The Middletown Press (Middletown, CT)
Overturning Roe v. Wade wouldn’t turn back clock to 1973
A wave of state abortion bans has set off speculation: What would happen if Roe v. Wade, the ruling establishing abortion rights nationwide, were overturned?
Although far from a certainty, even with increased conservative clout on the Supreme Court, a reversal of Roe would mean abortion policy would revert to the states, and many would be eager to impose bans.
What would not happen is a full-fledged turning back of the clock to 1973.
Women now have far more methods to avoid unwanted pregnancies, as well as safer, easier options for abortion. Many abortions are induced at home with a two-drug combination, and advocacy groups are spreading the word about home abortions using one of the drugs that can be done without a medical professional’s involvement.
“I don’t think you can put all those different genies back in the bottle,” said medical historian Andrea Tone at McGill University in Montreal. “Women are in charge of their procreative destiny. I don’t think women will put up with the absence of privacy and discretion that birth control and abortion provide.”
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At the time of Roe, abortion was broadly legal in four states, allowed under limited circumstances in 16 others, and outlawed under nearly all circumstances in the rest. A reversal of Roe would produce a patchwork map where perhaps 15 or so states would continue to make abortion easily accessible, a dozen or more would ban virtually all abortions unless the mother’s life is at stake, and the rest would thrash out their response in the public arena and the legislatures.
In 1974, a year after Roe, there were about 899,000 abortions in the U.S., according to the Guttmacher Institute, a research organization that supports abortion rights.
The number of abortions rose steadily, peaking at 1.61 million in 1990, before starting a steady decline — falling to 926,200 in Guttmacher’s latest national survey, covering 2014. Close to 90 percent of the abortions occur in the first 12 weeks of pregnancy.
The decline is attributed to increased availability of effective contraception and a sharp decrease in unintended pregnancies, notably among teens. In 1974, teens accounted for 32.5 percent of abortions in the U.S.; in 2014 that dropped to 12 percent.
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Technology and science have given women unprecedented options and control over fertility since 1973. Back then, single women had only recently gained nationwide access to birth control, thanks to a 1972 Supreme Court ruling, said Dr. Sarah Prager, who directs the University of Washington School of Medicine’s family planning fellowship.
“This is recent history,” Prager said. “Now we have these incredibly effective contraceptive methods available.”
A woman can get the morning-after pill without a prescription and keep some in her medicine cabinet for emergencies. Her smartphone sends birth control reminders. Or, if she prefers, a matchstick-size implant gives her no-hassle contraception for years at a time.
Surgical abortion has become safer, employing tools that use vacuum pressure rather than scraping. There’s increasing use of the medication alternative: Ending a pregnancy with mifepristone and misoprostol now accounts for about 30 percent of U.S. abortions.
“It’s safe and comfortable,” said Missouri resident Lexi Moore, 30, who ended a pregnancy in September with a prescription from Planned Parenthood. “You get to sit in the comfort of your home instead of doing it in a clinic or in a back alley. … You will have cramps, like a heavy period. But it’s worth it in the end, and you have control over that.”
Moore had to drive 70 miles to pick up her prescription and, lacking insurance, paid $800 out of pocket. But she welcomed the outcome, and wrote thank-you cards to the clinic.
Her experience contrasts with that of Vikki Wachtel, who as an 18-year-old attending school in Connecticut had an abortion in New York City’s Bellevue Hospital in October 1970. That was just a few months after New York became a pioneer in broadly legalizing abortion.
“The staff made us feel like we were about to commit a crime,” Wachtel said, recalling how she and other young women were treated callously.
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For women today, there’s even abortion by mail.
It’s still under study, but early results show women can manage their medical abortions safely at home. A doctor first confirms the woman’s pregnancy is less than 10 weeks, then mails the pills. About 300 U.S. women have ended pregnancies in the TelAbortion study .
“Women are really grateful not to have to travel three or four hours to a clinic,” said researcher Dr. Beverly Winikoff of Columbia University’s Mailman School of Public Health. “But there are also people within walking distance from a clinic who prefer to do it this way because it’s more private.”
Abortion-rights activists, at rallies supporting Roe v. Wade, often display images of coat hangers that were sometimes used in illegal abortions many decades ago.
However, warnings that large numbers of women would die from unsafe abortions if Roe were overturned don’t reflect the fact that abortionrelated deaths — which numbered as high as 2,700 in 1930 — fell to under 200 a year by the mid-1960s thanks to the development of antibiotics and other medical advances.
To the extent that women can get and use misoprostol to end pregnancies at home, women even in states with bans would have a relatively safe option. It’s available only by prescription in the U.S. but is available online from some countries where it is sold over the counter.