UNC SWACThe United States Supreme Court has overturned the 50-year-old Roe v Wade precedent that protected a woman’s right to have an abortion. While this decision comes as a victory to some, it is unpopular to most Americans and it is devastating to many. Here at the Pipette Pen, we believe that our democracy relies on a well-informed electorate. To that end, we, the graduate students on the board of the Science Writing and Communication team which publishes The Pipette Pen, have written the following to answer a few questions about abortion that should be important to the evidence-based voter. These answers are predominantly taken from rigorous and peer reviewed scientific sources or reliable journalistic outlets. Citations are hyperlinked for readers to learn more.
Given the large body of research on this topic, the SWAC board agrees that access to abortion is an important evidence-based healthcare policy that saves lives and improves the health and well-being of people who seek abortions.
This statement has been written collaboratively by the SWAC board (names presented in alphabetical order):
Bree Iskandar
Jillian Battista
Kirsten Giesbrecht
Manuel Galvan
Nila Pazhayam
Taylor Tibbs
Will the recent supreme court decision cause people to lose access to abortion?
Yes, many people will lose access due to the overturning of Roe v Wade.
The overturning of Roe v Wade does not itself illegalize abortion in the United States. Rather, it makes it much easier for conservative lawmakers at the state level to pass legislation that will illegalize abortion services. For example, on the day of the decision, the sole abortion provider in West Virginia announced it will no longer perform abortions. This is one of several rare clinics in conservative states that began canceling appointments as soon as the decision was announced. We are quickly moving toward a nation where people who don’t live in the most liberal states will lose access to abortion services. Further, without the federal protection of the Roe decision, whatever abortion rights are maintained over the next few years are left precarious; as soon as conservative law makers gain power, they may pass legislation to disrupt the abortion infrastructure in their state, which can be difficult to rebuild even when they leave office. It is always easier to dismantle vital services than it is to rebuild or maintain them.
Certain people will have a more difficult time getting abortions than others. With new bans in place, many people now live hundreds of miles away from the nearest abortion clinic. Many low and middle income folks will find it prohibitively expensive to travel to another state to receive an abortion. Even more troubling are forthcoming abortion-travel bans that will illegalize or criminalize state border crossings to receive abortion services. These laws have led to worrying surveillance possibilities, where internet searches and smartphone activities could be used to prosecute people who seek abortion services.
How do researchers answer questions about the effects of getting an abortion?
Researchers generally compare people who receive an abortion to those who are denied an abortion.
It’s important to make the right comparison to answer questions about abortion. Most of the studies we review below investigating the effects of abortion focus on comparing two groups: those who want an abortion but are denied one, and those who want an abortion and successfully receive one. This comparison allows us to see the effect of abortion laws on the people who will seek abortions (i.e., the people most affected by abortion policy).
How does abortion or lack of access to abortion relate to mental health?
Lack of access to abortion is associated with worse mental health. Receiving an abortion is not, unless the decision is highly stigmatized.
There is no evidence that receiving an abortion has negative mental health consequences relative to being denied access to abortion. Studies have found no differences in PTSD, depression, or thoughts of suicide between people who are denied an abortion versus those who receive them. However, perceived abortion stigma can contribute to long term negative health effects, such as an increased rate of psychological stress.
In contrast, being denied an abortion is associated with negative mental health outcomes across a wide variety of studies. Immediately following an abortion denial, women report lower levels of self-esteem and life satisfaction, greater perceived stress, and more anxiety. These studies find that the immediate negative mental health effects typically improve within six months to one year.
How does abortion or lack of access to abortion relate to physical health?
Lack of access to abortion is associated with worse physical health. Receiving an abortion is not.
In general, forcing someone to undergo an unwanted pregnancy is much riskier than having an abortion. The maternal mortality rate in the US is high relative to other comparable countries, and complications and risks to pregnancy are more numerous and serious relative to those related to abortion.
A study compared the health of women who received an abortion to women who were denied an abortion 5 years after the decision. Women who were denied an abortion had worse health outcomes: they reported poorer health, more chronic headaches, migraines, and joint pain. These women were also more likely to have died prior to the 5-year follow up.
The Roe v Wade decision (in addition to a previous decision legalizing contraception and general advancements in medical care) preceded a dramatic drop in abortion deaths in the United States. This observed decline in deaths and complications from abortions is likely caused by the replacement of illegal and unsafe procedures with legal, safe, and regulated ones. If the current bans on abortion increase demand for illegal procedures, this will likely result in an increase in deaths and complications from abortion services.
There are many more potential issues with the current laws that ban abortion. Many medical providers and pharmacists are not providing evidence based care out of fear of jailing, fines, and lawsuits. Some laws make the medical procedures to correct ectopic pregnancies (when the fertilized egg implants somewhere else in the body and not the uterus) more difficult. This could lead to delays in treatment, which can be lethal. Other laws delay access to drugs used to prevent sepsis and hemorrhaging after a miscarriage. Pregnant women struggling with cancer will no longer have the option to end a pregnancy so they can get life-saving cancer therapy. In total, one researcher estimated that abortion bans will lead to a 21% increase in pregnancy-related deaths, with a 33% increase among non-Hispanic Black people.
How does abortion or lack of access to abortion relate to economic outcomes?
Lacking access to abortion services is associated with more poverty, difficulty with employment, and higher need for public assistance.
The most commonly reported reason for abortion is financial difficulty, due to the great financial demands of having a child. Researchers have found that relative to women who successfully receive an abortion, women who are denied an abortion are more likely to be below the poverty line, more likely to be in need of public assistance (e.g., food stamps, welfare), and less likely to be employed full-time. Low-income women normally have more difficulty accessing and affording abortions, and this research suggests they will encounter compounded economic setbacks with increasingly restricted abortion access. Women denied an abortion generally experience more economic and financial distress relative to women who had access to an abortion.
How does abortion or lack of access to abortion relate to interpersonal relationships?
Relative to women who get abortions, women who are denied abortion services are no more likely to stay with their partner, and those that do are often prevented from leaving abusive relationships.
There is some evidence that getting an abortion can be a predictor for romantic relationship problems when comparing relationships of abortion seekers relative to non-abortion seekers.
However, it is more pertinent to compare abortion seekers who can access abortion services versus those who cannot. One study found that being denied an abortion did not improve the quality of relationships, nor did it increase the chances that the parents remained together. This implies that children resulting from forced birth due to limited abortion access are not likely to be cared for by two romantically involved parents.
Homicide is a top cause of maternal death in the United States, and intimate partner violence is more common among women who seek abortions. Often, abortion is sought specifically because a woman’s partner is an abusive man. One study found that intimate partner violence from men responsible for pregnancies decreased over time among women who have abortions, but not among women who are denied abortions. In other words, abortion restrictions increase the probability that women stay in abusive relationships, putting the woman and their children at risk of violence and homicide.
Are the children that are born to parents who have access to abortion better off than children that are born to parents who are denied access to abortion?
Yes, children are better off when their parents can choose when to have children.
Researchers have tried to answer this question by comparing children born after denial of abortion services to children born from women who received an abortion previously. Children born from women who were denied an abortion are more likely to grow up in a house hold that is below the federal poverty line and lacks the money to pay for basic living expenses. Given these difficult life circumstances, it’s unsurprising that these children are less likely to have the opportunity to fully bond with their mothers. These findings suggest that abortion access “enables women to choose to have children at a time when they have more financial and emotional resources to devote to their children.”
To answer this question another way, researchers investigated how timing of abortion legalization affected the outcomes of children across different states. Cohorts of children born prior to abortion legalization were 40 to 60% more likely to be born to single-parent families, to live in poverty, to receive welfare, and to die as an infant.
How does US law on abortion compare with other countries in the international community?
The US is an outlier relative to comparable countries.
As of 2020, of the 47 countries in Europe, 41 (87%) have legalized abortion rights to some extent. Only 6 countries in Europe have the kind of restrictive abortion laws we are likely to see in US conservative states in the coming years.
One interesting observation arises when comparing the trend in US abortion policies to the rest of the world. According to a Foreign Policy analysis, there has been a strong trend towards reproductive freedom worldwide. Over the past thirty years, 59 countries have seen an expansion of abortion access. The list of 11 countries that have restricted abortion access, which includes the US, also includes many authoritarian countries including Russia, North Korea, and Iran.
Are these the only reasons to support abortion access?
No. The above review of the scientific literature on this topic does not constitute the full set of arguments in support of abortion rights.
The right to abortion is supported by many arguments that go above and beyond the scientific evidence cited here. Many argue that abortion rights are an extension of rights to self-determination, privacy, bodily-autonomy, and the right to live. Although not the focus of this document, such arguments are crucially important to consider as well.
