Pushing Back Abortion Laws Pushes Us Back to the '70s

The U.S. is not alone in restricting access to abortion; many other countries have far more restrictive and even punitive legislations. But 41 years on, we are still grappling with providing access to an essential reproductive health service. And that feels so 1970s.
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Speaker of the House John Boehner, R-Ohio, meets with reporters on the morning after President Barack Obama's State of the Union speech, at the Capitol in Washington, Wednesday, Jan. 21, 2015. Boehner announced that he has asked Israeli Prime Minister Benjamin Netanyahu to address Congress on dealing with terrorism, but did not consult the White House on the invitation. (AP Photo/J. Scott Applewhite)
Speaker of the House John Boehner, R-Ohio, meets with reporters on the morning after President Barack Obama's State of the Union speech, at the Capitol in Washington, Wednesday, Jan. 21, 2015. Boehner announced that he has asked Israeli Prime Minister Benjamin Netanyahu to address Congress on dealing with terrorism, but did not consult the White House on the invitation. (AP Photo/J. Scott Applewhite)

A lot has changed since 1973. Forty-one years ago, Martin Cooper made the first telephone call on a portable handset, beginning the march to cell phone technology that would free us from decades spent connected to avocado-colored wall phones. In 1973, we played Magnavox Odyssey, the first home video game. Back then we were excited to watch a small ball ping across the screen: Now, we explore virtual worlds with strangers from across the globe from the comfort of our own home. Forty-one years ago families crowded around small televisions to watch All in the Family; now we can stream reruns on our 60-inch screens. We can even fast forward through commercials or pause for a bathroom break. Who'd have thought that? 1973 was also the year the Supreme Court voted on Roe v. Wade, effectively preventing federal or state bans on abortion. Forty-one years on we are still debating the legality of abortion. Who'd have thought that?

In 2013, 22 states passed 70 anti-abortion measures, including bans on late-term abortions, increasing doctor and clinic regulations and bans on insurance coverage for abortion. This week witnessed another flurry of legislation. A bill that would prohibit using federal money to pay for "any abortion" or for "health benefits coverage that includes coverage of abortion" was approved Thursday by the House. Introduced by Rep. Christopher Smith (R-N.J), and speaker John Boehner among others, the No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2015 bill passed by a vote of 242-179. With an almost certain White House veto looming, the legislation has little chance of becoming law. However, the passing comes only a day after House Republicans opted to shelve a bill that would have banned abortion at 20 weeks post-conception.

The Pain-Capable Unborn Child Protection Act (also known as HR36), passed by Arizona in 2013 and then shortly after struck down by the 9th U.S. Circuit Court of Appeals, floundered after a lack of support from female GOP lawmakers. HR36 was also heavily opposed by Democrats and women's and reproductive rights groups. However, fights to tighten abortion restrictions are not going away. Ten states already ban abortions after 20 weeks, two others are actively defending such laws in court, and although shelved for now, HR36 will continue to linger and shape the discourse around abortion rights and has strong potential for resurrection post-2016 elections.

Since 1973 there have been significant gains in several important areas of women's rights. Declines in the gender gap in salaries, legislation around sexual harassment in the work place, The Violence Against Women Act, and the lifting of the ban on women serving in combat roles are examples of significant strides towards gender equity. I am not saying we have achieved gender equity -- far from it, there still remain significant gender gaps in employment and income for example -- but we have made progress. Except, that is, when it comes to abortion.

True, abortion is more available than when Roe v. Wade passed in 1973. But access is quickly being eroded. Mississippi and Texas are examples of states where legislation has successfully closed clinics that could provide safe abortion services. Over the course of the 20th century the decline in childbirth-related deaths in the United States has been dramatic, with a drop of nearly 99 percent. However, the rate of decline has stagnated, and there is recent evidence that the U.S. has the unfortunate distinction of being one of a handful of countries that has seen an increase in maternal deaths. And the risks have risen most acutely for black women. Between 2006 and 2010, the death rate among black women in the U.S. was more than three times that of white women. Access to abortion care is not the only answer -- there are gains that also need to be made in providing quality obstetric care -- but it is clearly a part of the answer.

Sedgh and colleagues, in their review of global abortion trends between 1995 and 2008 published in The Lancet, show that globally approximately one in five pregnancies ended in abortion in 2008, and that restrictive abortion laws are not associated with lower abortion rates. This highlights a very important point. Restricting access to abortions does not prevent abortions, it merely shifts safe abortions provided by trained health care professionals in clinic settings to unsafe abortions often conducted by less trained individuals outside of clinical settings, increasing the risk of serious health threats to women. The Guttmacher Institute shows that globally each year 47,000 women die as a result of unsafe abortion, accounting for 13 percent of all maternal deaths worldwide. By eroding access to abortion, the U.S. risks undoing some of the progress made in maternal health. Our nation's health, as well our as progress towards gender equity, it literally retreating.

Sedgh and colleagues also show that the abortion rate is lower where more women live under liberal abortion laws. If we ensure equal access to safe abortions in the context of a program of quality reproductive health services, every woman will not suddenly want one. But they will have a choice. The U.S. is not alone in restricting access to abortion; many other countries have far more restrictive and even punitive legislations. But 41 years on, we are still grappling with providing access to an essential reproductive health service. And that feels so 1970s.

The views expressed in this article do not reflect those of the University of Michigan.

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