Written by Angel Joseph
Edited by Rayyan Bhuiyan
Imagine being told you weren’t capable of making decisions regarding your life, due to “rules” preventing you from going to the gym, eating what you please, and organizing your routine as you like it. Stripping away these decision-making rights takes away the individuality of a person, freedom to their possessions, and forces them to adhere to regulations they don’t agree with, right? Now apply this idea to the women living in the United States. Imagine being told you lost the rights to your own body, that the government will not prioritize your safety, and being forced to face the “consequences” of your actions behind bars serving multiple years in prison. This isn’t a conversation about the past and this isn’t a debate left up to politics; this is the reality of American women today. Let’s explore this further.
In 1973, a lawsuit reached the Supreme Court in which a woman named Jane Roe (a false name provided in court documents to protect her identity) filed a case against Henry Wade, the district attorney of Dallas County, Texas. At the time, the practice of abortion was illegal in Texas unless the mother’s life was on the verge of death, and it would only be legal to save the mother’s life. Roe’s practitioner told her that she couldn’t get an abortion because her life was not in danger, and so Roe went to court as the Texas policies on abortion were vague and didn’t grant her privacy to make decisions about her body (Cittadino, 2022). They were able to conclude and close the case with the effect of the Fourteenth Amendment. In its due process clause, the amendment “protects against state action the right to privacy, and a woman’s right to choose to have an abortion falls within that right to privacy” (Oyez, 1971).
From a bioethical perspective there are three principles that distinguish the practice of abortion as a human right: autonomy, beneficence, and justice. The idea of autonomy stresses people's right to make decisions regarding their own bodies. Many people believe that a woman's right to abortion stems from her rights to regulate her reproductive health and make decisions free of governmental or social intrusion. The aspects of beneficence place a significant emphasis on individual well-being and the avoidance of harm. Advocates for abortion access say that banning abortion causes harm by forcing women to carry undesired pregnancies, which can have significant social, economic, and psychological implications. These unwanted pregnancies can be the outcome of assault/abuse, unplanned conceptions, or medical complications that jeopardize the life and reproductive health of the mother.
According to a study that analyzed 813 pregnant participants, women who are denied abortions are more likely to encounter financial difficulties, remain in abusive relationships, and develop long-term health consequences. These are women who live 100% below the federal poverty line and 75% percent of these women did not meet any of the financial needs for transportation, food, living, etc. (Foster, 2022). In the context of abortion, the principle of justice raises concerns about inequality in access to reproductive healthcare, especially among underprivileged communities. Corresponding to research, abortion restrictions disproportionately impact low-income women and women of color, who may lack financial means or geographical access to safe abortion facilities. Amongst the women who are of reproductive age and are denied healthcare (such as Medicaid), two-thirds are women of color (Guttmacher, 2023). These disparities and inequities are simply a reflection of how the system excludes non-Whites and stereotypes them into categories and demographics based on the color of their skin.
Along with racial inequalities influencing abortion outcomes, there are great concerns the accessibility of abortion clinics in socioeconomically disadvantaged areas. Abortion availability is an essential component of women's reproductive rights and gender equality (Berg, 2023). Loretta Ross, a law scholar and activist who founded the Reproductive Justice framework, says that "the right to abortion is not just a medical issue, it's a human rights issue" (Ross, 2021). Abortion is frequently regarded as necessary for women to maintain control over their life, including economic and educational prospects, as well as their capacity to actively participate in society. Denying women the access to abortion might result in economic instability, which could lead to higher maternal mortality rates, a decline in women’s employment, decrease in childcare while there would be an increase in single-parent households. All to say, there is a domino-like-effect that plays into taking away a decision that should be made autonomously by the mother.
In terms of public health, maintaining access to safe and legal abortion services is critical to safeguarding women's health and well-being. Research repeatedly shows that stringent abortion regulations do not lower the number of abortions, but rather increase the number of risky, illegal operations. The World Health Organization (WHO) has said that restrictive abortion regulations increase maternal morbidity and death, particularly in countries with limited healthcare facilities; as per their research in 2023, there have been 23,000 women that die due to unsafe abortions (WHO, 2023). In the United States, persons in rural regions have been disproportionately affected by limited access to abortion, as travel to a clinic can be long and expensive, which ties back into why the accessibility and availability of abortion clinics are significant (Hundrup, 2023).
The landscape of abortion availability has shifted dramatically in recent years, notably following the Dobbs v. Jackson Women's Health Organization decision by the United States Supreme Court in June 2022. The ruling reversed Roe v. Wade, which guaranteed a constitutional right to abortion. Dobbs held that individual states had the authority to restrict abortion. This has resulted in a patchwork of state laws: some, such as New York, have extended abortion availability, while others, like Texas have imposed near-total prohibitions. The Dobbs ruling has important consequences for abortion access throughout the United States. Corresponding to some statistics released by the Guttmacher Institute (2023), in the year after the decision, more than 25 states imposed abortion restrictions or outright bans, resulting in a 96% decline in the number of legal abortions conducted in those states. Conversely, in places where abortion is still allowed, the number of out-of-state residents seeking care has increased by 28% after the overturning of Roe v. Wade in 2022, putting a burden on clinics and healthcare professionals (Guttmacher, 2023).
Abortion continues to be an important bioethical problem, having profound repercussions for human autonomy, public health, equality, and justice. Advances in medical technology, shifting societal norms, and altering legal frameworks will continue to have an impact on the ethical discussion around abortion. As abortion debates continue, it is critical to address not just the moral issues around the fetus and women's rights, but also the larger social, economic, and health implications of restricting access to legal and secure abortion practices.
References
Berg, Judith A., and Nancy Fugate Woods. “Overturning Roe v. Wade: Consequences for Midlife Women’s Health and Well-Being - Women’s Midlife Health.” BioMed Central, BioMed Central, 6 Jan. 2023, womensmidlifehealthjournal.biomedcentral.com/articles/10.1186/s40695-022-00085-8.
Cittadano, M., "Dobbs v. Jackson: The Overturning of Roe v. Wade and Its Implications on Substantive Due Process." Syracuse Law Review, 2022, https://lawreview.syr.edu/dobbs-v-jackson-the-overturning-of-roe-v-wade-and-its-implications-on-substantive-due-process/.
Foster, Diana G., et al. "Socioeconomic Outcomes of Women Who Receive and Women Who Are Denied Wanted Abortions in the United States." JAMA, vol. 324, no. 3, 2022, pp. 245-251. https://ajph.aphapublications.org/doi/10.2105/AJPH.2017.304247
Guttmacher Institute. "Inequity in U.S. Abortion Rights and Access After the End of Roe: Deepening Existing Divides." Guttmacher Institute, 2023, https://www.guttmacher.org/2023/01/inequity-us-abortion-rights-and-access-end-roe-deepening-existing-divides.
Office, U.S. Government Accountability. “Why Health Care Is Harder to Access in Rural America.” U.S. GAO, 29 Aug. 2024, www.gao.gov/blog/why-health-care-harder-access-rural-america.
Roe v. Wade, 410 U.S. 113. Oyez, 22 Jan. 2020, https://www.oyez.org/cases/1971/70-18.
Ross, Loretta. Reproductive Justice: An Introduction. University of California Press, 2021.
World Health Organization (WHO). "Safe Abortion: Technical and Policy Guidance for Health Systems." World Health Organization, 2023, https://iris.who.int/bitstream/handle/10665/173586/WHO_RHR_15.04_eng.pdf;sequence=1#:~:text=It%20provides%20information%20on%20how,adolescents%2C%20rape%20survivors%2C%20refugees%2C
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