Personal freedom is an essential right in the United States for which its residents have fought since the country’s founding. While the execution of this right might not always have been considered a success, most would agree that we have made progress. The recent ruling by the Supreme Court to overturn Roe vs. Wade, however, seems a perilous move away from the personal freedom that women have achieved to date.

As a ruling of the Supreme Court of the United States, the lack of right to abortion has become the law of the land, with states able to forge their own legislation. Thirteen states have enacted “trigger laws,” and another eight are expected to severely restrict or outright ban abortion in short order. On the whole, these are states with limited access to maternal and infant health care, wide gender pay gaps, child welfare systems with unacceptable records of abuse and neglect, and with no provision for family leave or subsidized child care. To label anti-abortion laws as pro-life is deeply flawed.

The Supreme Court decision has left women across the United States in shock and frightened. What does it mean if women cannot be trusted to make their own decisions about their bodies, their health, and their destinies? Social workers and nurses are acutely aware that safe and affordable access to health care for all is essential to the formation of a just society. Reversing 50 years of precedent on abortion denies women access to safe reproductive health care, which is essential not only to their general health, but to the health of the nation, and sends a clear message of inequality from the highest court. This decision will disproportionately affect BIPOC women and individuals, children and families of lower-socioeconomic status.

It is worth noting that the legalization of abortion in our country did not begin with Roe vs. Wade. At our nation’s founding, abortion was a legal practice. Laws restricting abortion did not begin until the mid-1800s, and by the mid-20th century it had become a felony in most states.

I began my career 43 years ago working in OB/GYN and neonatal medicine. My scholarship revolves around women’s health, especially how the social environment gets “under the skin” to affect biology and health. I led one of the U.S. Public Health Service’s Maternal and Child Health Training Program sites. By virtue of these experiences, I have seen firsthand the impact that an unwanted pregnancy can have on a woman and her child. I also have seen the effects of poorly done illegal abortions.  The effect of laws and policies that limit a woman’s reproductive choice and thus her access to quality health care do not stop at the birth of an unplanned pregnancy. It ripples to families, communities, and society as a whole.

According to the work of M. Antonia Biggs, Ushma D. Upadhyay, Diana G. Foster, and Charles E. McCulloch that was published in 2017 in JAMA Psychiatry (“Women’s mental health and well-being 5 years after receiving or being denied an abortion”) JAMA Psychiatry (2017), being denied an abortion may be more detrimental to a women’s mental health than having one. Using data collected during the Turnaway Study, a prospective longitudinal study by the Bixby Center for Global Reproductive Health at the University of California San Francisco, Biggs’ study suggests that women who are denied an abortion suffer more adverse psychological outcomes, including anxiety, low self-esteem, low life satisfaction, and depression than those who are not denied. They also found no evidence to justify laws that require women seeking an abortion to receive counseling or warnings that abortion harms a women’s mental health.¹

While it is argued that women can simply carry a pregnancy to term and put the child up for adoption, I have yet to see those making this argument offer to raise a child born in this manner. And we know that there are not enough adoptive homes for the children currently in the system. Our child welfare system is already challenged to serve children and youth in most states. If we are to provide adequate care for children, will state and federal lawmakers spend time and expend resources to prepare for the influx of tens of thousands of additional children who will need care each year that this legislation will garner?

While imperfect, Roe vs. Wade had a significant, positive impact on the health and well-being of American women, in particular the lives of young women. Economist Caitlin Knowles Myers notes in her study published in 2017 in the Journal of Political Economy (“The power of abortion policy: reexamining the effects of young women’s access to reproductive control”) Journal of Political Economy (2017), that the legalization of abortion reduced teen motherhood by 34% and teen marriage by 20%.2

Restricting access to abortion will not stop the termination of unwanted pregnancies. It will simply force women to seek alternative options that often put them at risk and are unsafe. Although social work allows a diversity of views, certain facts are incontrovertible. I deeply respect the views of those in our community who struggle with personal values and professional principles. It is the time to use our voices and the knowledge that has been accrued by social scientists and nursing scholars to disrupt the status quo and let our elected officials know that we do not accept this ruling.

 

¹Biggs, M. A., Upadhyay, U. D., McCulloch, C. E., & Foster, D. G. (2017). Women’s mental health and well-being 5 years after receiving or being denied an abortion: A prospective, longitudinal cohort study. JAMA Psychiatry, 74(2), 169-178. https://doi.org/10.1001/jamapsychiatry.2016.3478

²Myers, C. K. (2017). The power of abortion policy: Reexamining the effects of young women’s access to reproductive control. Journal of Political Economy, 125(6), 2178-2224. https://doi.org/10.1086/694293