I used to think of Roe v Wade as the turning point in the struggle for women's rights and health. By recognizing reproductive rights as constitutional rights, the 1973 Supreme Court decision promised women in the United States would never return to the days of back-alley health care. And we haven't -- not yet anyway. Four decades later, abortion is safe and legal in this country. Medical schools routinely offer training in abortion care to gynecology residents, and nearly a third of all women terminate a pregnancy by the age of 45.
Sadly, what seemed a turning point is starting to look like a mere detour. Roe is still technically the law of the land. But nearly four decades later, low-income women still struggle for affordable care. And new restrictions are taking hold at a dizzying pace. Having failed to reverse the Supreme Court decision, anti-choice ideologues are managing -- through intimidation, harassment, and cynical legislative maneuvers -- to strip it of meaning for many women in America. As the Guttmacher Institute reported this July, 19 states enacted 80 new abortion restrictions during the first six months of 2011 alone. That's more than three times the number of state restrictions enacted in 2010.
If you doubt we're losing ground, just glance at a map of the country. Some 87 percent of U.S. counties, including 97 percent of rural ones, now lack even a single abortion provider -- and the situation is worsening. Last week, researchers at the University of Chicago reported that only 14 percent of obstetrician/gynecologists-- the lowest proportion in decades -- now provide abortion care, even though 97 percent of them encounter patients who request it. Within days of that report, two more states proposed or inflicted onerous new restrictions.
What is driving these trends? Has America changed its mind about abortion? Not at all. Recent polls show that a solid and growing majority believes the procedure should be legal in most or all cases. And the University of Chicago survey found that newly trained physicians were more likely than older ones to provide abortion care -- not what you'd expect if anti-choice sentiment were sweeping the profession. In fact, intimidation may be the real reason so few physicians now provide abortion care. As expected, the survey found that rural providers were less abortion-friendly than those in urban areas. But rural doctors were less likely to provide abortion care even if they had no personal objection to the procedure --because they faced more opposition and harassment.
Rarely has harassment been so rampant. Anti-choice legislators have turned it into an art form since riding to power on unfulfilled promises to fix the economy last fall. Instead of creating the jobs they promised, politicians have worked tirelessly to take away health care from women. The tactics range from restricting insurance coverage to burying health centers that provide full reproductive health services in red tape. Last week, Virginia's department of health released draft rules that would likely require every women's health center in the state to make extensive structural modifications that have no proven medical benefit to patients and ultimately may drive up health care costs or drive health care providers out of practice - making comprehensive preventive reproductive health care much less accessible.
Meanwhile in Arizona, legislators effectively forced Planned Parenthood to eliminate abortion care at seven of 10 health centers -- by stripping nurse practitioners of their well-established authority to administer medication abortion. So although abortion is still technically legal in the 13 Arizona counties affected, women in those areas will now have to travel long distances to get the care they need. To compound this burdensome rule, Arizona now forces every patient seeking abortion care to sit through a partisan lecture after reaching a health center, then wait another 24 hours before actually receiving the care she needs.
The onslaught of new laws threatens more than our rights. It also threatens women's health, by forcing them to delay needed care while they navigate a bureaucratic and political gauntlet. Studies show that when abortion care is delayed in pregnancy, risk of complication increases. By requiring women to take time away from work, arrange child care, and travel hundreds of miles to hear lectures and sit out mandatory waiting periods, the new laws won't reduce the need for abortion. But they will surely push it later into many women's pregnancies. This is the cost of letting politicians impose their values on our health care. Women who once received safe, timely care will now experience needless delays and avoidable medical complications.
Can we stop this dangerous trend? Absolutely - if we mobilize and vote. Politicians need to know that women are watching and taking action. Planned Parenthood is working on all fronts to stop the assault on women's health and rights. We beat back unprecedented attacks in Congress earlier this year and are now fighting them in statehouses and courts all over the country. The bigger challenge is to remake the legislative bodies that are pulling us into the past. The bedrock of reproductive freedom is crumbling, but it's ours to restore. The place to start is the ballot box.
Cecile Richards is president of Planned Parenthood Federation of America and the Planned Parenthood Action Fund
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