A new vision
Ensure access to care of choice
Arkansas women seeking abortions and pregnancy-related services continue to face an uncertain future in light of mounting regulations and persistent disparities. After breathing a sigh of relief following a federal judge’s decision to block enforcement of Arkansas’ abortion-pill ban, the legal challenge took another turn as Attorney General Leslie Rutledge appealed the federal judge’s order last week.
And now, with President Trump’s nomination of Judge Brett Kavanaugh to replace Justice Anthony Kennedy on the Supreme Court, the fate of reproductive health access and abortion care is even more critical.
Now more than ever, we need a new vision for abortion care where women can decide on the type of care that will best meet their needs and situation, including safe and effective medication abortion. This need is especially pressing in Arkansas, where abortion services are severely limited and may be banned altogether. Earlier this week, a federal judge ruled that Arkansas’ medication abortion ban “will operate as a substantial obstacle to a woman’s choice to undergo an abortion.”
The Arkansas law threatens constitutional freedoms and intrudes on women’s private medical-care decisions. As the legal challenge to the abortion-pill ban proceeds, increased abortion restrictions continue to reflect the lived experiences of women in Arkansas and across the nation where anti-abortion politicians are standing in the way of safe, effective, affordable methods of abortion care. Politicians have passed more than 400 state laws against abortion since 2011 that make abortion unaffordable and shut down clinics. Many of these restrictions limit the use of abortion pills, imposing barriers that are medically unjustified and even harmful.
As a result of abortion restrictions, some women must drive hundreds of miles or even out of state to get the care they need. This could mean increased expenses for lost work, travel and child care, while experiencing longer wait times affecting the quality of their care. Others can’t afford the cost of an unexpected medical procedure that many insurance policies don’t cover.
Restrictions on abortion care fall hardest on low-income people, women of color and communities experiencing financial and logistical barriers to care. Barriers to reproductive health services exacerbate severe reproductive health disparities among women of color, as reflected in Arkansas: Black women are four times more likely to die from pregnancy-related causes than are white women.
A recent community panel explored the question of how women of color in Arkansas navigate pregnancy-related care when the odds are stacked against them. I had the privilege of moderating the discussion among a physician and anti-poverty organizer, a public health professional and expert in maternal health disparities, and an award-winning doula who works with women during and after pregnancy. The conversation explored real-life experiences and implications of infant and maternal mortality in Arkansas.
Panelists shared that health-care providers working with pregnant women are seeing stark differences between black patients and their other patients. They emphasized the connection between race and poverty as forces harming pregnant women of color in Arkansas and the need to acknowledge the roots of racial health disparities.
One of the remarkable outcomes of the continuing discussions about maternal and infant health disparities has been uniting abortion activists, black doulas and public health professionals around the need to increase access to reproductive and pregnancy-related care for underserved communities.
When someone decides to end a pregnancy, she should be able to determine the type of care that will best meet her needs and situation. This includes expanding options for safe, effective abortion care. Medication abortion is an FDA-approved method to end a pregnancy. After more than 15 years of use in the U.S., we know it is extremely safe and effective, as documented in the 2018 report “The Safety and Quality of Abortion Care in the United States.”
Research on medication abortion points to opportunities for improving access, including options like self-managing an abortion at home or through telemedicine. Self-managed abortion methods like the abortion pill are safe and effective when taken according to directions. When people have accurate information about what to expect and a way to get their questions answered, they can use the abortion pill safely and effectively on their own.
Women’s health is a priority that must be addressed with urgency, both in Arkansas and among underserved communities across the country. At a time when abortion access is becoming increasingly out of reach due to anti-abortion restrictions and the longterm implications of racial disparities in health care, medication abortion offers a new vision for abortion care. Now is the time to challenge inequities and ensure accurate information and reliable support are available to everyone who seeks to end a pregnancy with dignity and on their terms.