Post Roe, Post Reckoning

Advocates warned of the consequences, sounded the alarm for decades of what was to come should the threats against Roe v Wade find fruition. There were talks of federal, nationwide protections for the sake of long-term preservation. This was not genuinely pursued for reasons that remain debatable and anger-inducing. We now stand on the other side, close to 2 years in the rearview, treading water as our resources and safety nets have been flooded and reproductive rights continue to be chipped away in perhaps unfathomable ways.

As can be seen in the Center for Reproductive Rights After Roe Fell: Abortion Laws by State map, the Southeastern US has transformed into a sinkhole swallowing up reproductive healthcare, unraveling our threads to bodily autonomy, and spreading outwards. As reproductive and abortion decisions are left up to state legislatures, we see the balances of power between communities as constituents and between legislators widen. As abortion funds and reproductive justice collectives stretch their finances and their person-power for the sake of genuine and literal survival, the alarm continues to be rung.

Post-2022 headlines and viral soundbites are especially illuminating as to the state of this sector of health:

• A Year After the Supreme Court Overturned Roe v. Wade, Trends in State Abortion Laws Have Emerged. In the absence of federal protections, state legislatures have become arbiters of abortion access, with some states banning or severely restricting abortion
• In states with bans, women often take abortion pills alone, afraid
• Life Insurance To Be Given to Embryos Under New Bill. A new bill in South Carolina is seeking to extend life insurance coverage to embryos
• With Florida and Arizona bans looming, abortion funds are running out of money. Nonprofits help people cross lines for abortions. Now those journeys will be longer and costlier – and donations are dwindling.
• Florida abortion ban prompts two states to prepare for influx of patients
• Florida’s 6-week abortion ban could displace thousands each month in a region where access is already severely limited
• How the reversal of Roe v Wade. led to the Alabama Supreme Court ruling that frozen embryos are children.
• “Fearing Legal Threats, Doctors are Performing C-Sections in Lieu of Abortions.” Some physicians are doing unnecessary and invasive surgery on pregnant patients “to preserve the appearance of not doing an abortion.”
• ‘Medical apartheid’: HHS secretary derides Florida’s six-week abortion banThe increasing risk of criminal charges for women who experience a miscarriage
• Ohio Woman Who Miscarried Faces Charge That She Abused Corpse
• Sixty-one people in US criminalized for alleged self-managed abortions, report finds
• Nearly 10,000 more babies born in nine months under Texas’ restrictive abortion law, study finds
• Texas teen birthrate rose for first time in 15 years after abortion ban, largely affecting Latinas. Hispanic women and teens delivered 84% of all additional babies in Texas from 2021 to 2022, the year a six-week abortion ban took effect.
• More young people seek sterilization as abortion restrictions increase

Christian, Conservative Journalist Ben Zeisloft, “Birth control pills sometimes cause abortions by stopping embryos from implanting. They should be banned for that reason alone, without even getting into the massive societal harm they cause by discouraging fruitfulness and enabling widespread sexual immorality.”

I share this seemingly extensive but in actuality, a microcosm, of starting headlines as a snapshot of post-Roe trajectory. The unheeded warnings projected that a targeted rollback of abortion rights was not the end goal, but rather an access point from which to seek further encroachment. As is seen within these headlines, we now see threats, both verbal and realized, against medicated abortion, classification of embryos as people with a wave of repercussions including IVF barriers, criminalization of miscarriages, and birth control restrictions within sight. It cannot be lost amongst our community planning and response of who are the targets, who aims to lose the most should these restrictions come to pass? Who does not have the financial resources to seek out alternative states and support for their reproductive and mental well-being? Who will face persecution? Who depends on IVF for family building? Who depends on birth control for stability and safety? We must ask, how worse can it get?

These attacks are often framed as a debate, but we must not just caution but demand that we refrain from political politeness. Bodily autonomy is an absolute and must be pursued as such.

We must also ask ourselves - How will we persevere? How will we push back? How do we weave our collective community power – from reproductive health to racial justice to health equity to trans affirmation and wield it for our futures? Time and power are imperative.

These claustrophobic times require a new level of creativity and commitment to turn the wave, and as we ask ourselves these pressing questions, we can take inspiration from the pockets of power dotting the country’s landscape. While the fall of Roe v Wade via Dobbs v Jackson removed the federal constitutional right to abortion, it also opened up the door for cities and states to step in and offer unprecedented protections.

In response to Texas largely spearheading abortion restrictions and criminalization, San Antonio city council allocated $500,000 towards a reproductive justice fund aimed at emergency contraception, STI testing, and potentially abortion access, as logistics and community partner contracts are finalized. Additional Texas cities have found their own path - Austin city council approved a resolution decriminalizing abortion and Amarillo rejected an abortion travel ban ordinance, one of the more recent anti-abortion strategies restricting access to neighboring states by outlawing the use of Texas roads in the pursuit of abortion services. This makes Amarillo the largest conservative city in Texas to reject the proposal.

States and cities across the country are not only securing resources for their own residents, but providing a counterpoint to abortion restrictions to those seeking refuge and services away from home. 7 states have passed shield laws, offering protection for physicians providing reproductive health care both locally and virtually - as of right now, a safety net for residents in states like Florida who cannot seek out telehealth visits related to abortion at any stage of pregnancy if the provider is based in the state. In the year following the overturning of Roe v Wade, at least 15 municipalities and six state governments set aside roughly $208 million in funds earmarked for contraception, abortion, and support services. California has allocated $20 million to support travel costs for those seeking abortion services from out-of-state. Cities like Chicago, Baltimore, and Seattle are leveraging city budgets to support in-state abortion funds directly. New Mexico’s governor committed $10 million for the construction of a new reproductive health clinic, a site that will be sought after for those fleeing Texas.

In addition to funds and legislative protections, medication abortion has risen in popularity, filling in the gaps of procedural abortions and offering many a lifeline. 2023 saw medication abortion account for 63% of all pregnancy terminations, with groups leveraging virtual options and out-of-state providers to broaden access in every state. Resources like Plan C and the corresponding documentary are providing crucial support and demystifying this sector of care in powerful ways.

As the November election looms in the near future, state politics over the past 2 years have granted insight into the role abortion and reproductive health may play at the federal level. Only three months ago, a traditionally Republican-held seat in Alabama was flipped in a special election, granting victory to Democrat Marilyn Lands, who spoke openly of her own abortion and her continued commitment to the reproductive healthcare fight. Voters in Kansas and Kentucky have rejected statewide constitutional amendments removing abortion protections. Republican lawmakers are working to remove or block abortion referendums on November ballots, backpedaling on prior anti-abortion hardline stances, knowing the impact it could have on voter turnout and election results.

There is no denying the harm the overturning of Roe v Wade has caused - from thousands of forced pregnancies and births, the toll upon individual’s physical and mental health, personal finances, entire lives and family units upended. But perhaps, the sweeping rollbacks and non-consensual possession of bodily autonomy has not been fully realized. Perhaps we can entertain with cautious optimism that it has in fact backfired in ways. The fear of its upheaval allowed many to remain silent and neutral, placating the public. But knee-deep in this restrictive reality has required a vocal call to action, lit a fire, with more leaders of influence, community conversations, and dedicated resources invested in new avenues of reproductive protections. Abortion is no longer in the shadows. We must carry this momentum forward, broaden the investments to rebuild our networks of care in holistic ways.

Today, the Supreme Court announced a unanimous rejection of an effort to heavily restrict access to mifepristone, a pill used in medication abortions. This ruling preserves the ability for a patient to be mailed the medication without an in-person doctor’s appointment, a lifeline for many living in abortion-outlawed states. It also continues to allow other advanced practice providers, in addition to MDs, the ability to prescribe and access through 10-weeks of pregnancy, rather than the proposed 7. Notably, many Republican legislators have yet to provide comment. Republican Representative Mike Lawler, who is running for reelection in New York, praised the ruling and Danielle Alvarez, a senior advisor to Trump went on the record to state, “The Supreme Court has unanimously decided 9-0. The matter is settled.”

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Perhaps a reckoning awaits. Perhaps a reckoning has arrived.

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