit to a Planned Parenthood clinic in October 2022 in Kansas City, Kan.</span>
<span class="attribution"><span class="source">(AP Photo/Charlie Riedel)</span></span>
</figcaption>
</figure>
<p>Second, employers should offer flexible, paid time off to minimize financial insecurity issues that could limit benefit use. Travelling to access abortion care out-of-state may take a week or more, and could require hospital stays and multiple nights of accommodation.</p>
<p>Lastly, employers should recognize that, even when out-of-state travel is not required, <a href="https://www.plannedparenthood.org/learn/abortion/in-clinic-abortion-procedures/what-can-i-expect-after-having-an-in-clinic-abortion">the physical recovery</a> associated with an abortion often requires at least one full day of reduced activity. However, this can vary across individuals and procedures.</p>
<h2>Reduce abortion and benefit stigma</h2>
<p>Another significant barrier to using abortion benefits is the stigma associated with it. Employees seeking abortion care may fear that disclosing this information to their manager or co-workers could jeopardize their job security or result in them being viewed negatively.</p>
<p>To reduce the stigma associated with abortion and abortion-related benefits, there are a number of things employers can do. First, they should offer equitable, accessible health-care leave policies and travel funding that don’t require detailed disclosure or justification.</p>
<p>Second, employers should provide managers with appropriate training on benefit promotion and implementation. Managers must not only understand how employees can access and use policies and benefits, but also how they can support employees as managers. This may involve authorizing paid time off and offering temporary flexible work arrangements.</p>
<p>Lastly, managers should be trained on how to use de-stigmatizing language and show appropriate social support toward an employee if they disclose the need or desire to use abortion care benefits. Managers often set the tone within their teams and can dictate whether employees feel safe to use benefits and accommodations.</p>
<h2>Abortion is a workplace issue</h2>
<p>As stated by <a href="https://www.nytimes.com/2022/05/04/business/dealbook/us-businesses-roe-wade-abortion.html">the <em>New York Times</em>, “abortion is a business issue</a>.” By offering abortion care benefits and policies, employers serve as a <a href="https://www.ft.com/content/e745d12f-924e-4a0a-9819-2f4595b179cf">“firewall” to protect against harmful legislation</a>. </p>
<p>But to be effective, employers must promote and de-stigmatize reproductive health and abortion care benefits by normalizing them. Human resource professionals and front-line managers must be trained on how to discuss these benefits and support any employees who use them.</p>
<p>In addition, these benefits must be known about and easily accessible to employees — only then will employers avoid the dark side of well-intentioned, but poorly implemented abortion care benefits and policies.</p><img src="https://counter.theconversation.com/content/207101/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jennifer Dimoff receives funding from SSHRC and the University of Ottawa.</span></em></p><p class="fine-print"><em><span>Jacquelyn Brady receives funding from San Jose State University. </span></em></p><p class="fine-print"><em><span>Mikaila Ortynsky receives funding from SSHRC and the University of Ottawa. </span></em></p><p class="fine-print"><em><span>Stephanie Gilbert receives funding from SSHRC and Cape Breton University. </span></em></p>By offering abortion care benefits and policies, employers can serve as a “firewall” to protect against harmful legislation — but only if these benefits are easily accessible and de-stigmatized.Jennifer Dimoff, Associate Professor, Organizational Behaviour and Human Resource Management, L’Université d’Ottawa/University of OttawaJacquelyn Brady, Assistant Professor of Psychology, San José State UniversityMikaila Ortynsky, PhD Student, Organizational Behaviour and Human Resource Management, Telfer School of Management, L’Université d’Ottawa/University of OttawaStephanie Gilbert, Assistant Professor of Organizational Management, Cape Breton UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2073902023-06-21T12:30:58Z2023-06-21T12:30:58ZOne year after the fall of Roe v. Wade, abortion care has become a patchwork of confusing state laws that deepen existing inequalities<figure><img src="https://images.theconversation.com/files/532284/original/file-20230615-17-u98cyj.jpg?ixlib=rb-1.1.0&rect=22%2C0%2C4914%2C1638&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The range of reproductive health care available to women depends significantly on the state they live in.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/sad-young-woman-sitting-looking-out-window-and-royalty-free-image/1132941100?phrase=abortion&adppopup=true">fizkes/iStock via Getty Images Plus</a></span></figcaption></figure><p>In the year since the <a href="https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf">U.S. Supreme Court’s Dobbs v. Jackson ruling</a> <a href="https://theconversation.com/supreme-court-overturns-roe-upends-50-years-of-abortion-rights-5-essential-reads-on-what-happens-next-184697">struck down the constitutional right to abortion</a>, society has been seeing the results of a post-Roe world. </p>
<p>While there is no law in the U.S. that regulates what a man can do with his body, the reproductive health of women is now more regulated than it has been in 50 years. And the scope of reproductive health care that women can receive is highly dependent on where they live. </p>
<p>This creates a <a href="https://doi.org/10.1177/10901981221125430">system of inequalities</a> and further exacerbates health disparities.</p>
<p>I am a <a href="https://www.uml.edu/health-sciences/nursing/faculty/collins-fantasia-heidi.aspx">nurse practitioner</a> who <a href="https://scholar.google.com/citations?user=6rrHhmUAAAAJ&hl=en">studies women’s reproductive health across the lifespan</a>. </p>
<p>My research found that college women are concerned about pregnancy, but they lack knowledge and skills about <a href="https://doi.org/10.1097/JFN.0000000000000046">navigating sexual consent</a> and often participate in <a href="https://doi.org/10.1111/j.1939-3938.2011.01108.x">sexual activity without explicit consent</a>, leaving them at risk for not using contraception and exposure to sexually transmitted infections. </p>
<p>These findings indicate that women are at risk of pregnancy at a historic time when women’s reproductive rights in the U.S. are restricted and not guaranteed. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/z4nHG4_Sqhw?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">A retrospective on Roe v. Wade – and a look ahead.</span></figcaption>
</figure>
<h2>Current state of abortion in the US</h2>
<p>The <a href="https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf">Dobbs v. Jackson ruling</a> returned decisions regarding abortion to individual states. This has led to a <a href="https://theconversation.com/in-the-year-since-the-supreme-court-overturned-roe-v-wade-and-ruled-states-should-decide-the-legality-of-abortion-voters-at-the-state-level-have-been-doing-just-that-4-essential-reads-207299">patchwork of laws</a> that <a href="https://states.guttmacher.org/policies/">span the entire range</a> from complete bans and tight restrictions to full state protection for abortion.</p>
<p>In some states, such as Texas, Louisiana and Mississippi, <a href="https://www.guttmacher.org/state-policy/explore/overview-abortion-laws">abortion is banned</a> beginning at six weeks gestational age, when very few women even know they are pregnant. Other states, such as Massachusetts, Vermont, New York and Oregon, have enacted state-level protections for abortion. </p>
<p>The patchwork of state laws also results in a great deal of confusion. In the past year, women’s rights organizations and women’s health advocates have brought numerous <a href="https://www.kff.org/womens-health-policy/issue-brief/legal-challenges-to-state-abortion-bans-since-the-dobbs-decision/#">legal challenges to restrictive abortion laws</a>. These cases have halted the implementation of some of the strictest abortion regulations until additional court rulings are finalized. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/533009/original/file-20230620-27-mj0m9l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Protesters gather in a small crowd holding signs including " src="https://images.theconversation.com/files/533009/original/file-20230620-27-mj0m9l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/533009/original/file-20230620-27-mj0m9l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/533009/original/file-20230620-27-mj0m9l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/533009/original/file-20230620-27-mj0m9l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/533009/original/file-20230620-27-mj0m9l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/533009/original/file-20230620-27-mj0m9l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/533009/original/file-20230620-27-mj0m9l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Protesters against a stricter abortion ban stand in the State House lobby on May 23, 2023, in Columbia, S.C.</span>
<span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/AbortionSouthCarolina/a08c0479d51341e493cf4850cb1df634/photo?Query=abortion%20bans&mediaType=photo&sortBy=&dateRange=Anytime&totalCount=2705&currentItemNo=12">AP Photo/Jeffrey Collins</a></span>
</figcaption>
</figure>
<h2>Downstream effects for health care professionals</h2>
<p>Abortion training is considered <a href="https://doi.org/10.1097/ACM.0000000000005154">essential health care and a core competency</a> for physicians in obstetrics and gynecology, or OB-GYN, residency programs. Approximately 50% of OB-GYN residency programs are located in states <a href="https://doi.org/10.1097/AOG.0000000000004832">with restricted or highly restricted access to abortion</a>. This will logically result in not only fewer health care providers being trained to perform gynecologic procedures for abortion, but also other conditions such as miscarriage, fetal death and nonviable pregnancies. </p>
<p>In states with changing abortion laws and legal challenges to new laws, <a href="https://www.ama-assn.org/delivering-care/population-care/ambiguous-anti-abortion-laws-are-putting-patients-risk">physicians are uncertain</a> of what procedures can be legally done. <a href="https://www.politico.com/news/2022/05/06/potential-abortion-bans-and-penalties-by-state-00030572">Penalties for violating abortion laws</a> may include arrest, loss of medical license, fines and discipline by state boards of medicine. </p>
<p>As a result, physicians are <a href="https://www.axios.com/2023/04/18/abortion-ban-states-drop-student-residents">choosing to leave states</a> with the <a href="https://www.npr.org/sections/health-shots/2023/05/23/1177542605/abortion-bans-drive-off-doctors-and-put-other-health-care-at-risk">most restrictive abortion laws, and clinics are closing</a>, which is contributing to the current <a href="https://www.cnn.com/2023/04/19/health/abortion-ban-affects-physician-training/index.html">shortage of health care providers</a>.</p>
<h2>Inequalities in health care access</h2>
<p>The unequal access to abortion procedures across the country is most directly affecting the poorest women in the U.S.</p>
<p>Currently, 12 states restrict abortion coverage by private insurance, and more than 30 states <a href="https://www.guttmacher.org/state-policy/explore/overview-abortion-laws">prohibit public Medicaid payment</a> for abortion. Women who qualify for Medicaid are among the poorest in the U.S. Lack of access to abortion limits education and wage earning and <a href="https://www.npr.org/2022/08/18/1111344810/abortion-ban-states-social-safety-net-health-outcomes">contributes to poverty</a>. States with the most restrictive abortion laws also have <a href="https://www.axios.com/2022/05/20/abortion-roe-supreme-court-babies-mothers">limited access to pregnancy care</a> and <a href="https://www.usnews.com/news/politics/articles/2022-04-07/social-programs-weak-in-many-states-with-tough-abortion-laws">supportive programs</a> for pregnant and parenting women. </p>
<p>In addition, traveling to a different state to obtain an abortion is often not possible for poor women. Lack of transportation and limited financial resources reduce or eliminate options to obtain an abortion in a different geographic location. </p>
<p>What’s more, states with the most abortion restrictions have some of the <a href="https://worldpopulationreview.com/state-rankings/maternal-mortality-rate-by-state">worst pregnancy and maternal health outcomes</a> for women, especially women of color. Pregnancy itself is associated with a <a href="https://doi.org/10.1097%2FAOG.0000000000003762">risk of dying</a>. </p>
<p>Maternal morbidity is the term used to describe short- or long-term <a href="https://www.nichd.nih.gov/health/topics/maternal-morbidity-mortality">health problems that result from pregnancy</a>. Maternal mortality refers to the <a href="https://www.who.int/news-room/fact-sheets/detail/maternal-mortality">death of women during pregnancy</a> or within the first six weeks after birth. </p>
<p>For example, Mississippi and Louisiana have the highest rates of maternal mortality in the U.S. and also <a href="https://www.guttmacher.org/state-policy/explore/overview-abortion-laws">have the most restrictive abortion laws</a>. Black women have the <a href="https://www.ama-assn.org/print/pdf/node/66881">highest maternal mortality of all races</a> and ethnicities. Women in these states who are unable to terminate a pregnancy have a higher risk of dying as a result of the pregnancy than women in other states. </p>
<p>Additionally, research shows that a <a href="https://doi.org/10.1097/aog.0b013e31823fe923">woman’s risk of dying</a> related to pregnancy or childbirth is about 14 times higher than the risk of death from an abortion. </p>
<p>In addition to the increased risks of death, there are other <a href="https://www.ansirh.org/research/ongoing/turnaway-study">physical and mental health implications</a> associated with carrying an undesired pregnancy to term. Being denied access to abortion is associated with increased anxiety and <a href="https://www.ansirh.org/research/ongoing/turnaway-study">fewer future plans</a> for the next year. Research also shows that not being able to obtain an abortion makes women more likely to <a href="https://doi.org/10.2105/AJPH.2017.304247">live below the federal poverty level</a> and to <a href="https://doi.org/10.1363/psrh.12216">lack partner support</a>. </p>
<p>Conversely, research has shown that there are <a href="https://doi.org/10.1016/j.contraception.2008.07.005">few if any significant negative mental health outcomes</a> among women who have abortions. </p>
<h2>Unsafe abortions</h2>
<p>Restricting legal abortion increases the risk that women will seek out <a href="https://doi.org/10.1016/j.bpobgyn.2010.02.012">pregnancy termination from unskilled people</a> in unsafe settings. Or they may not seek care quickly for pregnancy complications due to fear of being accused of a crime.</p>
<p>In Texas, physicians are <a href="https://www.newyorker.com/news/dispatch/in-the-post-roe-era-letting-pregnant-patients-get-sicker-by-design">reporting an increase in sepsis</a>, or an <a href="https://theconversation.com/sepsis-still-kills-1-in-5-people-worldwide-two-icu-physicians-offer-a-new-approach-to-stopping-it-175650">overwhelming response to infection</a>, from incomplete abortions. These physicians predict that sepsis will become the leading cause of maternal death in Texas. </p>
<p>Prior to 1973, when Roe v. Wade established constitutional protection for abortion in the U.S., women often resorted to unsafe methods to induce abortion that resulted in a high death toll. <a href="https://doi.org/10.2307/3419941">Septic abortion wards</a> – or designated areas of hospitals where women were treated for sepsis as a result of illegal abortions – were common. In 1965, 17% of all deaths related to pregnancy were <a href="https://www.guttmacher.org/sites/default/files/article_files/gr060108.pdf">attributed to illegal abortion</a>. </p>
<p>Now that the constitutional right to abortion has been eliminated, more women will inevitably <a href="https://doi.org/10.1016/j.ajog.2022.07.033">die or become seriously ill</a> due to lack of safe access to abortion services. In states with the most restrictions on abortion, whether a woman meets the criteria for an exemption to save the life of the mother may be <a href="https://publichealth.jhu.edu/2023/a-year-without-roe">decided by a hospital committee</a>. This can delay necessary care and increase the risk to the mother.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/rSWwX7lBEGk?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Said one: “I didn’t know I was important enough to draw boundaries around what people could and couldn’t do with my body.”</span></figcaption>
</figure>
<h2>Women affected by violence</h2>
<p>In the U.S., more than 25% of women will <a href="https://ncadv.org/STATISTICS">experience physical or sexual violence</a> in their lifetime. Violence from an intimate partner is a <a href="https://www.ansirh.org/research/ongoing/turnaway-study">leading reason for abortion</a>. My research shows that women affected by violence have a <a href="https://doi.org/10.1016/j.contraception.2012.03.005">higher risk of pregnancy</a> and that college women are at increased risk of <a href="https://doi.org/10.1097/jfn.0000000000000086">nonconsensual and forced sexual encounters</a>.</p>
<p>Currently, there are 14 states with abortion bans that contain <a href="https://www.kff.org/womens-health-policy/issue-brief/a-review-of-exceptions-in-state-abortions-bans-implications-for-the-provision-of-abortion-services/">no exception for rape or incest</a> or require that the sexual assault be reported to law enforcement to qualify for exception. </p>
<p>Research has shown that women often <a href="https://doi.org/10.3200/JACH.55.3.157-162">don’t report sexual assault</a> due to stigma, embarrassment or fear of not being believed. Even if women qualify for an abortion as a result of sexual violence, those who have not filed a formal police report lack “proof” that their pregnancy resulted from assault. </p>
<p>While the changes that have occurred since the fall of Roe one year ago are already deeply concerning, the full effect of eliminating the constitutional right to an abortion won’t be known for years. And as laws are enacted and subsequently challenged, uncertainty and confusion regarding women’s reproductive health care will undoubtedly continue for years to come.</p><img src="https://counter.theconversation.com/content/207390/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Heidi Collins Fantasia has received funding from the National Institutes of Health, National Institute of Child Health and Human Development and Heart, Lung, and Blood Institute. Dr. Fantasia is the editor of Nursing for Women's Health. </span></em></p>Abortion bans and restrictions have numerous downstream effects on health care. For instance, medical students in states where those laws exist will not receive training for some standard procedures.Heidi Collins Fantasia, Associate Professor of Nursing, UMass LowellLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2076482023-06-16T09:41:51Z2023-06-16T09:41:51ZAbortion prison sentence shows the law is focused on foetuses – why that’s dangerous for women<figure><img src="https://images.theconversation.com/files/532234/original/file-20230615-19-y1oe3n.jpg?ixlib=rb-1.1.0&rect=87%2C45%2C2460%2C1849&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/pregnant-woman-looking-scan-baby-images-589166537">Emituu/Shutterstock</a></span></figcaption></figure><p>The <a href="https://www.theguardian.com/world/2023/jun/12/woman-in-uk-jailed-for-28-months-over-taking-abortion-pills-after-legal-time-limit">imprisonment of a woman</a> in the UK for taking abortion pills at 32-34 weeks of pregnancy has shocked many. Most people are still unaware that abortion at any stage of pregnancy is <a href="https://theconversation.com/woman-jailed-over-abortion-an-expert-on-what-uk-law-actually-says-and-what-needs-to-change-207578">illegal in England and Wales</a>, unless authorised by two doctors. </p>
<p>Any woman who obtains abortion medication from sources other than an official provider faces the prospect of life imprisonment under the <a href="https://www.legislation.gov.uk/ukpga/Vict/24-25/100/contents">Offences Against the Person Act 1861</a>. As does any woman who uses legally obtained medication in any way other than as directed, for example, delaying taking the medication.</p>
<p>Abortion (or “procuring a miscarriage”) was made a criminal offence to <a href="https://books.emeraldinsight.com/page/detail/Criminal-Justice-Responses-to-Maternal-Filicide/?k=9781839096211">protect women from the dangers</a> that backstreet abortion posed in the 1800s. At this time, all abortions were surgical abortions. There were no antibiotics, and few remedies if the procedure caused uncontrollable bleeding. </p>
<p>Today, abortion is incredibly safe when it can be legally accessed – far safer than it is for a woman to <a href="https://www.scientificamerican.com/article/pregnancy-is-far-more-dangerous-to-women-than-abortion/">continue a pregnancy</a> to full-term. Which leads to the question: what is the purpose of the offence today?</p>
<p>Reading the sentencing hearing from this and <a href="https://books.emeraldinsight.com/page/detail/Criminal-Justice-Responses-to-Maternal-Filicide/?k=9781839096211">other cases</a>, it appears the law is being used to protect foetuses. </p>
<p>In his sentencing remarks, the judge focused on the late stage of the woman’s pregnancy. Arguing that this was an aggravating factor of the case, he describes the woman’s “daughter” as “stillborn”. </p>
<p>It is important to note here that the offence of procuring a miscarriage (as detailed in the Offences Against the Person Act) makes no reference to the gestational stage of the pregnancy. The offence is also not dependent on the death of the foetus. </p>
<p>No woman who has illegally ended her pregnancy (for example, by obtaining abortion medication illegally) at an early gestational stage has been prosecuted. This suggests the application of the law is focused on protecting foetuses that could survive if born alive – not on preventing abortion.</p>
<h2>Extreme vulnerability for women</h2>
<p>This case may have further horrified many people due to the stage the woman’s pregnancy had reached at the time she took the abortion medication. </p>
<p>The limited details of the woman’s experience that are outlined in the <a href="https://www.judiciary.uk/wp-content/uploads/2023/06/R-v.-Foster-sentencing-remarks-12.6.23.pdf">sentencing remark</a> indicate that she, like every other <a href="https://books.emeraldinsight.com/page/detail/Criminal-Justice-Responses-to-Maternal-Filicide/?k=9781839096211">woman whose case I have examined</a>, acted from a place of extreme vulnerability and profound crisis. The reality is that no woman wants a late-term abortion. The motivation to seek one comes from a place of desperation.</p>
<p>During the sentencing, the judge noted the woman’s “deep emotional attachment” to her unborn child, a common experience for women in similar situations. These are not simply “unwanted” pregnancies resulting in delayed abortions.</p>
<p>Women who self-abort pregnancies late in gestation do not necessarily want the unborn baby to die. This is the situation of a woman who believes it would be impossible, possibly due to <a href="https://www.thetimes.co.uk/article/lauras-story-jailed-for-having-an-abortion-in-britain-0m06nzrlx">fear of violence or abuse</a>, for her to bring a child into the world.</p>
<h2>The role of the criminal law</h2>
<p>Some may argue that a late-term foetus is no different to a newborn baby, and that both need criminal legal protection. But such application of the criminal law carries significant risks for women, as well as for babies and foetuses.</p>
<p>In the US, many states now explicitly <a href="https://time.com/6191886/fetal-personhood-laws-roe-abortion/">protect the unborn child</a>, resulting in women being arrested, detained and imprisoned following miscarriages and stillbirths, after exerting their right to refuse medical care during pregnancy, and for behaviour that would be legal <a href="https://scholarship.law.upenn.edu/penn_law_review/vol138/iss1/11/">if they were not pregnant</a>. </p>
<p>As with almost all forms of crime control, it is the most vulnerable people – women of colour and those of lower socioeconomic status – who have been <a href="https://www.cambridge.org/gb/universitypress/subjects/law/socio-legal-studies/policing-womb-invisible-women-and-criminalization-motherhood?format=PB">disproportionately criminalised</a>. In addition, a direct line can be drawn between foetal protection laws and the <a href="https://www.pregnancyjusticeus.org/pregnant_drug_users_fetal_persons_and_the_threat_to_roe_v_wade_by_lynn_m_paltrow/">overturning of Roe v Wade</a>, the supreme court case that protected the right to an abortion in the US. Protecting a foetus in law is a direct threat to reproductive rights.</p>
<figure class="align-center ">
<img alt="Black and white photo of a woman with her face in her hands" src="https://images.theconversation.com/files/532163/original/file-20230615-15-mql66x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/532163/original/file-20230615-15-mql66x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=397&fit=crop&dpr=1 600w, https://images.theconversation.com/files/532163/original/file-20230615-15-mql66x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=397&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/532163/original/file-20230615-15-mql66x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=397&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/532163/original/file-20230615-15-mql66x.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=499&fit=crop&dpr=1 754w, https://images.theconversation.com/files/532163/original/file-20230615-15-mql66x.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=499&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/532163/original/file-20230615-15-mql66x.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=499&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">No one wants to have a late-term abortion – it comes from a place of deep crisis.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-depressed-woman-155806436">Twin Design/Shutterstock</a></span>
</figcaption>
</figure>
<p>The criminalisation of pregnant women has also had disastrous consequences for foetuses and babies. While the aim of foetal protection laws is to prevent harm to unborn babies, the threat of legal sanctions against pregnant women has led many to <a href="https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2011/01/substance-abuse-reporting-and-pregnancy-the-role-of-the-obstetrician-gynecologist">actively avoid medical care</a> during their pregnancy due to a fear that they will be reported to the police. Lack of antenatal care is a leading factor in <a href="https://jaapl.org/content/43/2/137">pregnancy complications</a>.</p>
<p>There is also evidence that women in the US have sought abortions to <a href="https://www.repository.law.indiana.edu/ilj/vol89/iss2/8/">escape prosecution</a> under foetal protection laws. For example, one woman who was charged with the reckless endangerment of her foetus after inhaling paint fumes, had the <a href="https://www.pregnancyjusticeus.org/napw-documentation-state-v-greywind/">charges against her dropped</a> after she terminated the pregnancy. </p>
<p>Attempts to “protect” foetuses are, in some instances, resulting in worse health outcomes, or even death, for both foetuses and pregnant women.</p>
<p>Whether the criminal law should protect foetal life is a complex question, but it is a question for parliament alone. The courts and the Crown Prosecution Service, who decide to prosecute women, have interpreted procuring a miscarriage as a crime against a foetus. They have decided that women should be punished if their actions in later pregnancy cause the death of an unborn child. </p>
<p>Their interpretation of the law moves the statute beyond the intentions of parliament when enacted. It is time parliament involves itself in this area of criminal law, conducting a thorough and compassionate review.</p><img src="https://counter.theconversation.com/content/207648/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Emma Milne received funding to support this research from the Arts and Humanities Research Council (AH/L503861/), the Socio-Legal Studies Association Research Grants Scheme 2018, and Durham Law School. Emma is a trustee of the Socio-Legal Studies Association, a charitable incorporated organisation (registered charity number 1186333).</span></em></p>Foetal protection laws carry health risks for both mothers and babies.Emma Milne, Associate Professor in Criminal Law and Criminal Justice, Durham UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2075782023-06-14T10:56:57Z2023-06-14T10:56:57ZWoman jailed over abortion – an expert on what UK law actually says and what needs to change<figure><img src="https://images.theconversation.com/files/531693/original/file-20230613-27-cae5hq.jpg?ixlib=rb-1.1.0&rect=70%2C50%2C6639%2C4416&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/crop-close-young-african-american-woman-1863927673">fizkes/Shutterstock</a></span></figcaption></figure><p>Many people assume that because abortion is relatively accessible in England, it is not a crime. The fact that a woman has now received a <a href="https://www.theguardian.com/world/2023/jun/12/woman-in-uk-jailed-for-28-months-over-taking-abortion-pills-after-legal-time-limit">28-month prison sentence</a> for taking abortion pills past the legal time limit shows that this assumption is wrong. </p>
<p>Abortion remains within the criminal law to some extent in almost every country globally, despite the fact that it is a safe and relatively common procedure. Laws can criminalise women and pregnant people, healthcare providers or anyone who helps a woman get an abortion. The sentencing in Poland of activist <a href="https://www.amnesty.org/en/latest/news/2023/03/poland-conviction-of-activist-prosecuted-for-aiding-an-abortion-offers-chilling-snapshot-of-future/">Justyna Wydrzyńska</a> is one example. In March 2023, she received eight months community service for aiding an abortion seeker. </p>
<p>The 28-month sentence for the 44-year-old mother of three in England reflects the desperate need for a change to the law, in the form of decriminalisation. </p>
<p>In England and Wales, abortion is considered legal when it is performed by a registered medical practitioner, authorised by two doctors and meets certain conditions, such as risk to physical or mental health or risk of fetal anomaly. Abortion can only be performed after 24 weeks gestation in very limited circumstances. </p>
<p>The <a href="https://www.bpas.org/get-involved/campaigns/briefings/abortion-law/">1967 Abortion Act</a> determines the situations in which an abortion is not a criminal act and the gestational time limits when one can be performed. The <a href="https://academic.oup.com/sp/article-abstract/21/1/26/1607984?login=false">act was written</a> in response to healthcare providers’ concerns about unsafe “backstreet” abortions, rather than out of concern for women’s bodily rights or autonomy. </p>
<p>Lawmakers did not want to make abortion available on request, therefore the sections of the <a href="https://www.legislation.gov.uk/ukpga/Vict/24-25/100/contents">1861 Offences Against the Person Act</a> which criminalise abortion were not repealed. Sections 58 and 59 make it a criminal offence to administer or supply drugs or use instruments to procure an abortion. The offences carry a maximum sentence of life imprisonment.</p>
<p>While the 1967 Abortion Act applies in Scotland, the Offences Against the Person Act does not. There, abortion is considered a crime in common law, developed by court precedent. </p>
<p>The recent prosecution is not an anomaly. In the past eight years, police in England and Wales <a href="https://www.theguardian.com/commentisfree/2022/aug/19/abortion-legal-great-britain-women-life-sentences-roe-v-wade">have investigated</a> at least 17 people for procuring their own abortion outside the law. The legacy of the 1861 act as a Victorian colonial era law continues to be felt globally, and still applies in countries such as the Gambia, Malawi and Jamaica. </p>
<h2>Decriminalising abortion</h2>
<p>Northern Ireland is the only region of the UK where abortion is <a href="https://www.tandfonline.com/doi/full/10.1080/14616742.2022.2053297">decriminalised</a>. The 1967 act was never extended to Northern Ireland. </p>
<p>After years of activist lobbying and an international inquiry by the UN committee for the elimination of discrimination against women, Westminster repealed sections 58 and 59 of the Offences Against the Person Act in 2019 – but only in Northern Ireland. The <a href="https://www.legislation.gov.uk/uksi/2020/345/contents/made">Abortion (Northern Ireland) Regulations 2020</a> now govern abortion access. </p>
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Read more:
<a href="https://theconversation.com/westminster-steps-in-after-northern-ireland-fails-to-comply-with-abortion-law-change-how-it-happened-158239">Westminster steps in after Northern Ireland fails to comply with abortion law change – how it happened</a>
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<p>But while the law in Northern Ireland is now more liberal, issues remain around <a href="https://theconversation.com/westminster-steps-in-after-northern-ireland-fails-to-comply-with-abortion-law-change-how-it-happened-158239">access</a> to abortion services. Healthcare providers have had to organise themselves to provide medical abortions, rather than receiving government support and people seeking surgical abortions still have to travel to England.</p>
<p>The <a href="https://policycommons.net/artifacts/2269625/abortion-care-guideline/3029443/">World Health Organization</a> (WHO) and <a href="https://gh.bmj.com/content/7/12/e010409">international human rights bodies</a> have recommended that, at minimum, abortion be removed from the criminal law and decriminalised around the world.</p>
<p>The WHO defines this as “the complete decriminalisation of abortion for all relevant actors: removing abortion from all penal/criminal laws, not applying other criminal offences (e.g., murder, manslaughter) to abortion, and ensuring there are no criminal penalties for having, assisting with, providing information about or providing abortion”. </p>
<p>This approach recognises that making abortion a crime does not prevent abortion, nor does it protect people from having unsafe abortions. What it does do is impede access and influence how people who have abortions are viewed. Higher levels of <a href="https://www.makeinroads.org/making-inroads/2021/September/how-abortion-stigma-and-criminalization-shape-each-other">stigma</a> are often seen in regions with stricter abortion laws.</p>
<p>Removing abortion from the criminal law does not mean that it is ungoverned, simply that is it governed in the same way as other health procedures. The case of Northern Ireland shows that there is nothing stopping Westminster from repealing sections 58 and 59 of the Offences Against the Person Act. This latest case should make it an issue of political urgency.</p><img src="https://counter.theconversation.com/content/207578/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Claire Pierson receives funding from the British Academy and is a board member of Alliance for Choice Belfast. </span></em></p>In the past eight years, police in England and Wales have investigated at least 17 people for procuring their own abortion outside the law.Claire Pierson, Senior Lecturer in Politics, University of LiverpoolLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2048702023-06-01T10:00:02Z2023-06-01T10:00:02ZHow food insecurity affects people’s rights to choose whether or not to have children, and how they parent<figure><img src="https://images.theconversation.com/files/528284/original/file-20230525-21-ihkudx.jpg?ixlib=rb-1.1.0&rect=17%2C69%2C2484%2C2484&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/tired-mom-shopping-her-daughter-pushing-2057951918">Nicoleta Ionescu/Shutterstock</a></span></figcaption></figure><p><a href="https://www.fao.org/hunger/en/">Food insecurity</a> – difficulties getting enough nutritious food for a healthy life – is a growing problem <a href="https://www.fao.org/3/cc0639en/online/sofi-2022/key-messages.html">globally</a>. It has been linked to many health and social problems including malnutrition, difficulties managing <a href="https://link.springer.com/article/10.1007/s13668-014-0104-4">diabetes</a>, impaired development <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/mcn.12967">in childhood</a>, and reduced <a href="https://www.sciencedirect.com/science/article/pii/S0022316623095974">school performance</a> for children. </p>
<p>Our recent <a href="https://www.tandfonline.com/doi/full/10.1080/19317611.2023.2201841">research</a> shows how food insecurity also matters for reproductive justice: people’s ability to have only the children they want and raise them the way they want. </p>
<p>Led by Black women, the <a href="https://time.com/5735432/reproductive-justice-groups/">reproductive justice movement</a> began in the US in the 1990s.</p>
<p>Awful acts of violence, such as forced sterilisation and child removals, have aimed to prevent the most marginalised people from having and raising children. Reproductive justice highlights how marginalised people’s options are systematically limited by the way our societies are organised.</p>
<p>Reproductive justice activists assert that everyone has the right to have a child or – equally – to not have a child. If people choose to have children, they should be able to parent them with dignity in safe and healthy environments. In our research, we show how food insecurity can restrict each of these rights. </p>
<h2>Why food insecurity matters</h2>
<p>For one thing, food insecurity affects nutrition. Malnutrition is linked with <a href="https://www.ajol.info/index.php/wajm/article/view/27946">infertility</a> and poorer pregnancy and <a href="https://read.dukeupress.edu/demography/article/51/5/1775/169405/The-Effects-of-Intrauterine-Malnutrition-on-Birth?casa_token=BMrVDMvi4fIAAAAA:fuvpRlo0K480qx63WCKZXs5iEtv8JFdVJy5qObpbRff1vV79WNDMuq0PEKr8w3gCC7dFJDdm_A">birth outcomes</a>. This affects both the right to have a child and the right to parent in safe and healthy environments. It is impossible to provide a healthy environment for a child without access to sufficient nutritious food. </p>
<p>And food insecurity can make it hard to meet other basic needs. Food insecure people are more likely to live in <a href="https://www.cambridge.org/core/journals/social-policy-and-society/article/housing-situations-of-food-bank-users-in-great-britain/E7F99E23A37ED593292584F324A34069">unfit housing conditions</a>, or even without a home entirely. They can face impossible spending choices, such as whether to spend on food versus heating or cooling their home. Having to make trade-offs between food and other necessities is a barrier to the right to parent in safe and healthy environments.</p>
<p>Impossible spending choices also affect access to reproductive healthcare. Where healthcare systems charge for service, food insecure people face challenging decisions of whether to use their limited funds on food or healthcare. </p>
<p>And even where healthcare is free in principle – such as the NHS in the UK – there can be hidden cost trade-offs. Missing work to attend a healthcare appointment can mean less money for food. For people in precarious work who are more at risk of food insecurity, missing work could mean losing their job, placing future wages at risk.</p>
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<img alt="Woman sat looking sad" src="https://images.theconversation.com/files/528341/original/file-20230525-23265-3hhbom.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/528341/original/file-20230525-23265-3hhbom.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/528341/original/file-20230525-23265-3hhbom.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/528341/original/file-20230525-23265-3hhbom.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/528341/original/file-20230525-23265-3hhbom.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/528341/original/file-20230525-23265-3hhbom.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/528341/original/file-20230525-23265-3hhbom.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Food insecurity leads to having to make impossible choices.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/panic-attacks-alone-young-girl-sad-1459594841">panitanphoto/Shutterstock</a></span>
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<p>Such impossible decisions between spending on reproductive healthcare and food affect both the right to have, and to not have, a child. It may limit access to contraception, abortion, prenatal care, infertility treatment, and other reproductive healthcare. Trade-offs between spending to feed one’s child versus to take them to a doctor also impede the right to parent with dignity in a healthy environment.</p>
<p>Food insecure people may resort to criminalised methods to obtain food, which can lead to a prison sentence. For example, in some countries sex work is criminalised, but it can be an important source of income. Broader food security crises, triggered by events such as regional conflict or the COVID-19 pandemic, may make criminalised strategies <a href="https://securelivelihoods.org/publication/the-many-faces-of-transactional-sex-women%C2%92s-agency-livelihoods-and-risk-factors-in-humanitarian-contexts-a-literature-review/">more likely</a>. </p>
<p>In turn, disruption of routine reproductive healthcare in prison can negatively impact the right to have a child, and separating families through parental imprisonment compromises the right to parent. A criminal record may also limit employment opportunities and access to housing, increasing the risk of food insecurity after release from prison. </p>
<p>And these are only a few examples.</p>
<h2>Why is this a timely issue?</h2>
<p>Events such as the pandemic, conflict in places such as Ukraine, Sudan, Ethiopia, Yemen and Syria, and the cost of living crisis have made matters worse. Such events have disrupted global food supply chains, displaced people, and made basic necessities unaffordable. On top of everything, the climate crisis will compound these problems in the coming years.</p>
<p>Meanwhile, reproductive justice is a pressing – and linked – global issue. Though it’s been over 50 years since the UN <a href="https://www.unfpa.org/events/international-conference-human-rights">acknowledged</a> reproductive rights as a human right, reproductive choice continues to be compromised globally. Just one <a href="https://www.bmj.com/content/380/bmj.p521">high-profile example</a> is the restriction of women’s right to abortion following a landmark 2022 US Supreme Court Ruling. </p>
<p>Recognising the link between food insecurity and reproductive justice is important. The most marginalised people are at greatest risk of impediments to both food security and reproductive justice.</p>
<p>As an activist movement, grassroots action sits at the core of reproductive justice, with a commitment to elevate voices previously unheard or overlooked. There is much to be gained from collaborating with similar groups working to combat food insecurity to drive mutual learning and action.</p><img src="https://counter.theconversation.com/content/204870/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jasmine Fledderjohann receives funding from UKRI in the form of a Future Leaders Fellowship (grant number MR/T021950/1).</span></em></p><p class="fine-print"><em><span>Maureen Owino is a Vanier Canada Graduate Scholarship (Vanier CGS) Scholar and receives funding from CIHR. </span></em></p><p class="fine-print"><em><span>Sophie Patterson receives funding from NIHR in the form of a Clinical Lectureship, in addition to a Clinical Lecturer Starter Grant from the Academy of Medical Sciences.</span></em></p>Everyone should have the right to have, or not have, a child and to parent with dignity in a safe environment – but food insecurity makes this difficult.Jasmine Fledderjohann, Senior Lecturer in Sociology, Lancaster UniversityMaureen Owino, PhD Candidate, Faculty of Environmental and Urban Change, York University, CanadaSophie Patterson, Clinical Lecturer in Public Health, Lancaster UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2065032023-06-01T05:57:19Z2023-06-01T05:57:19ZWant long-term contraception? There are more effective options than the pill. But they can be hard to find<figure><img src="https://images.theconversation.com/files/529283/original/file-20230531-17-pe8br4.jpg?ixlib=rb-1.1.0&rect=15%2C286%2C3521%2C2068&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/female-contraceptive-spiral-hands-nurse-device-2206348007">Shutterstock</a></span></figcaption></figure><p>Australians’ access to a range of contraceptive options depends on where they live and how wealthy they are. A recent <a href="https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/ReproductiveHealthcare/Report">parliamentary inquiry</a> recommends ways to end this “postcode lottery” for people who want to use long-acting reversible contraception.</p>
<p>There are several types of long-acting reversible contraception: the hormonal contraceptive implant, the hormonal intrauterine devices (IUD) and copper IUDs. </p>
<p>With fewer than <a href="https://www.nejm.org/doi/pdf/10.1056/nejmoa1110855">one in 100 users</a> becoming pregnant in a year while using them (compared to up to <a href="https://theconversation.com/how-effective-is-the-pill-122189">seven</a> in 100 contraceptive pill users) these are the <a href="https://www.nejm.org/doi/pdf/10.1056/nejmoa1110855">most effective</a> contraceptives available. Once they’re inserted into the body, you don’t need to remember to carry a condom, take a daily pill or fill a new script. </p>
<p>So why are they so hard to access in Australia? And what needs to change?</p>
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Read more:
<a href="https://theconversation.com/australian-womens-access-to-abortion-is-a-postcode-lottery-heres-what-needs-to-change-206504">Australian women's access to abortion is a postcode lottery. Here's what needs to change</a>
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<h2>How do they work?</h2>
<p>The <a href="https://www.tandfonline.com/doi/abs/10.1080/13625187.2000.12067162">contraceptive implant</a> (known as Implanon NXT in Australia) is a small flexible rod, inserted just under the skin of the upper inner arm. It releases a progestogen hormone which prevents monthly egg release from the ovary for up to three years. </p>
<p>IUDs are small T-shaped devices which are inserted into the uterus. Hormonal IUDs contain a progestogen hormone and <a href="https://pubmed.ncbi.nlm.nih.gov/21074010/">mainly work</a> by thickening the cervical mucus and preventing sperm from swimming up into the uterus. There are two types of hormonal IUDs: Mirena and Kyleena. Both last up to five years. Kyleena is slightly smaller and contains a lower dose of hormone than Mirena. </p>
<p><a href="https://pubmed.ncbi.nlm.nih.gov/17531610/">Copper IUDs</a> are hormone-free and last up to ten years. They work through their toxic effect on sperm and the egg to prevent fertilisation. </p>
<h2>They have additional benefits for some users</h2>
<p>As well as better protection from pregnancy, some long-acting reversible contraception methods have other benefits. </p>
<p>The hormonal IUD, Mirena, for example, <a href="https://pubmed.ncbi.nlm.nih.gov/35611632/">reduces heavy menstrual bleeding</a>. This can improve people’s quality of life and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC28513/">reduce the need for a hysterectomy</a>.</p>
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<img alt="Clinician talks to patient" src="https://images.theconversation.com/files/529488/original/file-20230601-21858-ivgtnh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/529488/original/file-20230601-21858-ivgtnh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529488/original/file-20230601-21858-ivgtnh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529488/original/file-20230601-21858-ivgtnh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529488/original/file-20230601-21858-ivgtnh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529488/original/file-20230601-21858-ivgtnh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529488/original/file-20230601-21858-ivgtnh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">IUDs can have other benefits.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/abortion-provider-talking-care-patient-2063751323">Shutterstock</a></span>
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<p>Hormonal pills (containing estrogen) and the vaginal ring can’t be used by people with certain conditions, such as migraine with aura, or by people aged 35 years or older who smoke. This isn’t the case for long-acting reversible contraception methods, which most people can safely use. </p>
<p>Copper IUDs are an <a href="https://www.fsrh.org/standards-and-guidance/documents/ukmec-2016/fsrh-ukmec-full-book-2019.pdf">essential option</a> for people who cannot or prefer not to use hormones. This includes people with hormone-driven cancers such as breast cancer, for whom any hormonal contraceptive would be considered unsafe. </p>
<h2>Why aren’t they more available?</h2>
<p>Access to long-acting reversible contraception is not universal in Australia. </p>
<p>Cost can be a <a href="https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-015-0227-9">considerable barrier</a> to uptake for some people. While the implant and hormonal IUDs are subsidised by the Pharmaceutical Benefits Schedule (PBS), this is not the case for copper IUDs, which can cost up to A$120 for the device. </p>
<p>Out-of-pocket IUD insertion-related costs can also vary from zero to hundreds of dollars if people don’t have access to publicly funded services. </p>
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Read more:
<a href="https://theconversation.com/considering-an-iud-but-worried-about-pain-during-insertion-heres-what-to-expect-179831">Considering an IUD but worried about pain during insertion? Here’s what to expect</a>
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<p>On the supply side, too few health professionals provide these essential services. </p>
<p>Inadequate remuneration for insertion procedures <a href="https://pubmed.ncbi.nlm.nih.gov/35557481/">act as a deterrent</a>. An IUD takes 30 minutes of inserter and assistant time, and the equipment costs around A$25 per insertion. Yet the <a href="http://www9.health.gov.au/mbs/fullDisplay.cfm?type=item&q=35503&qt=item">Medicare rebate</a> is just A$72.05. Costs may be higher in rural areas, due to higher set-up costs and reduced access to things like sterilising services for procedural equipment.</p>
<p>Insertion and removal of long-acting reversible contraception also requires practical training. This can be costly for GPs and nurses, especially for IUD training, which also means taking around three days off work to achieve the necessary number of supervised IUD insertions. This can be even longer and more costly for rural practitioners, with additional travel time and accommodation costs.</p>
<p>This lack of trained inserters contributes to inequities for people who have chosen a long-acting reversible contraception but can’t find a local practitioner to insert their IUD or implant. </p>
<figure class="align-center ">
<img alt="Doctor types on laptop" src="https://images.theconversation.com/files/529487/original/file-20230601-25431-g1chk0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/529487/original/file-20230601-25431-g1chk0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/529487/original/file-20230601-25431-g1chk0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/529487/original/file-20230601-25431-g1chk0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/529487/original/file-20230601-25431-g1chk0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/529487/original/file-20230601-25431-g1chk0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/529487/original/file-20230601-25431-g1chk0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Doctors are deterred by inadequate remuneration for IUD and implant insertion.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/NFvdKIhxYlU">Unsplash/National Cancer Institute</a></span>
</figcaption>
</figure>
<p>Nurses and midwives could <a href="https://pubmed.ncbi.nlm.nih.gov/26662068/">ably fill this gap</a>. There are multiple <a href="https://pubmed.ncbi.nlm.nih.gov/34836756/">successful models</a> of nurse-led long-acting reversible contraception services and postpartum insertion of implants by midwifes nationally and internationally. </p>
<p>However, most nurses aren’t able to access Medicare remuneration, which creates <a href="https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-015-0227-9">additional barriers</a> for this highly skilled workforce to provide these services. </p>
<h2>What are the recommendations for reform?</h2>
<p>The Senate inquiry has recognised these barriers and recommends making contraception universally affordable, and specifically, subsidising copper IUDs. </p>
<p>It also recommends adequate remuneration through Medicare for GPs, nurses and midwives to provide long-acting reversible contraception insertion and removal, and collaborative efforts between the government and medical colleges to improve access to workforce training. </p>
<p>While the recommendations are welcome, they now need to be turned into actions through adequate funding. </p>
<p>The government also needs to fund every Primary Health Network (which plan services) across Australia to identify local gaps and ensure the contraceptive needs of the communities they serve are met equitably, affordably and transparently. </p>
<p>While one size does not fit all, and people must be provided with sufficient and accessible information to make an informed choice, no one who wants an IUD or implant should be denied this choice based on where they live and how much they can pay. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/how-effective-is-the-pill-122189">How effective is the pill?</a>
</strong>
</em>
</p>
<hr>
<img src="https://counter.theconversation.com/content/206503/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Deborah Bateson has received honoraria for attending advisory committees and providing education to health professionals sponsored by Organon and Bayer, and has received untied research support from Organon. </span></em></p><p class="fine-print"><em><span>Kathleen McNamee's employer, Sexual Health Victoria, receives funding from Organon, Mayne Pharma, and Bayer Australia and New Zealand to train and support doctors and nurses in the provision of contraception. She has not received any personal remuneration for these activities.</span></em></p>Fewer than one in 100 people who use IUDs and contraceptive implants become pregnant each year, making them the most effective contraceptives. But they can be difficult to access. Here’s why.Deborah Bateson, Professor of Practice, University of SydneyKathleen McNamee, Adjunct Senior Lecturer, Obstetrics & Gynaecology, Monash UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2047282023-05-12T12:20:57Z2023-05-12T12:20:57ZAn obscure 1800s law is shaping up to be the center of the next abortion battle – legal scholars explain what’s behind the Victorian-era Comstock Act<figure><img src="https://images.theconversation.com/files/525475/original/file-20230510-27-6r8iwd.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Anti-abortion activists gather outside the Supreme Court building on April 15, 2023. </span> <span class="attribution"><a class="source" href="https://media.gettyimages.com/id/1252038585/photo/washington-d-c-april-15-pro-life-activist-also-gather-at-th.jpg?s=1024x1024&w=gi&k=20&c=C5Ris2nTdaa2mUJSDSp8clY4jytuN_xW8v0v9UYQOjQ=">Astrid Riecken for The Washington Post via Getty Images </a></span></figcaption></figure><p><a href="https://www.npr.org/2023/04/18/1170371877/abortion-pill-mifepristone-judge-comstock#:%7E:text=What%20is%20the%20Comstock%20Act,used%20to%20cause%20an%20abortion.">Anti-abortion groups</a> are looking for new ways to wage their battle against abortion rights, eyeing the potential implications of a 150-year-old law, the Comstock Act, that could effectively lead to a nationwide abortion ban. </p>
<p>Congress passed the Comstock Act in 1873, <a href="https://www.law.cornell.edu/uscode/text/18/1461">making it a crime</a> to mail <a href="https://www.law.cornell.edu/uscode/text/18/1462">or ship</a> any “lewd, lascivious, indecent, filthy or vile article” and anything that “is advertised or described in a manner … for producing abortion.” </p>
<p>There are now legal cases questioning the Food and Drug Administration’s <a href="https://www.pbs.org/newshour/politics/what-does-comstock-act-a-law-from-the-1870s-have-to-do-with-abortion-pills">regulation of mifepristone</a>, one of the two drugs used in the standard regimen for medication abortion. If courts find that the FDA has the authority to approve mifepristone for abortion, the Comstock Act could still prevent the pill’s distribution. </p>
<p><a href="https://www.law.gwu.edu/sonia-m-suter">As scholars</a> of law and <a href="https://www.law.virginia.edu/faculty/profile/nrc8g/2915359">reproductive justice</a>, we have been analyzing potential strategies to use this Victorian-era law to restrict the ability to get an abortion in the U.S.</p>
<p>Read one way, the Comstock Act could prevent mailing mifepristone to a person’s home, regardless of whether this person lives in a state where abortion is legal. </p>
<p>A broader interpretation, <a href="https://www.thenation.com/article/society/comstock-act-jonathan-mitchell/">advanced by anti-abortion groups</a> in recent months, would mean the Comstock Act applies to the distribution of all <a href="https://www.cnn.com/2023/04/28/politics/comstock-act-abortion-ban-legal-fight/index.html">drugs and medical tools</a> used <a href="https://www.pbs.org/newshour/politics/what-does-comstock-act-a-law-from-the-1870s-have-to-do-with-abortion-pills">for abortions, not just mifepristone</a>. </p>
<p>The Supreme Court returned the <a href="https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf">question of abortion rights</a> to states in June 2022. But it’s important to understand that the Comstock Act is a federal law that applies to states, regardless of their approach to abortion.</p>
<p>So while abortion <a href="https://www.nytimes.com/interactive/2022/us/abortion-laws-roe-v-wade.html">remains legal in certain states</a>, we believe it’s possible that a court could interpret the Comstock Act to prevent the distribution of any tool used for an abortion, anywhere in the U.S. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/525474/original/file-20230510-9330-8oheqr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A cartoon shows a man dressed as a monk in the center holding up his hands to a display of female mannequins. The monk appears in other cases leading a horse away, chasing a poodle with a bare bottom exposed." src="https://images.theconversation.com/files/525474/original/file-20230510-9330-8oheqr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/525474/original/file-20230510-9330-8oheqr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=391&fit=crop&dpr=1 600w, https://images.theconversation.com/files/525474/original/file-20230510-9330-8oheqr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=391&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/525474/original/file-20230510-9330-8oheqr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=391&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/525474/original/file-20230510-9330-8oheqr.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=492&fit=crop&dpr=1 754w, https://images.theconversation.com/files/525474/original/file-20230510-9330-8oheqr.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=492&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/525474/original/file-20230510-9330-8oheqr.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=492&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A 1906 illustration shows Anthony Comstock, center, thwarting excessive displays of flesh, be it a woman, dog or horse.</span>
<span class="attribution"><a class="source" href="https://media.gettyimages.com/id/160176791/photo/st-anthony-comstock-the-village-nuisance.jpg?s=1024x1024&w=gi&k=20&c=hX0j6PFsb7H2cZU3ba7wJ-sLDEnwklLtvgzjGvmZiRM=">PhotoQuest/Getty Images</a></span>
</figcaption>
</figure>
<h2>The history of the Comstock Act</h2>
<p>Devout Christian and self-described “<a href="https://scholar.google.com/scholar_case?case=7584004164925736257&q=US+v.+Dellapia&hl=en&as_sdt=20000006&as_vis=1">moral evangelist</a>” <a href="https://www.npr.org/2023/04/18/1170371877/abortion-pill-mifepristone-judge-comstock">Anthony Comstock</a> came up with the idea of what would become the Comstock Act after he felt troubled by the large amount of pornography and alcohol his fellow Union army soldiers consumed. </p>
<p>He lobbied for Congress to pass a law restricting what he deemed lewd behavior, displaying “his impressive collection of pornographic pictures, <a href="https://www.washingtonpost.com/made-by-history/2023/04/12/mifepristone-kacsmaryk-medication-abortion/">sex toys and contraceptive materials</a>” in the Capitol building “to help galvanize Congress to pass anti-obscenity legislation.” </p>
<p>Congress then <a href="https://www.pbs.org/wgbh/americanexperience/features/pill-anthony-comstocks-chastity-laws/">passed the Comstock Act</a> in 1873.</p>
<p>Although prosecutions under the Comstock Act were brought in the early 1900s, <a href="https://www.cnn.com/2023/04/28/politics/comstock-act-abortion-ban-legal-fight/index.html#:%7E:text=CNN%20Store-,The%20150%2Dyear%2Dold%20chastity%20law%20that%20may%20be%20the,next%20big%20fight%20over%20abortion&text=A%20law%20passed%20150%20years,where%20the%20procedure%20is%20legal.">enforcement started to wane by the 1930s</a>.</p>
<p>Nonetheless, the Supreme Court <a href="https://scholar.google.com/scholar_case?case=16134723048539384332&hl=en&as_sdt=6&as_vis=1&oi=scholarr">has heard</a> the occasional <a href="https://supreme.justia.com/cases/federal/us/463/60/">case related to the law</a> over the past 100 years. In 1983, for example, the Supreme Court found that applying the Comstock Act to prohibit <a href="https://supreme.justia.com/cases/federal/us/463/60/">mailed advertisements about contraceptives</a> violated the First Amendment. </p>
<p>No court has since ruled decisively to actually enforce the Comstock Act. </p>
<p>Indeed, <a href="https://www.justice.gov/olc/opinion/file/1560596/download">major court decisions</a> have limited <a href="https://slate.com/news-and-politics/2023/04/abortion-pill-ban-comstock-act-history-mifepristone-kacsmaryk.html">the law’s applicability</a>. </p>
<p>And, in 2022, the Justice Department issued an opinion concluding that the Comstock Act <a href="https://www.justice.gov/olc/opinion/file/1560596/download">does not prohibit</a> mailing mifepristone if the sender doesn’t know the recipient intends to use those pills “illegally” for abortions – for example, the recipient might be using them to treat a miscarriage.</p>
<h2>Applying the Comstock Act today</h2>
<p>As anti-abortion rights groups try to reinvigorate the Comstock Act, the question is what the law covers, exactly. Several legal cases are addressing this point in different contexts. </p>
<p>Texas federal court Judge Matthew Kacsmaryk – who issued a preliminary decision on April 7, 2023, <a href="https://s3.documentcloud.org/documents/23746119/read-texas-federal-judge-ruling-on-abortion-pill.pdf">effectively rescinding the FDA’s approval of mifepristone</a> – said the Comstock Act prevented the mailing of abortion pills. </p>
<p>When that decision was appealed, the appellate court seemed to agree with Kacsmaryk. It noted that the law <a href="https://storage.courtlistener.com/recap/gov.uscourts.ca5.213145/gov.uscourts.ca5.213145.183.2_1.pdf">does not necessarily require users</a> “of the mails or common interstate carriage to intend that an abortion actually occur,” contrary to the Justice Department’s 2022 opinion. It emphasized, however, that it was “not required to definitively interpret the Comstock Act” because it was not issuing a final ruling. </p>
<p>That decision was then appealed to the Supreme Court, which temporarily upheld the availability of mifepristone and <a href="https://www.supremecourt.gov/opinions/22pdf/22a901_3d9g.pdf">sent the case back to the 5th Circuit Court of Appeals for full review</a> on April 21. </p>
<p>The appellate court will hear oral arguments on May 17 and should issue a more definitive interpretation. </p>
<h2>Extending to other lawsuits</h2>
<p>The Comstock Act is also at the center of other kinds of litigation and legal campaigns focused on whether people can get abortions.</p>
<p>Jonathan Mitchell, <a href="https://www.newyorker.com/news/annals-of-inquiry/the-conservative-who-wants-to-bring-down-the-supreme-court">a conservative lawyer</a> and <a href="https://www.npr.org/2023/05/07/1174672358/jonathan-mitchell-the-legal-mind-behind-the-texas-abortion-ban">former solicitor general of Texas</a>, is trying to use the Comstock Act to outlaw abortion altogether. Notably he also <a href="https://www.nytimes.com/2021/09/12/us/politics/texas-abortion-lawyer-jonathan-mitchell.html">devised</a> <a href="https://www.npr.org/2023/05/08/1174552727/jonathan-mitchell-abortion-texas-sb8-roe-v-wade-dobbs">the Texas “bounty-hunter” abortion legislation </a>in 2021 that bans most abortions and “<a href="https://www.nytimes.com/2021/07/09/us/abortion-law-regulations-texas.html">deputizes citizens to sue people involved in the process</a>.” </p>
<p>Since 2019, two counties and more than 60 cities in Texas, Nebraska, Iowa, Ohio, New Mexico, Louisiana and Illinois <a href="https://sanctuarycitiesfortheunborn.com/">have passed ordinances</a> that ban abortion. This is part of a political campaign called Sanctuary Cities for the Unborn – orchestrated by Mitchell and <a href="https://www.theguardian.com/world/2023/mar/09/pastor-push-national-abortion-ban-sanctuary-cities-for-the-unborn">conservative pastor Mark Lee Dickson</a>. </p>
<p>Some of these places <a href="https://sanctuarycitiesfortheunborn.org/">now prohibit</a> the shipment and <a href="https://www.law.cornell.edu/uscode/text/18/1462">receipt of abortion drugs or medical items</a> used for abortions.</p>
<p>These ordinances have led to two lawsuits questioning their legal status.</p>
<p>New Mexico Attorney General Raúl Torrez sued several Sanctuary City towns in January 2023, claiming that the ordinances <a href="https://www.nmag.gov/wp-content/uploads/2023/03/Mandamus-Reply.pdf">violated state law that says</a> people have the right to access health care and that physicans’ care of patients is a private matter. </p>
<p>But then the New Mexico city of Eunice, another Sanctuary City, also filed a <a href="https://drive.google.com/file/d/1kHwoeKlQNgJ7gEFPd-RNVrya1d8-21gS/view">lawsuit in April 2022</a>, asking a state court to determine that the <a href="https://drive.google.com/file/d/1kHwoeKlQNgJ7gEFPd-RNVrya1d8-21gS/view">Comstock Act is enforceable</a>. </p>
<p>Finally, the Comstock Act is being applied even after an abortion has occurred.</p>
<p><a href="https://s4f4x7d5.rocketcdn.me/wp-content/uploads/2023/03/1-Silva-v.-Noyola-Original-Petition-FINAL.pdf">In a Texas lawsuit filed</a> in March 2023, Texas resident Marcus Silva sued three women for wrongful death, saying they assisted in “murdering Ms. Silva’s unborn child with illegally obtained abortion pills.” The complaint notes that Silva will also sue the pills’ manufacturer for wrongful death based on the Comstock Act. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/525483/original/file-20230510-25-g46cen.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A truck shows a purple advertisement on its side that says, 'Pharmacists know, mifepristone saves lives.'" src="https://images.theconversation.com/files/525483/original/file-20230510-25-g46cen.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/525483/original/file-20230510-25-g46cen.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/525483/original/file-20230510-25-g46cen.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/525483/original/file-20230510-25-g46cen.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/525483/original/file-20230510-25-g46cen.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/525483/original/file-20230510-25-g46cen.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/525483/original/file-20230510-25-g46cen.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">An advertisement outside a pharmacists conference in Phoenix advocates for the safety and necessity of mifepristone.</span>
<span class="attribution"><a class="source" href="https://media.gettyimages.com/id/1476304220/photo/ultraviolet-calls-on-pharmacists-to-reaffirm-that-mifepristone-a-medication-abortion-drug-is.jpg?s=1024x1024&w=gi&k=20&c=vJBZrHKeA1NR572zGNXCuj0gMCaq9O_xqJVH2sFa1VE=">Chris Coduto/Getty Images for UltraViolet</a></span>
</figcaption>
</figure>
<h2>Mailing, distributing or banning?</h2>
<p>It seems likely that the high-profile federal <a href="https://www.nytimes.com/2023/04/07/health/abortion-pills-ruling-texas.html">FDA mifepristone case in Texas</a> could <a href="https://apnews.com/article/abortion-pill-mifepristone-supreme-court-texas-436fe0de292379b469159a3ed7b62fef">head back to the Supreme Court</a> after the 5th Circuit issues its ruling. If so, the Supreme Court could determine that the Comstock Act only applies to the mailing of items if the sender knows the items are intended to be used “illegally” for abortions. In that case, little or nothing would change in states where abortion is legal.</p>
<p>Or, the court could decide that the Comstock Act bars mailing mifepristone regardless of its user’s intent, making access to medication abortion more difficult. The court could also cast a wider net, prohibiting the shipping of abortion medication altogether across the U.S. </p>
<p>And if the Comstock Act applies to mifepristone, it could also apply to any other item or tool that is used to terminate a pregnancy. Such a ruling would effectively impose a nationwide ban on abortion, even in states that allow abortions. To achieve this result based on an 1873 Victorian statute would be entirely consistent with Dobbs v. Jackson Women’s Health Organization, which overturned Roe v. Wade based on the state of the law in 1868.</p><img src="https://counter.theconversation.com/content/204728/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>The authors do not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The 1873 Comstock Act makes it a crime to mail abortion drugs or medicine – raising legal questions about the law’s potential revival and influence over nationwide abortion laws.Sonia Suter, Professor of law, George Washington UniversityNaomi Cahn, Professor of Law, University of VirginiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2031312023-04-10T20:00:33Z2023-04-10T20:00:33ZBritish Columbia’s coverage of contraceptives should inspire the rest of North America<figure><img src="https://images.theconversation.com/files/520087/original/file-20230410-7003-jfzc31.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C6000%2C3655&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">British Columbia's move to provide free contraception is an act of defending and upholding reproductive rights and freedoms.</span> <span class="attribution"><span class="source">(Shutterstock)</span></span></figcaption></figure><p><a href="https://bc.ctvnews.ca/access-to-free-birth-control-begins-in-british-columbia-1.6339248">As of April 1, 2023 all residents of British Columbia gained access to free prescription contraception</a>. This includes the birth control pill, injections and implants, IUDs and emergency contraception known as Plan B or the “morning after” pill.</p>
<p>The bold move makes good on a campaign promise of the NDP government. </p>
<p>It’s the focus of sustained activism of groups like <a href="https://www.accessbc.org/">AccessBC</a> and Action Canada for Sexual Health and Rights, and was ignited by the ongoing abortion politics south of the border, where a judge in Texas just <a href="https://www.nytimes.com/2023/04/07/health/abortion-pills-ruling-texas.html">issued a preliminary ruling invalidating the Food and Drug Administration’s 23-year-old approval of the abortion pill mifepristone</a>. That ruling was almost immediately followed <a href="https://apnews.com/article/washington-abortion-pills-lawsuit-fda-1857d1a4fd356c61ad76e00621e93b44">by a contradictory decision</a> by a judge in Washington state.</p>
<p>The <a href="https://www2.gov.bc.ca/gov/content/health/health-drug-coverage/pharmacare-for-bc-residents/what-we-cover/prescription-contraceptives">B.C. policy</a> could serve as a model for other provinces — Ontario’s Progressive Conservative government, for example, has already said it’s “<a href="https://www.thestar.com/politics/provincial/2023/03/08/ontario-looking-closely-at-bc-plan-to-offer-free-contraception-health-minister-says.html">looking closely at what British Columbia has proposed</a>.” </p>
<p>Nonetheless, universal coverage of contraception beyond British Columbia is unlikely at the moment. It does not seem to be a serious proposal of any current provincial government. </p>
<p>While some provincial opposition parties have promised universal contraception, policy progress depends on whether they actually get elected. It will also depend on a number of factors that will shape their political agenda once in office.</p>
<h2>List not fully complete</h2>
<p>The new coverage in B.C. is extended to anyone with a provincial health card and requires a physician’s prescription until later this spring, when <a href="https://www2.gov.bc.ca/gov/content/health/accessing-health-care/pharmacy-services">pharmacists will be able to prescribe contraceptives</a>. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/519991/original/file-20230409-6385-i30zeg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A package of birth control pills." src="https://images.theconversation.com/files/519991/original/file-20230409-6385-i30zeg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/519991/original/file-20230409-6385-i30zeg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=458&fit=crop&dpr=1 600w, https://images.theconversation.com/files/519991/original/file-20230409-6385-i30zeg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=458&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/519991/original/file-20230409-6385-i30zeg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=458&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/519991/original/file-20230409-6385-i30zeg.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=576&fit=crop&dpr=1 754w, https://images.theconversation.com/files/519991/original/file-20230409-6385-i30zeg.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=576&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/519991/original/file-20230409-6385-i30zeg.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=576&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A one-month dosage of hormonal birth control pills.</span>
<span class="attribution"><span class="source">(AP Photo/Rich Pedroncelli, File)</span></span>
</figcaption>
</figure>
<p>The list of contraceptives included in this plan <a href="https://www.timescolonist.com/local-news/bc-provides-list-of-birth-control-methods-to-be-covered-6668608">is comprehensive but not exhaustive</a>. Other forms of birth control and menstrual regulation, according to the B.C. government, might be considered in the future. </p>
<p>There seems to be no significant discussion of extending the coverage to B.C. residents who don’t have a provincial health card, such as undocumented residents and migrant workers for whom <a href="https://www.alternateroutes.ca/index.php/ar/article/view/22448">reproductive rights</a> are already sometimes inaccessible. </p>
<p>And accessibility will be dependent upon pharmacists’ willingness to dispense medication, something that might be particularly contentious, not to mention time-sensitive with emergency contraception. </p>
<p>Pharmacists are allowed to refuse to stock or dispense medication as a matter of conscience, something that has been a <a href="https://doi.org/10.1370/afm.2562">barrier for medication abortion access</a> in Canada, especially in rural areas. Yet despite these criticisms, the B.C. plan serves as an example of equitable primary sexual and reproductive health care delivered at the provincial level.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/roe-v-wade-canada-can-respond-to-u-s-bans-by-improving-access-to-abortion-care-here-185827">Roe v. Wade: Canada can respond to U.S. bans by improving access to abortion care here</a>
</strong>
</em>
</p>
<hr>
<h2>Opposition promises in other provinces</h2>
<p>Opposition parties in Alberta, Manitoba and Saskatchewan have all promised to implement the <a href="https://bc.ctvnews.ca/access-to-free-birth-control-begins-in-british-columbia-1.6339248">same policy</a> if elected. But at this point, such a commitment really just amounts to a progressive idea in the context of conservative provincial politics, with <a href="https://thecanadaguide.com/data/provincial-premiers/">centre-right parties in power in eight of 10 provinces. </a></p>
<figure class="align-left ">
<img alt="A man is seen in profile under a large golden ceiling light." src="https://images.theconversation.com/files/519993/original/file-20230409-24-z3gijl.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/519993/original/file-20230409-24-z3gijl.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=406&fit=crop&dpr=1 600w, https://images.theconversation.com/files/519993/original/file-20230409-24-z3gijl.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=406&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/519993/original/file-20230409-24-z3gijl.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=406&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/519993/original/file-20230409-24-z3gijl.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=511&fit=crop&dpr=1 754w, https://images.theconversation.com/files/519993/original/file-20230409-24-z3gijl.JPG?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=511&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/519993/original/file-20230409-24-z3gijl.JPG?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=511&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">B.C. Health Minister Adrian Dix is seen during a news conference with his provincial counterparts in Vancouver in November 2022.</span>
<span class="attribution"><span class="source">THE CANADIAN PRESS/Darryl Dyck</span></span>
</figcaption>
</figure>
<p>This means that the B.C. policy might reflect the uniqueness of the province’s political dynamics and also demonstrates what is possible, given the right political conditions, in the realm of <a href="https://doi.org/10.1086/722896">reproductive rights</a>. </p>
<p>It’s also reflective of the broader North American <a href="https://doi.org/10.1177/14647001221114611">politics of abortion</a>, as the timing of the policy — a campaign promise of the NDP government, elected in 2020 — seems to respond to the reversal of reproductive rights in the United States with the <a href="https://www.nytimes.com/2022/06/24/us/roe-wade-overturned-supreme-court.html">overturn of <em>Roe v. Wade</em> </a> in June 2022.</p>
<p>The end of constitutional protection of the right to abortion in the U.S. created momentum for strengthening abortion policy and reproductive rights in Canada. </p>
<p>In response <a href="https://www.nytimes.com/interactive/2022/06/24/us/politics/supreme-court-dobbs-jackson-analysis-roe-wade.html">to the U.S. Supreme Court ruling</a>, the <a href="https://www.cbc.ca/news/politics/abortion-funding-expanded-roe-v-wade-1.6449487">federal Liberal government has increased and sustained commitments to ensuring access to abortion</a> and other areas of sexual and reproductive health and rights.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/mexicos-help-to-american-women-who-need-abortions-should-inspire-canada-202117">Mexico's help to American women who need abortions should inspire Canada</a>
</strong>
</em>
</p>
<hr>
<h2>Reproductive justice</h2>
<p>Much of this work is carried out by organizations like <a href="https://www.actioncanadashr.org/">Action Canada for Sexual Health and Rights</a> and the <a href="https://nafcanada.org/">National Abortion Federation Canada</a>, with advocacy and information campaigns by the <a href="https://www.arcc-cdac.ca/">Abortion Rights Coalition</a>. </p>
<p>All insist that contraception and abortion are both matters of individual autonomy and <a href="https://www.sistersong.net/reproductive-justice">reproductive justice</a>. At the provincial level, <a href="https://montreal.ctvnews.ca/mobile/quebec-college-of-physicians-announces-new-guidelines-to-make-access-to-abortion-medication-easier-1.5988310">Québec reduced restrictions</a> on the dispensing of mifegymiso, the drug used in medication abortion. Other provinces, including <a href="https://www.thecoast.ca/news-opinion/how-to-get-an-abortion-in-nova-scotia-28911462">Nova Scotia</a>, created abortion self-referral networks.</p>
<p>But the B.C. government’s universal contraception announcement is the most recent positive policy response to the reversal of reproductive rights in the U.S.</p>
<p>Of course not all of the impact of the <em>Dobbs</em> decision on Canada has been positive. In the immediate aftermath of the overturn of <em>Roe</em>, the Manitoba legislature <a href="https://winnipeg.ctvnews.ca/ndp-bill-for-abortion-clinic-buffer-zones-defeated-in-house-1.5623693">defeated a bill</a> that would have provided buffer zone protection for abortion clinics. </p>
<p>The same organizations that benefit from increased federal funding — and use it to support women and other pregnant people — indicate that Canadian women who used to travel to the U.S. for certain kinds of abortions are finding it more difficult to do so due to increased restrictions and bans on the American side of the border.</p>
<p>The recent <a href="https://www.washingtonpost.com/politics/2023/04/07/abortion-pill-ruling-texas-washington/">duelling U.S. court decisions</a> concerning restrictions on mifepristone will only increase this difficulty and limit reproductive rights. </p>
<p>Policies like B.C.’s universal coverage of contraception will help to expand reproductive rights. That’s why it’s such an important decision.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/519992/original/file-20230409-16-dgu48i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A sea of people carrying pro-choice signs." src="https://images.theconversation.com/files/519992/original/file-20230409-16-dgu48i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/519992/original/file-20230409-16-dgu48i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/519992/original/file-20230409-16-dgu48i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/519992/original/file-20230409-16-dgu48i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/519992/original/file-20230409-16-dgu48i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/519992/original/file-20230409-16-dgu48i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/519992/original/file-20230409-16-dgu48i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">People march through downtown Atlanta in June 2022 to protest the U.S. Supreme Court’s decision to overturn Roe v. Wade.</span>
<span class="attribution"><span class="source">(AP Photo/Ben Gray, File)</span></span>
</figcaption>
</figure>
<h2>Defending reproductive rights</h2>
<p>On a practical level, funding for contraception has the effect of making birth control available for everyone, with no privilege for those who have private insurance or can afford to pay and no disadvantage for those who have trouble affording it.</p>
<p>But beyond this, public support and payment for contraception serves to normalize birth control, Plan B and sexual health and reproductive rights as a public good and as a matter of public responsibility. </p>
<p>In an age of increased privatization in health care in general, and the increased stigmatization and criminalization surrounding abortion, the B.C. move is a positive step that fully embraces sexual and reproductive health and rights for everyone in post-<em>Roe</em> North America.</p><img src="https://counter.theconversation.com/content/203131/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Candace Johnson receives funding from The Social Sciences and Humanities Research Council of Canada (SSHRC).</span></em></p>British Columbia’s move to provide free contraceptives is a positive step that fully embraces sexual and reproductive health and rights for everyone in post-Roe North America.Candace Johnson, Professor of Political Science, University of GuelphLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1975752023-01-17T13:34:02Z2023-01-17T13:34:02Z50 years after Roe, many ethics questions shape the abortion debate: 4 essential reads<figure><img src="https://images.theconversation.com/files/504340/original/file-20230112-14-sf3ro2.jpg?ixlib=rb-1.1.0&rect=13%2C9%2C1008%2C669&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Anti-abortion protesters demonstrate in front of the Supreme Court in 1985, the 12th anniversary of the Roe v. Wade decision.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/washington-d-c-anti-abortionists-demonstrate-in-front-of-news-photo/515955026?phrase=1973%20abortion&adppopup=true">Bettmann/Bettmann via Getty Images</a></span></figcaption></figure><p>Jan. 22, 2023, marks the 50th anniversary of Roe v. Wade, the landmark Supreme Court decision that recognized a constitutional right to abortion. That stood for nearly half a century, until a majority of justices <a href="https://www.npr.org/2022/06/24/1102305878/supreme-court-abortion-roe-v-wade-decision-overturn">reversed it</a> in June 2022’s Dobbs v. Jackson Women’s Health decision. </p>
<p>People <a href="https://theconversation.com/there-is-no-one-religious-view-on-abortion-a-scholar-of-religion-gender-and-sexuality-explains-184532">with a broad range of views on abortion</a> often say their faith tradition helps inform their opinions. But beyond religion, many other ethical and moral questions shape Americans’ perspectives on the topic. </p>
<p>Here are some of The Conversation’s most thought-provoking articles on the underlying philosophical and bioethical issues involved in abortion debates.</p>
<h2>1. Rethinking ‘personhood’</h2>
<p>Activism for and against abortion rights often gets summed up into two simple-sounding terms: “pro-life” and “pro-choice.”</p>
<p>But “‘life’ and ‘choice’ are not, in and of themselves, really the issue,” <a href="https://theconversation.com/what-does-it-mean-to-be-a-person-different-cultures-have-different-answers-186015">wrote Robert Launay</a> of Northwestern University. “The central question is what – or who – constitutes a person.”</p>
<p>As <a href="https://anthropology.northwestern.edu/people/faculty/launay.html">an anthropologist</a>, Launay studies that question in terms of culture. Different religions and societies think about personhood in different ways, he explained. Ideas about personhood in the U.S., for example, often stem from Christian ideas about the soul and are black and white – something is or isn’t considered a person. </p>
<p>In some of the Indigenous African traditions where he has done research, meanwhile, “many view personhood as a process rather than a once-and-for-all phenomenon” – something humans gradually acquire over time, through relationships, or through rituals.</p>
<figure class="align-center ">
<img alt="A baby sucking its thumb lies on its back on a patterned blanket." src="https://images.theconversation.com/files/504387/original/file-20230113-26-h05j76.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/504387/original/file-20230113-26-h05j76.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=402&fit=crop&dpr=1 600w, https://images.theconversation.com/files/504387/original/file-20230113-26-h05j76.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=402&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/504387/original/file-20230113-26-h05j76.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=402&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/504387/original/file-20230113-26-h05j76.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=505&fit=crop&dpr=1 754w, https://images.theconversation.com/files/504387/original/file-20230113-26-h05j76.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=505&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/504387/original/file-20230113-26-h05j76.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=505&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A 4-month-old baby girl is tended by her grandmother inside a church in Duekoue, Ivory Coast, in 2011.</span>
<span class="attribution"><a class="source" href="https://newsroom.ap.org/detail/IvoryCoast/db6beed455e1419cb9bf3e92533c8370/photo?Query=baby%20cote%20d%27ivoire&mediaType=photo&sortBy=arrivaldatetime:desc&dateRange=Anytime&totalCount=5&currentItemNo=0">AP Photo/Rebecca Blackwell</a></span>
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<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-does-it-mean-to-be-a-person-different-cultures-have-different-answers-186015">What does it mean to be a 'person'? Different cultures have different answers</a>
</strong>
</em>
</p>
<hr>
<h2>2. Moral status</h2>
<p>Even within a single society, defining “personhood” can be complex and controversial. </p>
<p>Personhood is a key concern in bioethics, <a href="https://theconversation.com/what-is-personhood-the-ethics-question-that-needs-a-closer-look-in-abortion-debates-182745">wrote</a> University of Washington philosopher <a href="https://phil.washington.edu/people/nancy-s-jecker">Nancy Jecker</a>. In that context, being a “person” isn’t necessarily the same as being “human” – and it’s not an easy concept to nail down.</p>
<p>“When philosophers talk about ‘personhood,’ they are referring to something or someone having exceptionally high moral status, often described as having a right to life, an inherent dignity, or mattering for one’s own sake,” she explained. Personhood implies that someone or something can make strong moral claims, such as a claim against being interfered with. In abortion debates, Jecker added, “no one disputes the fetus’s species, but many disagree about the fetus’s personhood.” </p>
<p>Americans hold three main views of when personhood begins – at conception, at birth, or sometime in between – which is a central part of the country’s inability to agree about abortion rules. But the implications of how societies define personhood go much further, Jecker said, influencing areas like care for the environment and end-of-life treatment.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-is-personhood-the-ethics-question-that-needs-a-closer-look-in-abortion-debates-182745">What is 'personhood'? The ethics question that needs a closer look in abortion debates</a>
</strong>
</em>
</p>
<hr>
<h2>3. Breaking down bioethics</h2>
<p>Given Americans’ diverse views about religion and personhood, are there other concepts that can help forge consensus?</p>
<p>In another article, Jecker <a href="https://theconversation.com/abortion-and-bioethics-principles-to-guide-u-s-abortion-debates-184916">broke down four key bioethics terms</a>, four bedrock principles in the field: autonomy; nonmaleficence, or “do no harm”; beneficence, or providing beneficial care; and justice. </p>
<figure class="align-center ">
<img alt="A woman in a white shirt sits in bed beside a doctor wearing a stethoscope who holds her hand." src="https://images.theconversation.com/files/504390/original/file-20230113-18-q1l7ub.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/504390/original/file-20230113-18-q1l7ub.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/504390/original/file-20230113-18-q1l7ub.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/504390/original/file-20230113-18-q1l7ub.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/504390/original/file-20230113-18-q1l7ub.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/504390/original/file-20230113-18-q1l7ub.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/504390/original/file-20230113-18-q1l7ub.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Four basic principles guide the field of medical ethics.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/close-up-of-a-female-nurse-holding-hands-for-royalty-free-image/1315654897?adppopup=true">goc/E+ via Getty Images</a></span>
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<p>People disagree about how to interpret those principles: Someone in favor of abortion rights, for example, might be most concerned about harm to pregnant women, while someone who opposes them could be more concerned about harm to a fetus.</p>
<p>Understanding how people see those principles in play, though, is at least a constructive step. Jecker suggested that, short of reaching a moral consensus, “articulating our own moral views and understanding others’ can bring all sides closer to a principled compromise.”</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/abortion-and-bioethics-principles-to-guide-u-s-abortion-debates-184916">Abortion and bioethics: Principles to guide U.S. abortion debates</a>
</strong>
</em>
</p>
<hr>
<h2>4. Beyond ‘my body, my choice’</h2>
<p>For decades, one other phrase has dominated the U.S. abortion debate: the slogan “my body, my choice.”</p>
<p>At this point, the catchphrase is practically synonymous with the movement for reproductive rights. It’s profoundly shaped how people think about abortion rights: as an issue of privacy, decisions that women should make for themselves with their doctors.</p>
<figure class="align-center ">
<img alt="An activist seen holding a placard that says, 'My body My Choice.'" src="https://images.theconversation.com/files/414171/original/file-20210802-18-7zo3kh.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C4992%2C3330&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/414171/original/file-20210802-18-7zo3kh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/414171/original/file-20210802-18-7zo3kh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/414171/original/file-20210802-18-7zo3kh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/414171/original/file-20210802-18-7zo3kh.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/414171/original/file-20210802-18-7zo3kh.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/414171/original/file-20210802-18-7zo3kh.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">A protester holds aloft a ‘my body, my choice’ placard in a 2021 demonstration in Alabama.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/an-activist-seen-holding-a-placard-that-says-my-body-my-news-photo/1145542984?adppopup=true">Ronen Tivony/SOPA Images/LightRocket via Getty Images</a></span>
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<p>But “my body, my choice” <a href="https://theconversation.com/with-abortion-heading-back-to-the-supreme-court-is-it-time-to-retire-the-my-body-my-choice-slogan-163770">doesn’t fully capture the key ideas</a>, argued <a href="https://med.uc.edu/landing-pages/faculty-profile/Index/Pubs/lanphieh">Elizabeth Lanphier</a>, a moral philosopher and bioethicist at the University of Cincinnati. Reproductive rights aren’t just about a lack of interference, what philosophers call “negative liberty.” Abortion is also about the right to access health care. </p>
<p>“‘My body, my choice’ suggests that because people own their bodies, they get to control them,” she wrote. But self-ownership isn’t so valuable without also having “positive liberty,” the freedom to do something.</p>
<p>“My research suggests ‘my body, my choice’ was a crucial idea at the time of Roe to emphasize ownership over bodily and health care decisions,” Lanphier concluded. “But I believe the debate has since moved on – reproductive justice is about more than owning your body and your choice; it is about a right to health care.”</p>
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Read more:
<a href="https://theconversation.com/with-abortion-heading-back-to-the-supreme-court-is-it-time-to-retire-the-my-body-my-choice-slogan-163770">With abortion heading back to the Supreme Court, is it time to retire the 'my body, my choice' slogan?</a>
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<p><em>Editor’s note: This story is a roundup of articles from The Conversation’s archives.</em></p><img src="https://counter.theconversation.com/content/197575/count.gif" alt="The Conversation" width="1" height="1" />
Looking at the underlying philosophical and moral questions involved in abortion debates can help explain why it’s such an intensely divisive issue.Molly Jackson, Religion and Ethics EditorLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1919322022-10-05T22:24:02Z2022-10-05T22:24:02ZLoretta Lynn was more than a great songwriter – she was a spokeswoman for white rural working-class women<figure><img src="https://images.theconversation.com/files/488344/original/file-20221005-25-vdq94c.jpg?ixlib=rb-1.1.0&rect=110%2C423%2C2953%2C1972&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Loretta Lynn's music articulated the fears, dreams and anger of women living in a patriarchal society.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/loretta-lynn-performs-on-stage-at-the-country-music-news-photo/91885297?phrase=loretta lynn concert&adppopup=true">David Redfern/Redferns via Getty Images</a></span></figcaption></figure><p>Loretta Lynn’s <a href="https://www.nytimes.com/2022/10/04/arts/music/loretta-lynn-dead.html">death at the age of 90</a> marks the end of a remarkable life of achievement in country music.</p>
<p>Her dramatic life story – retold in the 1980 award-winning film “<a href="https://www.imdb.com/title/tt0080549/">Coal Miner’s Daughter</a>,” based on <a href="https://www.grandcentralpublishing.com/titles/loretta-lynn/coal-miners-daughter/9781538701690/">Lynn’s 1976 biography</a> – made Lynn a household name. She grew up in poverty in a small Kentucky mining town, marrying and starting a family as a teenager before reaching unprecedented heights of commercial success as a recording artist of modern country music.</p>
<p>But as a <a href="https://arts-sciences.buffalo.edu/music/faculty/faculty-directory.host.html/content/shared/arts-sciences/music/new-faculty-profiles/vander-wel-stephanie.html">scholar of gender and country music</a> and author of “<a href="https://www.press.uillinois.edu/books/?id=p084959">Hillbilly Maidens, Okies, and Cowgirls: Women’s Country Music, 1930-1960</a>,” I know that Lynn represented more than just star power and fame in country music – she spoke to the concerns of women, especially white working-class women in rural and suburban America.</p>
<h2>Speaking up, singing out</h2>
<p>Lynn’s rise in the 1960s took place when country music appeared tied to conservative politics. It was a time when Merle Haggard’s “<a href="https://academic.oup.com/california-scholarship-online/book/28551/chapter-abstract/238414028?redirectedFrom=fulltext">Okie from Muskogee</a>,” with its attacks on counterculture, marijuana and draft-card burning, became a populist anthem for the country’s cultural conservatives.</p>
<p>In contrast, Lynn’s songwriting continued the legacy of <a href="https://www.latimes.com/local/obituaries/la-me-kitty-wells-20120717-story.html">Kitty Wells</a>, <a href="https://www.tennessean.com/story/entertainment/music/2016/09/25/country-music-hall-famer-jean-shepard-dead-82/76568704/">Jean Shepard</a> and other women in country music who were willing to speak up about the concerns of American women.</p>
<p>Lynn’s songs defied societal expectations by connecting her musical representations of working-class and rural women to broader social issues affecting women across the U.S.</p>
<iframe style="border-radius:12px" src="https://open.spotify.com/embed/playlist/6IDd8Os7RLpa9DNKz4Wc33?utm_source=generator" width="100%" height="380" frameborder="0" allowfullscreen="" allow="autoplay; clipboard-write; encrypted-media; fullscreen; picture-in-picture"></iframe>
<p>She aimed for her music to articulate the fears, dreams and anger of women living in a patriarchal society. It railed against those who idealized women’s domestic roles and demonized outspoken feminists.</p>
<h2>‘There’s gonna be some changes’</h2>
<p>Specifically, for a generation of predominantly white women in the 1960s and 1970s who did not identify as urban or college-educated feminists, Lynn’s music offered candid conversations about their private lives as wives and mothers.</p>
<p>As Lynn <a href="https://www.grandcentralpublishing.com/titles/loretta-lynn/coal-miners-daughter/9781538701690/">stated in her autobiography</a>, her audience recognized her as a “mother and a wife and a daughter, who had feelings just like other women.”</p>
<figure class="align-right ">
<img alt="Black and white photo of woman posing with guitar." src="https://images.theconversation.com/files/488343/original/file-20221005-18-iyp0sv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/488343/original/file-20221005-18-iyp0sv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=693&fit=crop&dpr=1 600w, https://images.theconversation.com/files/488343/original/file-20221005-18-iyp0sv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=693&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/488343/original/file-20221005-18-iyp0sv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=693&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/488343/original/file-20221005-18-iyp0sv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=871&fit=crop&dpr=1 754w, https://images.theconversation.com/files/488343/original/file-20221005-18-iyp0sv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=871&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/488343/original/file-20221005-18-iyp0sv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=871&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Loretta Lynn made the concerns of everyday American women a focal point of her work.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/loretta-lynn-poses-for-a-portrait-holding-a-guitar-that-has-news-photo/74282205?phrase=loretta%20lynn&adppopup=true">Michael Ochs Archives/Getty Images</a></span>
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<p>She did this through clever and witty songwriting and lyrical techniques that combined the vernacular of her audience with her resonant voice.</p>
<p>Meanwhile, the song arrangements of Owen Bradley of Decca Records directed Lynn’s musical talents to a broad audience. He combined the edgier sound of honky-tonk instrumentation – electric guitars, pedal steels and fiddles – with the polish of the Nashville sound by including the smooth sounding vocal harmonies of the vocal quartet the <a href="http://www.jordanaires.net/">Jordanaires</a>, as heard in numerous country, gospel and rock ‘n’ roll recordings.</p>
<p>This provided a sound of strength and conviction to accompany Lynn’s bold and forthright songs as she laid bare the double standards of gender roles. </p>
<p>With her assertive and resonant voice, Lynn, in her 1966 track “<a href="https://www.rollingstone.com/music/music-lists/loretta-lynn-best-lyrics-songwriting-175002/">Don’t Come Home A Drinkin’ (With Lovin’ on Your Mind)</a>,” warns men not to expect women to be waiting at home, sexually available for them after they’d spent the night drinking: </p>
<blockquote>
<p>Well, you thought I’d be waitin’ up when you came home last night</p>
<p>You’d been out with all the boys and you ended up half tight</p>
<p>Liquor and love, they just don’t mix</p>
<p>Leave that bottle or me behind</p>
<p>And don’t come home a drinkin’ with lovin’ on your mind</p>
</blockquote>
<p>In a similar vein, Lynn, who <a href="https://www.grandcentralpublishing.com/titles/loretta-lynn/coal-miners-daughter/9781538701690/">claimed that her songs about wayward husbands</a> were inspired by her fraught marriage to Oliver “Doolittle” Lynn, confronted the “other woman” in songs such as 1966’s “You Ain’t Woman Enough” and 1968’s “Fist City.” </p>
<h2>A lasting legacy</h2>
<p>Fully aware that her personalized accounts became political messages for her fan base of women, Lynn co-wrote and recorded “<a href="https://www.washingtonpost.com/music/2022/10/04/loretta-lynn-the-pill/">The Pill</a>” in 1975. It was a rare foray into the topic of women’s reproductive rights for country music. In typical fashion, though, Lynn approached the issue from the perspective of a rural working-class woman: </p>
<blockquote>
<p>I’m tired of all your crowin’</p>
<p>How you and your hens play</p>
<p>While holdin’ a couple in my arms</p>
<p>Another’s on the way</p>
<p>This chicken’s done tore up her nest</p>
<p>And I’m ready to make a deal</p>
<p>And ya can’t afford to turn it down</p>
<p>‘Cause you know I’ve got the pill</p>
</blockquote>
<p>The song’s sexual innuendos about cavorting roosters and hens incorporated the double entendres and humor of early blues and country, while providing a frank discussion about female sexual pleasure. It also addressed the right for women to take control over their bodies and reproduction.</p>
<p>The song came out just two years after <a href="https://supreme.justia.com/cases/federal/us/410/113/">the Supreme Court passed Roe v. Wade</a>, granting women the ability to govern their own reproductive health through abortion.</p>
<p>Indeed, Lynn commented on the Supreme Court’s ruling in her autobiography:</p>
<blockquote>
<p>“Personally, I think you should prevent unwanted pregnancy rather than get an abortion. It would be wrong for me. But I’m thinking of all the poor girls who get pregnant when they don’t want to be, and how they should have a choice instead of leaving it up to some politician or doctor who don’t have to raise the baby.”</p>
</blockquote>
<p>Her recording “<a href="https://www.washingtonpost.com/music/2022/10/04/loretta-lynn-the-pill/">The Pill</a>” spoke to married women who wanted to be able to space out their children and prevent unwanted pregnancies so that they could pursue educational and professional opportunities. </p>
<p>In interviews, Lynn discussed at length how female listeners flocked to her after concerts, relieved to find a public figure with whom they felt comfortable to discuss birth control. </p>
<p>Not everyone was thrilled, though. Male country <a href="https://www.thedailybeast.com/after-country-stations-banned-loretta-lynns-the-pill-it-became-her-biggest-pop-hit">disc jockeys banned</a> “The Pill” from the airwaves. Nonetheless, the recording became her biggest seller in 1975 and furthered Lynn’s reputation as a spokeswoman for white rural working-class women. </p>
<p>Her music also inspired the women in country music who followed her to further explore issues of gender roles. Lynn’s legacy lives on in the music of female country artists – such as <a href="https://www.reba.com/">Reba McEntire</a> and <a href="https://www.mirandalambert.com/">Miranda Lambert</a> – who learned from Lynn how to create music that confronts and triumphs over the societal obstacles that women face.</p>
<p>While all of country music will mourn the death of Lynn, it is perhaps her female fans who will feel the loss more acutely. Lynn gave them a social and political voice, and helped make country music a genre relevant to the complexities of women’s lives.</p>
<figure class="align-center ">
<img alt="A star engraved in sidewalk pavement surrounded by bouquets of flowers." src="https://images.theconversation.com/files/488345/original/file-20221005-23-v55c75.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/488345/original/file-20221005-23-v55c75.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/488345/original/file-20221005-23-v55c75.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/488345/original/file-20221005-23-v55c75.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/488345/original/file-20221005-23-v55c75.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/488345/original/file-20221005-23-v55c75.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/488345/original/file-20221005-23-v55c75.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">Flowers left by fans on Loretta Lynn’s star on the Hollywood Walk of Fame in Los Angeles.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/flowers-are-placed-on-loretta-lynns-star-on-the-hollywood-news-photo/1430495880?phrase=loretta%20lynn&adppopup=true">Emma McIntyre/Getty Images</a></span>
</figcaption>
</figure><img src="https://counter.theconversation.com/content/191932/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Stephanie Vander Wel does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Through songs such as ‘The Pill,’ Lynn addressed issues confronting all women. The country star died on Oct. 4 at age 90.Stephanie Vander Wel, Associate Professor of Music, University at BuffaloLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1876622022-09-28T20:45:27Z2022-09-28T20:45:27ZWill baby drop boxes from the Italian Renaissance become more common after Meloni win?<figure><img src="https://images.theconversation.com/files/486622/original/file-20220926-21-psj4vf.jpg?ixlib=rb-1.1.0&rect=154%2C7%2C4675%2C3134&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Although pregnancy was celebrated in Renaissance paintings, like the 'Primavera' by Botticelli, the reality was quite different. Will Giorgia Meloni's far-right government reverse abortion rights in Italy?</span> <span class="attribution"><span class="source">Uffizi Gallery</span></span></figcaption></figure><p>In Italy, abortion has been legal since 1978. But now that Giorgia Meloni’s Brothers of Italy party <a href="https://theconversation.com/what-will-its-first-far-right-leader-since-wwii-mean-for-italy-190655">has won the national election</a> and the far-right form a majority in both the Italian Parliament and Senate, <a href="https://www.nytimes.com/2022/09/23/world/europe/giorgia-meloni-italy-women.html">access to abortion in Italy could face new restrictions</a>.</p>
<p>Anti-abortion supporters like Movimento per la Vita <a href="https://www.politico.eu/article/italy-abortion-access-erodes-riding-united-states-wave/">have been buoyed</a> by Meloni’s recent win as well as this summer’s United States Supreme Court ruling on Roe v. Wade. </p>
<p>As an art historian, my work has always seemed safely detached from today’s reality. However, after these recent political shifts, it seems historical artifacts and practices are now painfully relevant.</p>
<h2>Revival from ages past</h2>
<p>In Piazza di San Remigio, a few streets away from the Arno river in Florence, Italy, there’s a rectangular, box-like contraption encased in the wall about the same size as a bank machine. It sits opposite the façade of the church that gives the piazza its name. Drawings of sweetly swaddled babies are visible inside the box behind its glass pane. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/477926/original/file-20220805-7920-nph7d7.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A culla per la vita (baby box) in Piazza di San Remigio, Florence, Italy.</span>
<span class="attribution"><span class="source">Sarah Wilkins</span>, <span class="license">Author provided</span></span>
</figcaption>
</figure>
<p>The contraption is a <a href="https://www.nytimes.com/2007/02/28/world/europe/28rome.html"><em>culla per la vita</em></a> or “cradle for life” where <a href="http://www.culleperlavita.it/dove_sono.php">desperate mothers can deposit unwanted infants</a> while retaining anonymity. Pressing a button opens the glass panel and the newborn can be placed inside the ventilated space on a receiving cloth. The partition closes automatically after ten seconds and cannot be reopened. </p>
<p>A sensor immediately notifies monitoring personnel and medical services who come to retrieve the infant.</p>
<p>This <em>culla per la vita</em> was installed in 2006 by the Florentine chapter of Movimento per la Vita, which aims to make abortions illegal in Italy. It is one of a growing national network of deposit points.</p>
<p>In the United States, there are over 100 baby boxes and, as in Italy, <a href="https://www.nytimes.com/2022/08/06/us/roe-safe-haven-laws-newborns.html?searchResultPosition=1">most are tied to anti-abortion, safe-haven movements</a>.</p>
<h2>No reproductive rights during the Renaissance</h2>
<p>The mechanized “baby box” or “baby hatch” is a revival of centuries-old cultural practices — first recorded as early as the 12th century and which particularly flourished during the Italian Renaissance. </p>
<p>In 15th and 16th-century Italy women had no reproductive rights. Without access to advanced medical care, women used all kinds of methods to end unwanted pregnancies, such as <a href="https://daily.jstor.org/abortion-remedies-medieval-catholic-nun/">time-honoured herbal abortifacients</a>, acidic substances, the insertion of foreign objects and folkloric practices.</p>
<p>Regardless of whether the pregnancy was wanted or not, the risk of death during childbirth was inescapable across all social classes. Although historical maternal mortality rates are hard to calculate, one estimate, using Florentine <em>Libri dei morti</em> (Books of the Dead), <a href="https://hdl-handle-net.ocadu.idm.oclc.org/2027/heb01278.0001.001">concludes that at least one out of five women of childbearing age died due to neonatal complications and trauma</a>. </p>
<p>It was not unheard of <a href="https://doi.org/10.1163/9789004375871_012">for women to write wills while pregnant</a>, especially when carrying their first child. The risk of complications was amplified by the pubescent age of many Renaissance brides. </p>
<h2>The ‘Primavera’ by Botticelli</h2>
<p>In Florence today, visitors flock to the city’s historic Uffizi galleries to experience the beauty of Botticelli’s <em>Primavera</em> and other Renaissance artworks. But whether viewers of the painting realize it or not, <em>Primavera</em> draws attention to stark inequalities for women. </p>
<p>The painting, some argue, <a href="https://www.jstor.org/stable/1358279">commemorates a marriage</a>, possibly that between Lorenzo di Pierfrancesco de’ Medici and Semiramide Appiani in 1482. At the far right of the panel, the god Zephyr pursues the terrified nymph Chloris. Raped by Zephyr, Chloris transforms into the goddess Flora, who holds a cluster of blossoms at her abdomen, emphasizing her fertility, and to the eyes of a new bride, foreshadowing her expected pregnancies.</p>
<p>While new mothers of the elite were served sweetmeats and delicacies and given lavishly painted <em>deschi di parto</em> (birth trays) to celebrate the delivery of a child, most Italian women of the time experienced harrowing deprivation.</p>
<h2>An early baby box</h2>
<p>In 1419, Florence’s Silk Guild commissioned Filippo Brunelleschi to design the famed Ospedale degli Innocenti, which opened in 1445.</p>
<p>The building’s <em>loggia</em>, or portico, features semicircular arches made of soft grey <em>pietra serena</em>, ornamented with glazed terracotta roundels of swaddled infants by Andrea della Robbia inserted in 1487.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Three arches, above the columns are terracotta figures of infants surrounded by a circular blue background." src="https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=402&fit=crop&dpr=1 600w, https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=402&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=402&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=505&fit=crop&dpr=1 754w, https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=505&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/481337/original/file-20220826-1650-5xi5b8.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=505&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A few of the terracotta roundels in the portico of Brunelleschi’s Hospital of Innocents in Florence, Italy.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Unwanted newborns were initially left in the loggia in the <em>pila</em> — an elevated basin or pillar — followed by the <em>finestra ferrata</em>, a small gated window, with dimensions that restricted the age of those accepted. Later, infants entered via <em>la ruota degli esposti</em> (“wheel of the exposed” or “foundling wheel”) — the <a href="https://www.routledge.com/Visual-Cultures-of-Foundling-Care-in-Renaissance-Italy/Presciutti/p/book/9781138316171">preferred method</a> of surrender by the 16th century. </p>
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Read more:
<a href="https://theconversation.com/after-a-newborn-was-found-in-a-recycling-bin-a-safe-haven-baby-hatch-may-save-lives-132851">After a newborn was found in a recycling bin, a safe haven baby hatch may save lives</a>
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<p>This cylindrical wooden device allowed the baby to be placed in an opening, rotated inwardly, and received inside. Infants often arrived wrapped with small talismans or a scrap with a scrawled name. Half a ribbon, a broken <a href="https://www.visitflorence.com/florence-museums/innocenti-museum.html">charm</a>, pendant, or coin, these marks of recognition were left with the child hoping for future reconciliation. The mother or relative kept the other half as proof of the long-lost familial relationship.</p>
<h2>Catholic doctrine barred burials</h2>
<p>Infant deaths were not just an earthly tragedy. Catholic doctrine forbade the baptism of deceased infants. Unbaptized infants who died quickly after birth, were officially <a href="https://doi.org/10.3390/rel11120678">barred from burial</a> in consecrated cemeteries and family chapels or tombs.</p>
<p>Midwives plunged unresponsive newborns into water or doused them with liquid in a desperate test for life. If revived, religious authorities <a href="https://doi.org/10.1177/146960531770434">allowed emergency baptisms by midwives or laypeople</a>.</p>
<p>Thousands of unwanted infants nevertheless survived their births. </p>
<p>Ultimately, the compassionate retrieval of abandoned infants may be a well-intentioned outcome to a highly complicated dilemma. However, we cannot forget the systemic torment of the mother by a world that does not provide adequate healthcare.</p>
<h2>Will abortion rights change under Meloni?</h2>
<figure class="align-right ">
<img alt="A woman in a white suit waves." src="https://images.theconversation.com/files/486618/original/file-20220926-16-wvyhhq.jpg?ixlib=rb-1.1.0&rect=242%2C206%2C5748%2C4041&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/486618/original/file-20220926-16-wvyhhq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=426&fit=crop&dpr=1 600w, https://images.theconversation.com/files/486618/original/file-20220926-16-wvyhhq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=426&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/486618/original/file-20220926-16-wvyhhq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=426&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/486618/original/file-20220926-16-wvyhhq.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=535&fit=crop&dpr=1 754w, https://images.theconversation.com/files/486618/original/file-20220926-16-wvyhhq.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=535&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/486618/original/file-20220926-16-wvyhhq.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=535&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Fratelli d'Italia (‘Brothers of Italy’) leader Giorgia Meloni in Rome on Sept. 25.</span>
<span class="attribution"><span class="source">(AP Photo/Gregorio Borgia)</span></span>
</figcaption>
</figure>
<p>Despite the legality of abortion many Italian women struggle to obtain one. Almost 70 per cent of <a href="https://www.nytimes.com/2016/01/17/world/europe/on-paper-italy-allows-abortions-but-few-doctors-will-perform-them.html">gynecologists</a> — 83 per cent in Italy’s southern regions — <a href="https://www.ilpost.it/2021/03/29/aborto-obiezione-coscienza-italia/">are conscientious objectors</a>.</p>
<p>Giorgia Meloni has said that abolishing Italy’s abortion law is <a href="https://www.theguardian.com/world/2022/aug/22/abortion-rights-at-risk-in-region-led-by-party-of-italys-possible-next-pm">not on her agenda</a> but her party has been <a href="https://www.repubblica.it/politica/2022/09/15/news/meloni_aborto_legge_194_reazioni-365762519/?fbclid=IwAR2u8B44TEt_2ZMyTr2kG80B4f9SmaAr0NLsc57DQ_BPYuQmNIrUE2e4QKE">accused of impeding abortion access in some regions</a>.
For example, Marche’s regional council opposes abortions using pill RU 486 in clinics outside hospitals in contrast to Ministry of Health guidelines. </p>
<p>Meloni has said she wants women <a href="https://www.repubblica.it/politica/2022/09/15/news/meloni_aborto_legge_194_reazioni-365762519/?fbclid=IwAR2u8B44TEt_2ZMyTr2kG80B4f9SmaAr0NLsc57DQ_BPYuQmNIrUE2e4QKE">“to have the right to make a different choice” other than abortion</a>. The precise meaning of this statement is yet to be seen.</p><img src="https://counter.theconversation.com/content/187662/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Heather Coffey does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The baby drop box is a revival of centuries-old cultural practices from the Italian Renaissance when reproductive rights were zero.Heather Coffey, Assistant Professor of Art History, OCAD UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1866822022-09-06T12:36:15Z2022-09-06T12:36:15ZSupreme Court’s selective reading of US history ignored 19th-century women’s support for ‘voluntary motherhood’<figure><img src="https://images.theconversation.com/files/482327/original/file-20220901-23-94389p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Members of the National American Woman Suffrage Association participate in a 1910 parade in Washington, D.C. </span> <span class="attribution"><a class="source" href="https://media.gettyimages.com/photos/american-physician-anna-howard-shaw-leader-of-the-womens-suffrage-in-picture-id1393779815">Paul Thompson/FPG/Archive Photos/Hulton Archive via Getty Images</a></span></figcaption></figure><p>The history of abortion in the U.S. guided some of Supreme Court Justice Samuel Alito’s arguments in the <a href="https://www.oyez.org/cases/2021/19-1392">Dobbs v. Jackson Women’s Health Organization</a> decision. Alito argued that abortion has never been a “deeply rooted” constitutional right in the United States. </p>
<p>But <a href="https://facultyweb.kennesaw.edu/lthom182/">as a historian</a> of medicine, law and women’s rights, I think Alito’s read of abortion history is not only incomplete, <a href="https://www.politico.com/news/magazine/2022/06/02/alitos-anti-roe-argument-wrong-00036174">it is also inaccurate</a>. </p>
<p>Alito argued in the opinion that abortion has always been a serious crime, but there were no laws about abortion at all in Colonial America. Beginning in the 19th century, most states barred it only after “quickening,” when a pregnant woman can first feel the fetus move, typically around the fourth to sixth <a href="https://www.americanprogress.org/article/scarlet-letters-getting-the-history-of-abortion-and-contraception-right/">month of pregnancy</a>.</p>
<p>Abortion is indeed deeply rooted in the American experience and law. American women <a href="https://www.nytimes.com/interactive/2019/12/13/opinion/sunday/abortion-history-women.html">have always tried</a> to personally determine the size of their families. Enslaved Black women <a href="https://www.aaihs.org/enslaved-womens-sexual-health-reproductive-rights-as-resistance/">used contraception and abortion</a> as specific strategies of resistance against their physical and reproductive bondage. </p>
<p>The very passage of <a href="https://constitution.congress.gov/constitution/amendment-13/">the 13th</a> and <a href="https://www.law.cornell.edu/constitution/amendmentxiv">14th amendments</a>, which ended slavery and guaranteed citizenship for all, is <a href="https://www.nytimes.com/2022/06/26/opinion/justice-alito-reproductive-justice-constitution-abortion.html">evidence that the Constitution actually does protect</a> bodily autonomy. The 14th Amendment’s due process and equal protection clauses have long been the legal basis for gender equality cases. If, as the Supreme Court’s ruling suggests, the right to abortion is not constitutionally protected via the 14th Amendment, it opens up the possibility that other settled law concerning gender and racial equality also has the potential to be reversed. </p>
<p>Instead of examining abortion through the lens of past cases of gender law, however, Alito instead refers to the opinions of 17th-century male legal theorists, <a href="https://www.bostonglobe.com/2022/05/06/metro/who-was-matthew-hale-17th-century-jurist-alito-invokes-his-draft-overturning-roe/">who believed</a> in witches and the right of husbands to rape their wives. He also cites as evidence the passage of 19th-century state abortion laws by all-male legislatures, which criminalized abortion and birth control. The <a href="https://www.mtsu.edu/first-amendment/article/1038/comstock-act-of-1873#:%7E:text=The%20Comstock%20Act%20of%201873,picture%2C%20drawing%2C%20or%20advertisement.">Comstock Postal Act of 1873</a> also made possessing or selling all sexual information and contraceptive items a federal crime. </p>
<p>Meanwhile, Alito’s opinion does not discuss the women’s rights movement in the 1800s or women’s ordinary, daily perspectives on abortion at the time. In this landmark decision, the court has skipped one of the biggest parts of U.S. history on abortion, creating a glaring gap in an understanding of how abortions and abortion law in the country worked in the past.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/482329/original/file-20220901-13-ldb478.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A middle aged white, blonde woman wears a straw hat, white clothing and a sash that says 'Votes for women.' Five other women, also in white and with the same sashes, stand in the foreground. Two hold a sign that says 'Votes for Women.'" src="https://images.theconversation.com/files/482329/original/file-20220901-13-ldb478.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/482329/original/file-20220901-13-ldb478.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/482329/original/file-20220901-13-ldb478.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/482329/original/file-20220901-13-ldb478.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/482329/original/file-20220901-13-ldb478.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=500&fit=crop&dpr=1 754w, https://images.theconversation.com/files/482329/original/file-20220901-13-ldb478.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=500&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/482329/original/file-20220901-13-ldb478.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=500&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Candace Stitzman-Duley, center, a distant relative of Susan B. Anthony, poses with Democratic voting activists in Muhlenberg, Pa.</span>
<span class="attribution"><a class="source" href="https://media.gettyimages.com/photos/candace-stitzmanduley-front-back-from-left-are-ella-drumgold-of-of-picture-id1269372458">Ben Hasty/MediaNews Group/Reading Eagle via Getty Images</a></span>
</figcaption>
</figure>
<h2>Voluntary motherhood</h2>
<p>Considering how suffragists like the Black journalist and activist <a href="https://www.womenshistory.org/education-resources/biographies/ida-b-wells-barnett">Ida B. Wells</a> and other prominent women’s rights activists in the 19th century thought about rights to their own bodies is an overlooked part of this history.</p>
<p>Suffragists in the 19th century focused on a woman’s right to vote – and did not openly support legalizing abortion or <a href="https://doi.org/10.1017/S1537781420000304">birth control</a>. </p>
<p>The reason why reproductive rights were omitted from the suffragist campaign is complex. </p>
<p>Suffragists argued that legalizing birth control and abortion would hurt women, who already had few legal rights at the time. They said that men would then use these legal freedoms to further abuse and control women.</p>
<p>Instead, suffragists embraced an idea they termed “<a href="https://www.theatlantic.com/health/archive/2019/07/did-suffragists-support-birth-control/593896/">voluntary motherhood</a>.” This meant that women had the right to reject unwanted sex and could choose if and when they had children. </p>
<p>Even in happy marriages, many women in the 1800s could not necessarily control the number of pregnancies they had. <a href="https://www.criminaldefenselawyer.com/resources/criminal-defense/crime-penalties/marital-rape.htm">Marital rape</a> was legal, and enslavers had total control over enslaved women’s bodies. </p>
<p>The idea of voluntary motherhood – meaning that women should have full control over their own bodies – was a powerfully radical idea. </p>
<p>This notion appealed to women across race and class lines, and it helped drive the emergent women’s rights movement, beginning in the <a href="https://www.nps.gov/wori/learn/historyculture/womens-rights-movement.htm">1840s</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/482330/original/file-20220901-19-4xoqqf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A black and white photo shows two older women in old fashioned clothing seated at a table, looking at some papers." src="https://images.theconversation.com/files/482330/original/file-20220901-19-4xoqqf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/482330/original/file-20220901-19-4xoqqf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=640&fit=crop&dpr=1 600w, https://images.theconversation.com/files/482330/original/file-20220901-19-4xoqqf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=640&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/482330/original/file-20220901-19-4xoqqf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=640&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/482330/original/file-20220901-19-4xoqqf.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=804&fit=crop&dpr=1 754w, https://images.theconversation.com/files/482330/original/file-20220901-19-4xoqqf.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=804&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/482330/original/file-20220901-19-4xoqqf.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=804&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Susan B. Anthony and Elizabeth Cady Stanton, both noted suffragists, are shown in an 1890 photograph.</span>
<span class="attribution"><a class="source" href="https://media.gettyimages.com/photos/susan-b-anthony-and-elizabeth-cady-stanton-two-great-pioneers-in-the-picture-id624470444">Photo12/Universal Images Group via Getty Images</a></span>
</figcaption>
</figure>
<h2>What suffragists said about abortion</h2>
<p>Suffragist reformers recognized that the right to vote meant little if they did not have control of their bodies or reproductive lives. Black suffragists like Wells and <a href="https://www.loc.gov/exhibitions/women-fight-for-the-vote/about-this-exhibition/new-tactics-for-a-new-generation-1890-1915/western-states-pave-the-way/i-speak-of-wrongs-frances-ellen-watkins-harper/">Frances Ellen Watkins Harper</a>, for example, <a href="https://www.blackpast.org/african-american-history/speeches-african-american-history/1866-frances-ellen-watkins-harper-we-are-all-bound-together/">spoke eloquently</a> about the constant dangers Black women faced from white men raping and assaulting them.</p>
<p>They and White women suffragists like Lucy Stone argued that gaining the right to vote would help women have more power to combat these problems. </p>
<p>These activists recognized that women turned to contraceptives and abortion to control their own reproduction. But they also said that unscrupulous manufacturers and people who performed abortions sometimes took advantage of women, by selling them ineffective or harmful contraceptives or charging them large sums for abortions. Substances used to induce abortion, or <a href="https://www.atlasobscura.com/articles/19th-century-birth-control-dittrick">abortifacients</a>, also often contained harmful and poisonous ingredients that killed women, while surgical abortions were incredibly risky in an era where germ theory and understandings of infection were rudimentary at best.</p>
<p>Reformers also <a href="https://doi.org/10.1353/jowh.2019.0029">openly blamed</a> harsh anti-abortion laws for contributing to these problems – driving women to desperate measures while still allowing men to have sex freely and shirk their responsibilities of fatherhood. </p>
<p>Suffragist Matilda Joslyn Gage agreed, writing in a suffrage newspaper <a href="https://www.feministsforlife.org/matilda-joslyn-gage-1826-1898/">in 1868 that</a> “this crime of … abortion … lies at the door of the male sex.” </p>
<h2>Using history for today’s arguments</h2>
<p>Today, some anti-abortion rights women’s groups look to the suffragist movement to make the case that abortion should be limited or banned. </p>
<p>Feminists for Life and Susan B. Anthony Pro-Life America, for example, have long rested their funding and advocacy campaigns on attempting to <a href="https://www.wsj.com/articles/susan-b-anthony-was-pro-life-elizabeth-cady-stanton-roe-abortion-dobbs-decision-11655151459?mod=article_inline">prove that suffragists were “pro-life</a>.” But research shows that their argument is an incomplete reading of suffragists’ complex views of abortion, while also falsely presuming that suffragists would have supported current laws banning abortion today. </p>
<p>There is ample primary source evidence in suffrage newspapers like “The Revolution” or in the private letters of the suffragists showing that they repeatedly insisted that anti-abortion laws punished women, without actually eliminating the practice of abortion. </p>
<p>White suffragists like Anthony held <a href="https://www.nytimes.com/2018/07/28/opinion/sunday/suffrage-movement-racism-black-women.html">overtly racist</a> and eugenic views, and their support for women who sought abortions often incorporated ideas of eliminating disability and what they deemed undesirable offspring. They prioritized rights for white, middle-class women and ignored or outright rejected Black reformers’ <a href="https://www.americanyawp.com/reader/18-industrial-america/ida-b-wells-barnett-lynch-law-in-america-1900/#:%7E:text=The%20result%20is%20that%20many,him%20with%20insult%20or%20assault.">urgent pleas</a> for reproductive justice. </p>
<p>But that messy, complex past nonetheless remains central to understanding Americans’ experiences with abortion and abortion law. </p>
<p>Alito wrote that women’s role in abortion history is too “conflicting” to be useful. Yet considering women’s historical attitudes about reproductive rights – and the reasons behind these views – was a critical omission in the court’s historical considerations of the role of abortion in Americans’ lives.</p><img src="https://counter.theconversation.com/content/186682/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lauren Thompson does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>The women’s rights movement in the 1800s did not openly support legalizing abortion or birth control. But the reasons why are complex.Lauren Thompson, Assistant Professor of History and Interdisciplinary Studies, Kennesaw State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1870132022-08-31T12:26:45Z2022-08-31T12:26:45ZWhen abortion at a clinic is not available, 1 in 3 pregnant people say they will do something on their own to end the pregnancy<figure><img src="https://images.theconversation.com/files/478589/original/file-20220810-15-3oc00y.jpg?ixlib=rb-1.1.0&rect=60%2C0%2C6720%2C4325&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A self-managed abortion is the termination of pregnancy outside the formal health care system, often with self-sourced abortion pills.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/young-woman-with-abortion-pill-and-glass-of-water-royalty-free-image/1314748004?adppopup=true">Liudmila Chernetska/iStock via Getty Images Plus</a></span></figcaption></figure><p><em>The <a href="https://theconversation.com/us/topics/research-brief-83231">Research Brief</a> is a short take about interesting academic work.</em> </p>
<h2>The big idea</h2>
<p>One in three people in need of abortion will consider doing something on their own to end the pregnancy if they are unable to get an abortion at a clinic. These are the findings of a <a href="https://doi.org/10.1186/s12978-022-01486-8">study I recently published</a> after surveying over 700 people seeking abortions in three states across the U.S.: Illinois, California and New Mexico.</p>
<p>The one-in-three figure is even higher among those who have a difficult time affording the cost of their abortion, have no health insurance or are seeking an abortion because of concerns about their own physical or mental health. </p>
<p>These findings offer a clear snapshot of what lies ahead as states move to ban abortion outright or severely restrict access. </p>
<h2>Why it matters</h2>
<p>Research over the past two decades has shown that pregnant people who <a href="https://doi.org/10.1016/j.contraception.2021.09.009">face obstacles</a> to getting to an abortion clinic <a href="https://doi.org/10.1016/j.ajog.2020.02.026">or who have a desire</a> for a more natural or private abortion experience will try to end a pregnancy on their own. This might include turning to <a href="https://doi.org/10.1016/j.bpobgyn.2019.08.002">self-sourced abortion pills</a>, alcohol or drugs, herbs or physical methods. </p>
<p>My own research in 2017 found that 7% of U.S. women of reproductive age <a href="https://doi.org/10.1001/jamanetworkopen.2020.29245">will use one of these methods</a> in their lifetime to try to end a pregnancy outside of the formal health care system. </p>
<p>What has changed recently – and dramatically – is access to clinic-based abortion. With the Supreme Court’s decision <a href="https://theconversation.com/supreme-court-overturns-roe-upends-50-years-of-abortion-rights-5-essential-reads-on-what-happens-next-184697">overturning federal protections on abortion access</a>, as of Aug. 30, 2022, 14 states have already <a href="https://reproductiverights.org/maps/abortion-laws-by-state/">implemented bans on abortion</a>; an additional 12 are projected to do so in the coming months. </p>
<p><iframe id="KZgzc" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/KZgzc/2/" height="400px" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>These restricted-abortion states are home to just over <a href="https://www.nytimes.com/interactive/2022/05/07/us/abortion-access-roe-v-wade.html">one-half of U.S. women of reproductive age</a>. Putting these numbers together with data on who seeks abortion in the U.S., researchers estimate that over 100,000 pregnant people per year will soon <a href="https://doi.org/10.1016/j.contraception.2019.07.139">face insurmountable travel distances</a> to their nearest abortion provider and be unable to get an abortion at a clinic. </p>
<p>If people do as they project in our study, around 33,000 pregnant people per year will consider doing something on their own to end a pregnancy.</p>
<h2>What still isn’t known</h2>
<p>One yet unanswered question is how many of those in need of abortion and unable to get to a clinic will be able to <a href="https://doi.org/10.1001/jamainternmed.2022.2893">end a pregnancy on their own</a> with a <a href="https://theconversation.com/abortion-pills-are-safe-to-prescribe-without-in-person-exams-new-research-finds-179622">safe and effective method</a> such as the <a href="https://theconversation.com/how-to-navigate-self-managed-abortion-issues-such-as-access-wait-times-and-complications-a-family-physician-explains-186186">FDA-approved medications mifepristone and misoprostol, or misoprostol alone</a> – versus how many will turn to other, likely less effective, methods with potentially harmful outcomes. </p>
<p>Researchers now have clear evidence that <a href="https://doi.org/10.1001/jamanetworkopen.2021.22320">telehealth</a> and <a href="https://doi.org/10.1016/j.lana.2022.100200">mail-order models</a> enabling access to medication abortion <a href="https://doi.org/10.1001/jamainternmed.2022.0217">without the need for an in-person visit</a> with a health care provider – <a href="https://theconversation.com/covid-19-mental-health-telemedicine-was-off-to-a-slow-start-then-the-pandemic-happened-177670">models accelerated in part by the COVID-19 pandemic</a> – are safe, effective and satisfactory to patients.</p>
<p>However, these models will remain out of reach for some. This is especially true for those who are further along in their pregnancy, <a href="https://doi.org/10.1016/j.ssmqr.2021.100003">cannot afford the cost</a>, live in one of the 19 states that <a href="https://www.kff.org/womens-health-policy/slide/state-restrictions-on-telehealth-abortion/">ban telehealth provision of medication abortion</a> or don’t have a safe place to receive and use the pills. </p>
<p>What is also unknown is how many pregnant people will face legal repercussions for doing something to try to end a pregnancy. Although public support <a href="https://doi.org/10.1007/s13178-021-00572-z">for criminalizing a pregnant person</a> for self-managing an abortion is low, state legislators are <a href="https://www.ifwhenhow.org/resources/making-abortion-a-crime-again/">actively proposing such policies</a>. Between 2000 and 2020, more than 61 people were <a href="https://www.ifwhenhow.org/resources/self-care-criminalized-preliminary-findings/">investigated or arrested for such attempts</a>.</p>
<h2>What’s next</h2>
<p>In the coming months, my colleagues and I will document the magnitude of any increase in self-managed abortion by <a href="https://www.ansirh.org/research/ongoing/self-managed-abortion-attitudes-study-smaash">repeating a nationally representative survey</a> that we fielded <a href="https://doi.org/10.1001/jamanetworkopen.2020.29245">in 2017</a> and 2021. </p>
<p>Our research underscores that even when abortion is restricted, people will move forward with abortion on their own. Having access to abortion pills is critical so that when people need to self-manage an abortion, the health, medical and advocacy community is supporting them to do so safely and effectively.</p><img src="https://counter.theconversation.com/content/187013/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lauren Ralph receives funding from the Society of Family Planning Research Fund and an anonymous foundation. </span></em></p>The fall of Roe v. Wade will result in more people deciding to privately end a pregnancy, a new study finds. But how often people will turn to safe versus unsafe options remains to be seen.Lauren Ralph, Associate Professor of Obstetrics, Gynecology and Reproductive Sciences, University of California, San FranciscoLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1878332022-08-11T12:13:24Z2022-08-11T12:13:24ZThere’s reason for people on opposing sides of abortion to talk, even if they disagree – it helps build respect, understanding and can lead to policy change<p>The Supreme Court’s <a href="https://www.oyez.org/cases/2021/19-1392">decision to overturn</a> Roe v. Wade has split the country into joyous supporters and furious dissenters. Emotions are running high, and some protests have <a href="https://time.com/6194085/abortion-protests-guns-violence-extremists/">turned violent</a>. Yet research shows that people on either side of the abortion rights issue can bridge their divide if they speak directly and respectfully with one another.</p>
<p>In July 2022, former leaders of prominent abortion-rights and anti-abortion advocacy organizations in Massachusetts gathered to discuss a new <a href="https://www.csmonitor.com/Daily/2022/20220801/Lessons-of-Boston-s-secret-abortion-talks-Understanding-vs.-agreement">documentary film series</a> <a href="https://www.intergroupresources.com/rc/Fostering%20Dialogue%20Across%20Divides.pdf">about</a> <a href="https://uploads-ssl.webflow.com/57e552041c882348567f1676/593c1ebf230b5002a4a2179b_1.1.%20Talking%20with%20the%20Enemy%2C%20Boston%20Globe.pdf">conversations they had regularly</a> from 1995 to 2001. The warm friendships that they developed across their deep differences on abortion persist today, decades after their first meeting.</p>
<p>Nicki Gamble, the former president and CEO of <a href="https://www.plannedparenthood.org/planned-parenthood-massachusetts">Planned Parenthood League of Massachusetts</a>, said during the panel that the opportunity to engage with anti-abortion activists “changed my life.” </p>
<p>Others agreed.</p>
<p>“The facilitators made us really listen,” said Madeline McComish, former president of <a href="https://www.masscitizensforlife.org/">Massachusetts Citizens for Life</a>. “Most of the time the pro-choice women had said something different than what we thought.”</p>
<p>My <a href="https://odc.aom.org/HigherLogic/System/DownloadDocumentFile.ashx?DocumentFileKey=7690fa68-7776-e2e1-5162-c52758d7d2fb&forceDialog=1">research</a> on talks between abortion-rights and anti-abortion advocates found that respectful conversation produces numerous positive outcomes. It helps people listen more deeply and forge personal connections, which can reduce negative stereotypes and foster respect and empathy. In Boston, this translated to a lessening of inflammatory public language.</p>
<p>It can also lead people on opposite sides of an issue to evolve their views and develop more nuanced, complex perspectives. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/478562/original/file-20220810-9567-eziox2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Men dressed as police officers and investigators stand outside a generic looking brick building, blocked off with yellow police tape." src="https://images.theconversation.com/files/478562/original/file-20220810-9567-eziox2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/478562/original/file-20220810-9567-eziox2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/478562/original/file-20220810-9567-eziox2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/478562/original/file-20220810-9567-eziox2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/478562/original/file-20220810-9567-eziox2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/478562/original/file-20220810-9567-eziox2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/478562/original/file-20220810-9567-eziox2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Police block off a Massachusetts abortion clinic where two people were killed in 1994.</span>
<span class="attribution"><a class="source" href="https://media.gettyimages.com/photos/proabortion-demonstration-after-a-christian-fundamentalist-killed-two-picture-id525610370?s=2048x2048">Brooks Kraft/Contributor</a></span>
</figcaption>
</figure>
<h2>De-escalating violence</h2>
<p>The <a href="https://whatisessential.org/impact-stories/abortion-dialogues-greater-boston">Abortion Dialogues</a>, as they are known, were launched in Boston in response to <a href="https://time.com/3648437/john-salvi-shootings/">lethal shootings</a> in 1994 by an anti-abortion rights gunman at two local abortion clinics. </p>
<p>At <a href="https://www.washingtonpost.com/photography/2022/05/17/photos-1990s-abortion-show-how-present-is-like-past/">that time</a>, the country was deeply polarized about abortion, rocked by <a href="https://www.cnn.com/2015/11/30/us/anti-abortion-violence">violent protests</a> and <a href="https://www.nytimes.com/interactive/2015/11/29/us/30abortion-clinic-violence.html">murders</a> of prominent doctors who provided abortions. </p>
<p>Six women activists for and against abortion rights started confidential talks in Boston in 1995, hoping to de-escalate the violence.</p>
<p>They soon discovered that their moral worldviews presented two irreconcilable philosophies about how to live in the world. </p>
<p>The three participants on the “pro-life,” side, as they chose to call themselves, are all observant Catholics from Boston. They made life choices based on a worldview that there is one truth, guided by their faith, about moral rights and wrongs. </p>
<p>In contrast, the women on the “pro-choice” side, as they referred to themselves, said that they recognized a diversity of personal beliefs and weighed many circumstances in making life choices. </p>
<p>“The pro-choice side does not believe there are moral absolutes,” explained one “pro-life” leader who participated in the talks in a confidential research interview in 2008. “The pro-life participants would force others to conduct their lives according to the ‘one’ truth that they believe,” countered a “pro-choice” activist who also engaged in the talks. </p>
<p>Despite this irreconcilable difference, the participants valued their conversations. They enjoyed talking with people with whom they had formerly sparred via news interviews. </p>
<p>Gradually, each side’s negative stereotypes were replaced by greater understanding and respect for their opponents. They also discovered that they enjoyed each other’s company. They grew to be friends, celebrated birthdays together and shared the ups and downs of their lives. </p>
<p>Rehumanizing the fight led to their hoped-for public outcome – the participants toned down their name calling, spoke up loudly for nonviolent means of change and instructed their organizations to treat the people on the other side with respect.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/478571/original/file-20220810-4746-ghzqoi.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A blue lit room shows five middle aged and older women sitting at the front of an auditorium." src="https://images.theconversation.com/files/478571/original/file-20220810-4746-ghzqoi.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/478571/original/file-20220810-4746-ghzqoi.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=418&fit=crop&dpr=1 600w, https://images.theconversation.com/files/478571/original/file-20220810-4746-ghzqoi.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=418&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/478571/original/file-20220810-4746-ghzqoi.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=418&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/478571/original/file-20220810-4746-ghzqoi.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=525&fit=crop&dpr=1 754w, https://images.theconversation.com/files/478571/original/file-20220810-4746-ghzqoi.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=525&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/478571/original/file-20220810-4746-ghzqoi.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=525&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Boston women who are former leaders of abortion-rights and anti-abortion organizations spoke together in July 2022.</span>
<span class="attribution"><span class="source">Kate W. Isaacs</span></span>
</figcaption>
</figure>
<h2>Truth statements and policy</h2>
<p>The Boston leaders didn’t try to agree on policy, but in June 2022, a different, small group of 22 residents in Jessamine Country, Kentucky, interested in abortion rights succeeded in doing just that. </p>
<p>They used a guide for how to structure conversations produced by the nonprofit <a href="https://braverangels.org/">Braver Angels</a>, an organization I volunteer with, that sets out how to find common ground among those <a href="https://braverangels.org/what-we-do/common-ground/#:%7E:text=What%20is%20the%20Braver%20Angels,change%2C%20electoral%20reform%20or%20abortion.">with opposing viewpoints</a>. Their aim: create agreements <a href="https://braverangels.org/if-we-could-get-past-this-issue-we-could-talk-about-almost-anything-heres-how-the-jessamine-county-alliance-dove-into-a-heated-debate/">about abortion</a> between conservatives and liberals. </p>
<p>One key to the group’s success was a selection of background readings by abortion-rights and anti-abortion authors that established a shared set of facts about abortion. For instance, there is a strong link between abortion and poverty, in that <a href="https://www.guttmacher.org/fact-sheet/induced-abortion-united-states">3 out of 4 women</a> seeking abortions are poor or low-income.</p>
<p>The Kentucky abortion conversation also focused on a goal everyone could support – reducing unwanted pregnancies and, consequently, abortions. The result was <a href="https://docs.google.com/document/d/137HNquSyyod7k2PJbWjGEmLLNvGS2ApC/edit">unanimous agreement</a> on two concrete policy recommendations: better, age-appropriate sex education in Kentucky schools, and long-acting reversible contraception that is free of charge for Kentucky residents, modeled after the Colorado <a href="http://www.larc4co.com">contraception program</a>, which reduced abortion rates by 60% and birth rates by 59% among teenagers aged 15-19 from 2009 to 2014.</p>
<p>The participants are now working to communicate their recommendations to state legislators, local pastors, the local health department and the news media.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/478565/original/file-20220810-9577-n9g31l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A woman holds a toddler girl in a pink snowsuit and appears to talk in a heated manner with a middle aged woman wearing glasses and a black jacket." src="https://images.theconversation.com/files/478565/original/file-20220810-9577-n9g31l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/478565/original/file-20220810-9577-n9g31l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/478565/original/file-20220810-9577-n9g31l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/478565/original/file-20220810-9577-n9g31l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/478565/original/file-20220810-9577-n9g31l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/478565/original/file-20220810-9577-n9g31l.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/478565/original/file-20220810-9577-n9g31l.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">An abortion rights activist argues with an anti-abortion advocate at a 1992 rally in Washington.</span>
<span class="attribution"><a class="source" href="https://media.gettyimages.com/photos/prochoice-advocate-michelle-redstockings-holds-her-three-year-old-picture-id1231303438?s=2048x2048">Hai Do/AFP via Getty Images</a></span>
</figcaption>
</figure>
<h2>Beyond these cases</h2>
<p>The empathetic dialogue strategies used in Massachusetts and Kentucky may work in the longer term to reduce polarization in other places, too, and build greater consensus on future policy.</p>
<p>Ireland, for example, <a href="https://www.theguardian.com/world/2018/may/26/ireland-votes-by-landslide-to-legalise-abortion">voted in 2018</a> to roll back the country’s restrictive abortion law, replacing it with a new constitutional amendment that permits abortion during the first 12 weeks of pregnancy, and later if a woman’s life or health is at risk or the fetus has an abnormality.</p>
<p>Just as the Kentucky group did with their shared readings before they met, <a href="https://www.irishamerica.com/2022/06/abortion-legal-ireland/">Ireland undertook</a> joint fact-finding before the amendment vote, via a 100-person constitutional convention. When it came time to vote, empathetic story sharing played a key role. Nearly <a href="https://www.irishamerica.com/2022/06/abortion-legal-ireland/">40% of those</a> who voted to remove the abortion prohibition said their vote had been influenced by hearing from a woman about her experience. </p>
<p>These same lessons could apply to abortion in the U.S.</p>
<p>John Wood Jr., chairman of the Republican Party of Los Angeles County, called for the same respectful type of conversation <a href="https://braverangels.org/a-hopeful-argument-for-choice-a-tearful-tale-in-favor-of-life/">in a story he told in July 2022 about</a> his long-ago teenage girlfriend’s abortion. </p>
<p>“I cannot hate my fellow Americans who have dedicated their lives to either side of this issue,” he wrote. “There is deep humanity on each side of this divide.”</p>
<p>The groups in Massachusetts and Kentucky show that dialogue works. They built personal connections that crossed their respective ideologies, showed respect for different opinions and pushed for change that they could all support.</p><img src="https://counter.theconversation.com/content/187833/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kate W. Isaacs is affiliated with Braver Angels as a volunteer facilitator. </span></em></p>When ideological enemies talk across their great divides, something good can happen – it reduces stereotypes and inflammatory language directed at people who don’t agree on the abortion rights issue.Kate W. Isaacs, Lecturer, Massachusetts Institute of Technology (MIT)Licensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1869832022-07-20T12:22:02Z2022-07-20T12:22:02ZWhat the Bible actually says about abortion may surprise you<figure><img src="https://images.theconversation.com/files/474399/original/file-20220716-16-ksf3wr.jpg?ixlib=rb-1.1.0&rect=16%2C6%2C996%2C683&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Activist Jason Hershey reads from a Bible as he protests in front of the U.S. Supreme Court with the anti-abortion group Bound for Life in 2005 in Washington, D.C.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/pro-life-activist-jason-hershey-reads-from-a-bible-as-he-news-photo/56303642?adppopup=true">Win McNamee via Getty Images</a></span></figcaption></figure><p>In the days since the Supreme Court <a href="https://theconversation.com/a-revolutionary-ruling-and-not-just-for-abortion-a-supreme-court-scholar-explains-the-impact-of-dobbs-185823">overturned Roe v. Wade</a>, which had established the constitutional right to an abortion, some <a href="https://www.star-telegram.com/news/local/fort-worth/article262921023.html">Christians have cited the Bible</a> to argue why this decision should either be celebrated or lamented. But here’s the problem: This 2,000-year-old text says nothing about abortion.</p>
<p>As <a href="https://www.fresno.edu/person/001g000001wnx9yiac/melanie-howard">a university professor of biblical studies</a>, I am familiar with faith-based arguments Christians use to back up views of abortion, whether for or against. Many people seem to assume the Bible discusses the topic head-on, which is not the case. </p>
<h2>Ancient context</h2>
<p>Abortions were <a href="https://www.hup.harvard.edu/catalog.php?isbn=9780674168763">known and practiced</a> in biblical times, although the methods differed significantly from modern ones. The second-century <a href="https://www.fulcrum.org/concern/monographs/n870zr06z">Greek physician Soranus</a>, for example, recommended fasting, bloodletting, vigorous jumping and carrying heavy loads as ways to end a pregnancy. </p>
<p>Soranus’ <a href="https://www.fulcrum.org/concern/monographs/n870zr06z">treatise on gynecology</a> acknowledged different schools of thought on the topic. Some medical practitioners forbade the use of any abortive methods. Others permitted them, but not in cases in which they were intended to cover up an adulterous liaison or simply to preserve the mother’s good looks. </p>
<p>In other words, the Bible was written in a world in which abortion was practiced and viewed with nuance. Yet the Hebrew and Greek equivalents of the word “abortion” do not appear in either the Old or New Testament of the Bible. That is, the topic simply is not directly mentioned. </p>
<h2>What the Bible says</h2>
<p>The absence of an explicit reference to abortion, however, has not stopped its opponents or proponents from looking to the Bible for support of their positions.</p>
<p>Abortion opponents turn to several biblical texts that, taken together, seem to suggest that human life has value before birth. For example, the Bible opens by describing the creation of humans “<a href="https://www.biblegateway.com/passage/?search=gen+1%3A27&version=NRSVUE">in the image of God</a>”: a way to explain the value of human life, presumably even before people are born. Likewise, the Bible describes several important figures, including the prophets <a href="https://www.biblegateway.com/passage/?search=jeremiah+1%3A5&version=NRSVUE">Jeremiah</a> and <a href="https://www.biblegateway.com/passage/?search=isa+49%3A1&version=NRSVUE">Isaiah</a> and <a href="https://www.biblegateway.com/passage/?search=gal+1%3A15&version=NRSVUE">the Christian Apostle Paul</a>, as having being called to their sacred tasks since their time in the womb. <a href="https://www.biblegateway.com/passage/?search=psalm+139&version=NRSVUE">Psalm 139</a> asserts that God “<a href="https://www.biblegateway.com/passage/?search=psalm+139%3A13-15&version=NRSVUE">knit me together in my mother’s womb</a>.”</p>
<figure class="align-center ">
<img alt="A painting shows God's hand reaching out to touch Adam, the first human in the Bible's story of creation." src="https://images.theconversation.com/files/474400/original/file-20220716-16-uee3tw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/474400/original/file-20220716-16-uee3tw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/474400/original/file-20220716-16-uee3tw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/474400/original/file-20220716-16-uee3tw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/474400/original/file-20220716-16-uee3tw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/474400/original/file-20220716-16-uee3tw.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/474400/original/file-20220716-16-uee3tw.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">‘The Creation of Adam’ from the Sistine Chapel ceiling in the Vatican, painted by Michelangelo.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/the-creation-of-adam-from-the-sistine-chapel-ceiling-by-news-photo/566419839?adppopup=true">GraphicaArtis/Getty Images</a></span>
</figcaption>
</figure>
<p>However, abortion opponents are not the only ones who can appeal to the Bible for support. Supporters can point to other biblical texts that would seem to count as evidence in their favor. </p>
<p><a href="https://www.biblegateway.com/passage/?search=exod+21%3A22-25&version=NRSVUE">Exodus 21</a>, for example, suggests that a pregnant woman’s life is more valuable than the fetus’s. This text describes a scenario in which men who are fighting strike a pregnant woman and cause her to miscarry. A monetary fine is imposed if the woman suffers no other harm beyond the miscarriage. However, if the woman suffers additional harm, the perpetrator’s punishment is to suffer reciprocal harm, up to life for life.</p>
<p>There are other biblical texts that seem to celebrate the choices that women make for their bodies, even in contexts in which such choices would have been socially shunned. <a href="https://www.biblegateway.com/passage/?search=mk+5%3A25-34&version=NRSVUE">The fifth chapter of the Gospel of Mark</a>, for example, describes a woman with a gynecological ailment that has made her bleed continuously taking a great risk: She reaches out to touch Jesus’ cloak in hopes that it will heal her, even though the touch of a menstruating woman was believed to cause ritual contamination. However, Jesus commends her choice and praises her faith. </p>
<p>Similarly, in the Gospel of John, Jesus’ follower Mary <a href="https://www.biblegateway.com/passage/?search=john+12%3A1-8&version=NRSVUE">seemingly wastes resources</a> by pouring an entire container of costly ointment on his feet and using her own hair to wipe them – but he defends her decision to break the social taboo around touching an unrelated man so intimately.</p>
<h2>Beyond the Bible</h2>
<p>In the response to the Supreme Court’s decision, Christians <a href="https://www.cnn.com/2022/06/25/us/abortion-christian-debate-blake-cec/index.html">on both sides of the partisan divide</a> have appealed to any number of texts <a href="https://www.christianheadlines.com/contributors/michael-foust/tony-evans-urges-christians-to-promote-a-womb-to-the-tomb-strategy-for-pregnant-women.html">to assert that their particular brand of politics is biblically backed</a>. However, if they claim the Bible specifically condemns or approves of abortion, they are skewing the textual evidence to fit their position.</p>
<p>Of course, Christians can develop their own faith-based arguments about modern political issues, whether or not the Bible speaks directly to them. But it is important to recognize that although the Bible was written at a time when abortion was practiced, it never directly addresses the issue.</p><img src="https://counter.theconversation.com/content/186983/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Melanie A. Howard does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Faith can inform opinions about abortion on both sides of the political debate, but the Bible itself says nothing directly about the topic, a biblical scholar explains.Melanie A. Howard, Associate Professor of Biblical & Theological Studies, Fresno Pacific UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1861812022-07-12T12:33:03Z2022-07-12T12:33:03ZUS abortion restrictions are unlikely to influence international trends, which are largely becoming more liberal<figure><img src="https://images.theconversation.com/files/473433/original/file-20220711-26-papg1r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">In most countries, like the Netherlands, it has become easier to get a legal, safe abortion over the last two decades. </span> <span class="attribution"><a class="source" href="https://media.gettyimages.com/photos/demonstrators-speak-out-in-favor-of-the-abortion-law-in-dutch-law-on-picture-id1241665177?s=2048x2048">Evert Elzinga/ANP/AFP via Getty Images </a></span></figcaption></figure><p>The Supreme Court’s June 24, 2022, <a href="https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf">ruling that overturned</a> Roe v. Wade is already <a href="https://www.politico.com/news/2022/07/06/abortion-laws-states-roe-overturned-00044127">having profound effects</a> across the United States, from Florida to Wisconsin. And the ruling also bucks a clear worldwide trend. In countries <a href="https://freedomhouse.org/country/iceland/freedom-world/2020">from Iceland</a> to <a href="https://equityhealthj.biomedcentral.com/articles/10.1186/s12939-018-0908-8">Zambia</a>, abortion restrictions have been lifted over the last two decades, not tightened. </p>
<p>Today, <a href="https://qz.com/2161476/a-list-of-countries-where-abortion-is-illegal/">only 24 countries</a> out of 195 prohibit abortion, representing just 5% of women of reproductive age globally. Twice that many countries <a href="https://www.cfr.org/article/abortion-law-global-comparisons">have made it easier</a> to legally get an abortion in the past 20 years. </p>
<p>The U.S. joined the short list of countries that are increasing abortion restrictions when the Supreme Court overturned the constitutional right to abortion in <a href="https://www.supremecourt.gov/opinions/21pdf/19-1392_6j37.pdf">Dobbs v. Jackson Women’s Health Organization</a>. The ruling did not itself make abortion illegal – it said instead that there is no federal right to get an abortion and that the power to regulate belonged to the states. Many states are now <a href="https://news.trust.org/item/20201231112641-qfynt/">tightening restrictions</a> on abortion. </p>
<p>In the past, some Supreme Court rulings, such as Brown v. Board of Education, which deemed school segregation illegal, <a href="https://awpc.cattcenter.iastate.edu/2017/03/21/brown-v-board-of-education-in-international-context-oct-21-2004/">have been influential abroad</a>, cited by other courts in their rulings worldwide. Similarly, some women’s rights advocates <a href="https://www.pbs.org/newshour/world/how-the-end-of-roe-could-affect-abortion-access-in-latin-america">are concerned</a> that the Dobbs decision could lend legal support to more restrictive abortion policies in other countries.</p>
<p>I am a <a href="https://scholar.google.com/citations?hl=en&user=BZThBb8AAAAJ&view_op=list_works&gmla=AJsN-F68s7a91tzruhBlRP3s4o5sYb4oFJTNzbNrttpsZ73dVBWP1xP68b-eQk1DsvBTTG5-Y_Kh5I2I5Sb9AzZUxODh3wDaaI3iOwfz8ZQ9iUumQuxevLE">law professor</a> who has studied worldwide trends in abortion law. Rather than triggering a new wave of restrictive abortion laws in other countries, the Dobbs decision seems just as likely to wield little international influence. Two key reasons are the broad global momentum toward greater abortion access and the United States’ <a href="https://www.ohchr.org/en/statements/2022/07/access-safe-and-legal-abortion-urgent-call-united-states-adhere-womens-rights">waning international influence</a> in the area of women’s rights. </p>
<p>In fact, the Dobbs decision may serve to further isolate the U.S. and undermine its credibility as a global leader on women’s rights.</p>
<h2>Abortion trends in other countries</h2>
<p>Thirty countries changed their laws to either permit or make it easier to get an abortion since 2000, according to the <a href="https://www.cfr.org/article/abortion-law-global-comparisons">Council on Foreign Relations</a>. This trend spanned Africa, Asia, Europe, South America and Oceania. Wealthy countries like <a href="https://www.reuters.com/article/us-newzealand-abortion/new-zealand-passes-historic-law-to-decriminalize-abortion-idUSKBN2153YN">New Zealand</a> and <a href="https://www.swissinfo.ch/eng/fertility-matters_the-secret-of-switzerland-s-low-abortion-rate/33585760">Switzerland</a>, along with poorer countries like <a href="https://www.reuters.com/article/us-togo-abortion/togo-legalizes-abortion-in-rape-incest-cases-idUSL2837062220061228">Togo</a> and <a href="https://www.cfr.org/article/abortion-law-global-comparisons">Micronesia</a>, all increased the ability to get an abortion over the last two decades.</p>
<p>During the same period, only one wealthy Western country, <a href="https://www.washingtonpost.com/history/2022/06/12/poland-abortion-rights-history/">Poland</a>, increased restrictions on abortion, joining authoritarian regimes like Nicaragua on the <a href="https://www.guttmacher.org/sites/default/files/report_downloads/aww_appendix_table_1.pdf">short roster of nations</a> with near-complete abortion bans. </p>
<p>Nepal, <a href="https://theconversation.com/abortion-the-story-of-suffering-and-death-behind-irelands-ban-and-subsequent-legalization-182812">Ireland</a> and Argentina are examples of three countries that recently adopted more liberal abortion laws. </p>
<p>In each of these countries, this change came only after years of protests, court fights and people organizing for political change. These activists’ successes depended on building coalitions within their countries – not on U.S. influence.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/473432/original/file-20220711-18-b0yevu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Three black and white photos show a young smiling woman who appears South Asian. Under her photo is a sign that says 'never again.' A young woman walks past the street art." src="https://images.theconversation.com/files/473432/original/file-20220711-18-b0yevu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/473432/original/file-20220711-18-b0yevu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=334&fit=crop&dpr=1 600w, https://images.theconversation.com/files/473432/original/file-20220711-18-b0yevu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=334&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/473432/original/file-20220711-18-b0yevu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=334&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/473432/original/file-20220711-18-b0yevu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=420&fit=crop&dpr=1 754w, https://images.theconversation.com/files/473432/original/file-20220711-18-b0yevu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=420&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/473432/original/file-20220711-18-b0yevu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=420&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">A woman walks past posters showing Savita Halappanavar, a woman who died in Ireland in 2012 after doctors did not intervene and end her unviable pregnancy, resulting in a fatal infection.</span>
<span class="attribution"><a class="source" href="https://media.gettyimages.com/photos/young-woman-walks-past-art-work-featuring-savita-halappanavar-which-picture-id962636306?s=2048x2048">Charles McQuillan/Getty Images</a></span>
</figcaption>
</figure>
<h2>More liberal laws in Nepal and Ireland</h2>
<p>In Nepal, abortion rights activists secured parliament’s approval for a new abortion law in 2002 after highlighting the country’s high rates of <a href="https://reproductive-health-journal.biomedcentral.com/track/pdf/10.1186/1742-4755-9-7.pdf">maternal mortality</a> resulting from unsafe abortions. </p>
<p>Updated in 2018, <a href="https://apps.who.int/iris/bitstream/handle/10665/338768/factsheet-nepal-eng.pdf?sequence=9&isAllowed=y">Nepal’s law</a> now permits abortion before 12 weeks of pregnancy, and, in the cases of rape, incest, fetal abnormality or risk to a woman’s life or health, any time before 28 weeks. </p>
<p>In <a href="https://theconversation.com/abortion-the-story-of-suffering-and-death-behind-irelands-ban-and-subsequent-legalization-182812">Ireland</a>, activists worked for decades to overcome opposition to abortion from powerful forces within the Catholic Church. Using strategic messaging to destigmatize abortion and draw attention to Ireland’s isolated status among other European countries, activists <a href="https://www.hhrjournal.org/2019/12/from-the-grassroots-to-the-oireachtas-abortion-law-reform-in-the-republic-of-ireland/">gradually influenced</a> public opinion. </p>
<p>In 2018, <a href="https://www.bbc.com/news/world-europe-44256152">a national referendum</a> decisively repealed the long-standing constitutional abortion ban. The new law permits abortion up until 12 weeks of pregnancy. If there is a risk to the life or health of the pregnant woman, however, abortion is allowed up until <a href="https://www.economist.com/the-economist-explains/2022/05/23/why-does-america-allow-abortions-until-fetal-viability">when a fetus could survive</a> outside the womb. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/473428/original/file-20220711-16-3vesvk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A row of women dressed like characters from the handmaids tale - wearing red robes and white hats - march in a line on a dark night." src="https://images.theconversation.com/files/473428/original/file-20220711-16-3vesvk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/473428/original/file-20220711-16-3vesvk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/473428/original/file-20220711-16-3vesvk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/473428/original/file-20220711-16-3vesvk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/473428/original/file-20220711-16-3vesvk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/473428/original/file-20220711-16-3vesvk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/473428/original/file-20220711-16-3vesvk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Pro-abortion rights activists protest the Dobbs v. Jackson Women’s Health Organization decision in Buenos Aires on June 30, 2022.</span>
<span class="attribution"><a class="source" href="https://media.gettyimages.com/photos/prochoice-activists-disguised-as-characters-from-canadian-author-picture-id1241635310?s=2048x2048">Juan Mabromata/AFP via Getty Images</a></span>
</figcaption>
</figure>
<h2>Shaky ground</h2>
<p>Argentina also changed its <a href="https://www.bbc.com/news/world-latin-america-55475036">abortion policies</a> in 2020, repealing a law that allowed abortion only in cases of rape or when there was a serious risk to the health of the pregnant woman.</p>
<p>Now, people can get abortions up until 14 weeks of pregnancy. In this <a href="https://www.americamagazine.org/faith/2020/03/09/argentinas-catholic-numbers-sharp-decline-following-latin-american-trend">predominantly Catholic </a> country, people’s opposition to the law because of religious reasons has slowed implementation of this change in rural areas. Yet Argentina has also spurred a wave of expanded abortion rights in Latin America – called the “<a href="https://www.aljazeera.com/opinions/2022/6/29/latin-america-can-now-lead-the-way-on-abortion-rights">green wave</a>” because of the green scarves worn by abortion activists in the region. </p>
<p>In May 2022, for example, Colombia’s top court <a href="https://www.npr.org/sections/goatsandsoda/2022/05/10/1097570784/colombia-legalized-abortions-for-the-first-24-weeks-of-pregnancy-a-backlash-ensu">upheld</a> the right to get an abortion up until 24 weeks, adopting a standard like that in the <a href="https://www.government.nl/topics/abortion">Netherlands</a> and <a href="https://www.cbc.ca/news/canada-abortion-law-1.6503899">Canada</a>. </p>
<p><a href="https://time.com/6174249/ireland-abortion-rights-roe-v-wade/">Some observers speculate</a> that Roe’s reversal could give new energy to anti-abortion factions seeking to turn back the recent gains made through more liberal abortion laws in other countries. </p>
<h2>Other countries aren’t likely to follow the US’ lead</h2>
<p>But given the extensive coalition building by citizens groups that led to changes in places like Argentina, Nepal and Ireland, rescinding abortion rights will not be easy. </p>
<p>It would be misguided to attribute too much influence to U.S. developments and assume that countries would roll back abortion rights because of the Dobbs decision. </p>
<p>There was a time in the late 20th century when U.S. constitutional opinions were influential globally, but that is <a href="https://www.nyulawreview.org/issues/volume-87-number-3/the-declining-influence-of-the-united-states-constitution/">no longer the case</a>. One reason is that other countries’ democracies matured and their courts built up their own legal record, giving them less impetus to look to U.S. decisions. </p>
<p>And any vestiges of outsize U.S. influence ended during the Donald Trump presidency, when the U.S. systematically dropped out of <a href="https://apnews.com/article/united-nations-north-america-ap-top-news-international-news-politics-9c5b1005f064474f9a0825ab84a16e91">international groups</a> such as the United Nations Human Rights Council. </p>
<p>The U.S. has also long stood as an outlier on women’s rights in the international context. </p>
<p>For example, more women die in the U.S. during or <a href="https://www.wilsoncenter.org/event/what-explains-the-united-states-dismal-maternal-mortality-rates">shortly after pregnancy</a> than in any other rich country. The U.S. is also one of the few countries that does not have <a href="https://www.americanprogress.org/article/quick-facts-paid-family-medical-leave/#:%7E:text=Workers%20and%20their%20families%20lose,difficulty%20in%20making%20ends%20meet.">paid family and medical leave</a>.</p>
<p>The overturning of Roe and federally protected abortion rights after nearly 50 years is certainly a cautionary sign for abortion rights supporters worldwide. But given the strength of the global women’s movement and the robust defense of abortion rights in most countries, Dobbs’ relevance may prove isolated to the U.S. It’s not likely a signal that the worldwide trend of expanding abortion rights is reversing.</p><img src="https://counter.theconversation.com/content/186181/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Martha Davis does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Only 24 countries today totally ban abortion. The Dobbs v. Jackson Women’s Health Organization decision in the US is unlikely to lead other countries to join that list.Martha Davis, Professor of law, Northeastern UniversityLicensed as Creative Commons – attribution, no derivatives.