Unveiling the Ripple Effect: Navigating a World Transformed by the Reversal of Roe v. Wade
Roma Bhavsar
February 2024
Inequality
On June 24, 2022 Americans were left stunned and fearful as unexpected events unfolded. The Dobbs v. Jackson decision overturned Roe v. Wade, the Supreme Court decision that safeguarded a woman’s ability to choose to have an abortion or continue a pregnancy.[1,2] Consequently, the constitutional right to abortion was eliminated in the United States and this opened the door for states to enact legislation restricting or prohibiting access.[1] Roughly 50% of states have adopted some type of restriction and therefore limited access to proper healthcare for millions of women.[3] It has been almost two years since the reversal of Roe v. Wade, and American women are still reeling from the consequences of that dire decision and injustice. Without protective abortion laws, women are denied fundamental control over their own reproductive choices, potentially forcing them into unsafe and life-altering circumstances.
Surging Mental Health Burden, Financial Implications, Mortality, and More
Roughly 20% of pregnant women seek abortions in the United States every year. Limiting abortion access will force more women to carry pregnancies they do not want, causing them to potentially resort to unsafe procedures performed by untrained individuals in subpar conditions. The abortion ban heightens the risks associated with both pregnancies and abortions, making women’s outcomes worse and exacerbating existing inequalities.[3] There is plenty of evidence indicating that abortion restrictions disproportionately affect individuals who are already marginalized and oppressed including people of color, immigrants, and people with low incomes.[2]
There is a growing concern that the rate of maternal mortality will increase in the absence of legal abortion options. According to the World Health Organization, worldwide illegal abortions have a fatality rate of 350 times that of legal abortions. In the United States, the numbers suggest that having a legal abortion is no riskier than undergoing other minor surgeries. These findings strongly highlight the safety of legal abortion when compared to the potential risks of pregnancy. Surprisingly, pregnancy is associated with a maternal mortality rate 14 times higher than that of abortion.[4]
Furthermore, the psychological burden of being forced to carry a pregnancy to term can be traumatizing and daunting for both pregnant women and their families. This will exacerbate the existing mental health crisis which is already bursting at the seams. Studies have shown that unwanted pregnancies are linked to negative mental health outcomes such as perinatal depression, decreased self-esteem, and heightened anxiety.[3]
Financial distress and socioeconomic well-being are more obstacles for unwanted pregnancies.[3,5] While women have the option to travel to states where abortion is permitted, it comes at a significant cost. The cost of travel, hotel stay, time off from work, childcare, and the cost of the mediation or procedure required all add up, which makes getting an abortion impossible, unaffordable, and inaccessible for many women.[5] Women denied abortions suffer worse social, health, and financial outcomes. Data from a study in the United States found that 51% of women seeking abortion lived below the poverty line, had lower credit scores, and had more debt.[3]
At its core, having the freedom to choose abortion is a crucial part of medical care, involving open discussions between patients and their doctors. However, interference from lawmakers threatens this essential process. With the challenges posed by overturning Roe v. Wade, medical and nursing education is imperative for learners and educators to join forces to improve and enforce abortion education and the management of pregnancy complications in medical schools. Without this, there can be serious implications on the standard of care and skills needed to manage pregnant patients, particularly in states with abortion bans where healthcare resources are already very limited. Consequently, this may worsen existing disparities as some medical students may choose not to pursue clinical training or practice in states with strict abortion laws, opting for a more comprehensive education. To protect their own and their patients’ reproductive health, students might work in states where abortion is still accessible, adding to healthcare inequalities. Ultimately, this could lead to more shortages of doctors, a drop in school enrollment in states with abortion bans, and a decrease in the long-term quality of reproductive healthcare with adverse consequences for women’s health.[2,6] This is simply unacceptable.
My Body. My Choice.
No one should be forced to carry an unwanted pregnancy to term. Now more than ever, women feel trapped in a metaphorical prison when they are denied basic rights about what they can and cannot do with their bodies. This denial infringes on autonomy and control over their own lives. In order to regain some of that control back, it is our civil duty to make sure all women have access to basic healthcare information and know what their options are to get the proper care they need.
Promoting awareness through advocacy is crucial for disseminating evidence-based information regarding the negative consequences of denying abortion. The data clearly shows that women and families live better with access to safe abortion care.[3] To learn more about access to accurate, up-to-date general information on abortions, birth control, and out-of-state clinic options, please see the three links below.
After almost two years since Roe v. Wade fell, and with more restrictions likely to follow, the true extent of its impact remains uncertain and quite scary. The turmoil surrounding this issue is not just a concern for women today, but also an unsettling thought about the legacy we are leaving for the generations ahead.
References
[1] Lazzarini, Z. (2022). The End of Roe v. Wade — States’ Power over Health and Well Being. New England Journal of Medicine, 387(5). https://doi.org/10.1056/nejmp2206055.
[2] Berg, J. A., & Woods, N. F. (2023). Overturning Roe v. Wade: Consequences for Midlife Women’s Health and well-being. Women’s Midlife Health, 9(1). https://doi.org/10.1186/s40695-022-00085-8.
[3] Londoño Tobón, A., et al. (2023). The end of Roe v. Wade: implications for Women’s mental health and care. Frontiers in Psychiatry, 14. https://doi.org/10.3389/fpsyt.2023.1087045.
[4] Ginsberg, N. A., & Shulman, L. P. (2021). Life without Roe v Wade. Contraception and Reproductive Medicine, 6(1). https://doi.org/10.1186/s40834-021-00149-6.
[5] Kitchener, C., Roubein, R., Tran, A. B., Gilbert, C., & Dormido, H. (n.d.). A fragile new phase of abortion in America. Washington Post.
https://www.washingtonpost.com/politics/interactive/2023/roe-v-wade-ruling-one-year anniversary/.
[6] Traub, A. M., Mermin-Bunnell, K., Pareek, P., Williams, S., Connell, N. B., Kawwass, J. F., & Cwiak, C. (2022). The implications of overturning Roe v. Wade on medical education and future physicians. The Lancet Regional Health – Americas, 14, 100334. https://doi.org/10.1016/j.lana.2022.100334.
