What's Next? 7 Ways the Roe v. Wade Reversal Will Impact Health in America
The Supreme Court repeal of the constitutional right to abortion does more than make it harder for people who don’t want to give birth and those whose own health is at risk if they don’t end their pregnancies. Decades of studies reveal that abortion restrictions harm women’s health in many ways (and often their children’s health too). In fact, abortion is considered by the American College of Obstetrics and Gynecology to be “an essential component of women’s healthcare,” according to its statement.
Contrary to what you might have heard, abortion is a safe, low-risk procedure, says Ned Calonge, M.D., M.P.H., an associate professor of family medicine at the University of Colorado School of Medicine who spearheaded a comprehensive report by the National Academies of Sciences, Engineering and Medicine several years ago evaluating research on abortion care.
Some abortion critics have tried to link the procedure to negative health outcomes, but the evidence doesn’t support that, he says. Instead, it is the restriction of abortion access that causes challenges to the health of a woman — and that of her baby, if she is forced to continue her pregnancy.
Here are some of the repercussions of more limited access to abortion.
Restrictive laws lead to more disability and death
Abortion is not riskier than having a baby, according to extensive research. In fact, delivering a child is 14 times as deadly, researchers have found. Thankfully, both numbers are low, but there are 8.8 deaths per 100,000 live births for pregnant women (with women of color faring worst), while induced abortions cause just 0.6.
Pregnant people are also harmed by pregnancy-related hypertension, gestational diabetes, infections from cesarean section, and other pregnancy complications, Dr. Calonge says. And in some cases, such as when a woman has an ectopic pregnancy (one growing in her fallopian tube), having an abortion will save her life.
Even prior to the Roe v. Wade reversal, restrictions that curtailed the procedure with no exceptions unless the woman’s life was imminently endangered were keeping women from getting this lifesaving care. When researchers surveyed 25 clinicians across Texas after September 2021, when the state prohibited abortions after roughly six weeks of pregnancy, they found that doctors were delaying abortion even when a woman’s health was at risk until it became a medical emergency, often at the risk of her life.
Infant mortality rates rise
Take away women’s access to abortion and more babies die before their first birthdays, says research published in 2020 in the International Journal of Environmental Research and Public Health. The researchers compared government birth and death stats with the abortion laws in each state and found that infants in states with the most restrictive laws were less likely to survive than infants in those with fewer laws.
“Any barrier to having a clean, safe medical procedure presents risks not only to the mother, but also to the infant,” explains Peter Muennig, M.D., a professor of health policy and management at Columbia University and a coauthor of the study.
One reason: Women with lower incomes are less likely to access abortion if they live in a state with significant restrictions, and their babies typically have poor nutrition and worse medical care, he says. What’s more, the psychological stress these mothers are under can be passed to their babies in the uterus, causing them to have physical problems after they’re born.
A lot more stress and anxiety — and anger
In its comprehensive report, the National Academies examined many studies to ferret out whether abortion led to women’s having more mental health problems down the road, as anti-abortion groups sometimes claim. They found categorically that it did not. Not only is there no increased risk of anxiety, depression, or post-traumatic stress disorder (PTSD) from having an abortion, but women who are denied an abortion they want are actually the ones at risk of developing anxiety.
Do women have regrets after an abortion? Not nearly as much as they feel regret — or anger — when they are turned away for one, researchers from the University of California, San Francisco found when they queried women who had obtained an abortion near the limits of the law and others who had been unable to get one because the deadline had passed. While many in both groups felt a range of emotions, the vast majority who’d gotten an abortion said it had been the right decision.
Now that some states are limiting abortions to a few weeks after conception, a time when many women don’t even know they’re pregnant yet, that anxiety is only rising, Texas abortion providers who have seen this firsthand reported at a recent health journalism conference in Austin.
Sick preemies — and worse
The Texas clinicians surveyed after the restrictive law went into effect also told researchers that women were being forced to carry fetuses that had been diagnosed with fatal conditions such as having the neural tube defect anencephaly (babies with it are born without parts of their brains and live just a few hours or days) or missing both kidneys. Doctors in states with such laws also can’t reduce the number of fetuses in a pregnancy when there are too many, even when this can result in a woman’s losing them all.
Babies born to women of color are most affected by abortion restrictions. Black women in states with such laws, for example, are more likely than white women to give birth to preemies, one study discovered. The researchers concluded that these policies compound existing racial, ethnic and socioeconomic inequities in ways that harm babies.
Increased family poverty
The economic ripple effects from being denied an abortion can continue for years. When they followed up four years later, University of California researchers found that these women were more likely to live in poverty.
The same researchers also discovered that younger women who are forced to carry a child they don’t want (and likely can’t afford) are less able to go on to get a college degree. This lowers their lifetime income, something that often leads to worse health over the years and can even mean a shorter life.
More domestic violence
Women who seek abortions are less likely to have power in society, including those in poverty and who are part of sexual- and gender-identity minorities. If forced to continue an unwanted pregnancy, they are more likely to experience interpersonal violence, researchers say. “Psychological science suggests that the inability to obtain an abortion increases the risk for domestic abuse among those who are forced to stay in contact with violent partners,” Frank C. Worrell, Ph.D., the president of the American Psychological Association, said in a statement following the Supreme Court verdict.
Other health effects that aren’t yet known
American women have had legal access to abortion for more than 50 years (though some states have made it tough to exercise the right to choose), so what severe restrictions or outright bans in a large number of states will do to women’s mental and physical health can be known only over the course of time. Experts speculate that particular harm will come to women and girls who are the victims of incest or rape and are then forced to bear a child as a result.
What is clear is that more women will resort to unsafe abortions when safer options are unavailable to them, Dr. Worrell stated. This will lead to more women’s being injured and dying, all because a safe medical procedure — abortion as it has long been performed, in a sterile clinic or doctor’s office — will be much harder for many to come by.
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