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Abortion Protest March in Washington ;

Dobbs v. Jackson: A Year On

On the 24th June 2022, the US Supreme Court overturned the constitutional right to abortion established in Roe v. Wade fifty years ago, paving the way for harsher restrictions on abortion in many states. The criminalisation of abortion increases the prevalence of unsafe abortions, creating risks to pregnant people’s health as well as of prosecution. One year on, this post looks at the impact of abortion bans in the US and how activists have stepped in to help pregnant people access abortion care outside of the law.

In June 2022, in the case of Dobbs v. Jackson Women’s Health, the US Supreme Court overturned the constitutional protection for pre-viability abortion confirmed in Roe v. Wade (1973). This did not come as a shock; Justice Alito’s draft judgment had already been leaked some months before. The impact on access to abortion in the US has been significant. 13 states had ‘trigger laws’ in place to come into effect as soon as Roe was overturned. Some of these restrictions have left abortion almost entirely prohibited. In Texas, for example, abortion is illegal once foetal cardiac activity is detectable – limiting abortion beyond six weeks’ gestation. In the two months following the Dobbs decision, the estimated number of legal abortions across the US dropped by around 10,000. In 2022, 42 independent abortion clinics across the US were forced to close – including the Jackson’s Women’s Health Organization, the Mississippi clinic involved in the Dobbs case. As of April 2023, 7 more states have attempted to restrict access to abortion – though these laws have been temporarily blocked by the courts.

Feminist scholars have long connected the criminalisation of abortion to unsafe abortion along with maternal mortality and morbidity rates, while human rights bodies have recommended that governments decriminalise abortion for this reason. However, feminist networks worldwide have been instrumental in facilitating access to abortion pills and information on how to take them safely. Self-managed abortion is a term used to describe abortion using the pills misoprostol and mifepristone (or misoprostol taken alone) outside of medical and legal regulations. Abortion pills are safe and effective and are on the World Health Organisation’s model list of essential medicines. Misoprostol, a medication primarily developed to treat gastric ulcers, was first discovered to be an effective abortifacient by feminist networks in Brazil in the late 1980’s in the context of the near-total criminalisation of abortion. The use of these abortion pills outside of medico-legal regulation, when coupled with access to information, safe sources of medications, and follow-up care, is a safe method of abortion.

Even prior to Dobbs, abortion was inaccessible to many pregnant people in the US because of onerous ultrasound, mandatory counselling, and waiting period requirements and Targeted Regulation of Abortion Providers (TRAP) laws that led to clinic closures in many states. In this context, self-managed abortion had already become increasingly common across the US. Networks have expanded their efforts to help those left without legal access to abortion, by providing information on how to access abortion pills safely, and the National Network of Abortion Funds offers both advice on safe self-management as well as providing financial support for people to travel to states where abortion remains legal and accessible. The Colorado Doula Project’s Abortion Support Network is just one example of an organisation providing logistical and emotional support for people accessing abortions in a particular state – including those who travel from elsewhere.

Unsafe abortions will still take place, of course, but it is important to emphasise that unsafe abortion is not the only, or even primary, harm caused by the criminalisation of abortion. While public health has been a successful political strategy behind the legalisation of abortion, it has its limits. The emphasis must be on reproductive justice and autonomy – the harm of criminalisation is that people are forced to continue unwanted pregnancies, are prosecuted for self-management, have to travel away from home (and often for significant distances) to access necessary healthcare, and that it perpetuates the shame, secrecy, and stigma surrounding abortion. Furthermore, poor and Black women are disproportionately affected by barriers to abortion access and are more likely to be targeted by criminal abortion laws.

The prevalence of self-managed abortion will only increase in the US as more states attempt to restrict or prohibit abortion, and abortion clinics struggle to operate effectively. Of course, self-management will not work for everyone. While feminist networks work incredibly hard to fill the gaps in access left by the Supreme Court decision and existing structural inequalities, there will be pregnant people who attempt to obtain abortions through less safe means or cannot access abortion care at all. Until abortion is decriminalised and easily accessible to everyone, people capable of becoming pregnant will continue to be impacted by these laws. As Reproductive Justice collective SisterSong highlights: the right to bodily autonomy; to have or not have children; and safely parent one’s children is a human right that must be guaranteed for all. Activists in countries across the world fight for a future where this is realised.

About the author

Zoe L. Tongue (she/they) is a Lecturer in Law at the University of Leeds and PhD student at Durham Law School.

She researches abortion and reproductive justice, international human rights, feminist legal theory, and science fiction.

They are on Twitter at @whiterxbbit.

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