If Roe falls, some fear fallout for reproductive care
If the Supreme Court follows through on overturning Roe v. Wade, abortion likely will be banned or greatly restricted in about half the U.S. states. But experts and advocates fear repercussions could reach even further, affecting care for women who miscarry, couples seeking fertility treatments and access to some forms of contraception.
Many conservatives insist they are only interested in curtailing abortion, and legislation passed so far often has exceptions for other reproductive care. But rumblings from some in the GOP have experts concerned, and laws banning abortion could also have unintended side effects.
“The rhetoric has been really increasing over the last several years,” said Mara Gandal-Powers, the director of birth control access at the National Women’s Law Center. “There’s definitely a domino effect which I think people are really starting to wake up to and see this is how far it could go.”
If Roe is overturned, as suggested by a leaked draft opinion, states will set their own abortion laws, and conservative lawmakers are already passing a steady stream of deeply restrictive regulations. Oklahoma lawmakers, for example, passed legislation Thursday banning abortion at conception, the strictest in the nation.
Although that bill has some exceptions, it signals a direction that is deeply worrisome for many doctors.
“I truly think the people writing these laws either have no concept of the broad implications or do not care about how this impacts so many aspects of women’s health care,” said Dr. Kristyn Brandi, a New Jersey OB-GYN who provides abortion care.
“In medicine, you are not considered pregnant until this fertilized egg is implanted into the uterus — which happens after fertilization,” Brandi said. She said it is unclear whether doctors performing infertility treatments would be in violation of the law if they dispose of extra fertilized eggs. The Oklahoma measure “is not based in science and is incredibly confusing and frustrating for medical professionals trying to provide evidence based care.”
The Roe decision was based on a constitutional right to privacy — and the decision leaned on another landmark case eight years earlier that gave married couples the right to birth control, Griswold v. Connecticut.
Reliable birth control is now a feature of life for millions of Americans, but in March U.S. Sen. Marsha Blackburn of Tennessee recorded a video message naming the Griswold decision as “constitutionally unsound.” She’s not proposing restrictions on birth control but hasn’t commented further to clarify what she meant.
Other conservatives have conflated emergency contraception, often known as the morning-after pill, with abortion. Along with longacting birth control devices called IUDs, emergency contraception has been been attacked by abortion foes who believe life begins when an egg is fertilized. Emergency contraceptive pills like Plan B and IUDs may also prevent a fertilized egg from implanting in the womb, but experts say the science on that isn’t clear.
Political attempts to block access to intrauterine devices and other birth control “would be consistent with the pattern that we’re seeing right now,” said Dr. Jennifer Kerns, an associate professor at the University of California, San Francisco who also provides abortion care. “Many of us are very concerned that that’s kind of the next up on the chopping block.”
Some states still have abortion bans on the books that date back to the 1800s. If Roe is overturned, those bans with vague definitions of abortion could snap back into effect.
The Supreme Court isn’t expected to issue its final ruling until June or July, but some states are already considering going beyond banning abortion.