Rachel Roth

    Reproductive Rights and Realities on the 40th Anniversary of Roe v. Wade

    Posted January 21st, 2013 by

    When we observe the 40th anniversary of Roe v. Wade on January 22, we are celebrating a major milestone in women’s health, equality, and status as citizens. At its core, Roe stands for women’s right to make important decisions about our own lives.

    This momentous Supreme Court decision protects both women’s right to have an abortion and women’s right to continue a pregnancy. And yet, the reality of women’s lived experience often falls short of the rights pronounced 40 years ago.

    Roe built on a series of decisions throughout the 20th century dealing with marriage, procreation, and childrearing, including a 1972 case about the right to use contraception which said that if the right to privacy means anything, it is the right “to be free from unwarranted governmental intrusion into matters so fundamentally affecting a person as the decision whether to bear or beget a child.”

    In political circles, the meaning of Roe v. Wade is usually talked about as “the right to choose” or reduced to the shorthand of “choice.” This simplistic rhetoric not only diminishes the profound and fundamental nature of decisions about parenthood, it begs the question whether it make sense to talk about “choices” unless women have alternatives to choose from. For example:

    • to get pregnant or prevent pregnancy
    • to continue or terminate a pregnancy
    • to raise a child or make arrangements for someone else to do so

    Forty years after Roe, the reality for too many women is that these possibilities are severely constrained

    Constraints on abortion

    One of the biggest constraints is money. For the millions of women of women who use Medicaid for their health care, for example, the Hyde Amendment bans federal funding of abortion. Although the Hyde Amendment initially targeted women who use Medicaid, its reach has extended over the years to virtually every woman whose health insurance is part of the federal budget.

    Women who serve in the military or Peace Corps or work for the federal government – out of luck. Women who rely on the Indian Health Service – out of luck. Women who are sentenced to federal prison or immigration detention – out of luck. Women who qualify for Medicare because of disabilities – out of luck.

    (So, too, are women who live in the District of Columbia, because Congress has say over D.C. policy, even over how the District spends its own tax revenues.)

    All these groups of women, no matter how few resources they may have, must figure out how to pay for an abortion on their own, even when their very poverty is what qualifies them for government health assistance in the first place.

    (The official definition of poverty is living on less than $12,000/year for an individual and less than $18,000 for a family of three.)

    Because of the racial distribution of poverty, women of color are disproportionately likely to be low-income and rely on government sources of health insurance. Women who are young typically have few resources of their own, and women who live in rural areas, on reservations or in small towns, face the added difficulty of getting to an abortion provider whose office may be many miles away.

    It would be bad enough if money were the only significant barrier women had to deal with. But thanks to decisions in which the Court backtracked from Roe, states have enacted a slew of restrictions that turn the path to abortion care into an obstacle course littered with hurdles like biased “counseling” and mandatory waiting periods designed to dissuade women from going through with their decision.

    Constraints on parenthood

    Despite how difficult politicians have made it to get an abortion, they haven’t made it particularly easy to raise children. Consider some of the challenges:

    Race and economics matter here, too. The maternal mortality rate for African American women is three times higher than it is for white women, for example. Discrimination and policy failures take an especially heavy toll on women of color, young women, rural women, and all women working low-wage jobs.

    Among the groups for whom motherhood poses the biggest challenge are women in jail, prison, and immigration detention. Misguided drug policy and harsh sentencing rules have fueled a dramatic rise in the imprisonment of women since 1973. Increasingly, women risk arrest and imprisonment because they are pregnant.

    A majority of incarcerated women have children with whom they struggle to maintain relationships, both in terms of preserving their emotional bond and in terms of preserving their legal rights as parents. If they are pregnant, they face medical neglect and the prospect of being shackled when they are in labor and giving birth.

    Moving forward: supporting women’s decisions

    Women go to school, work, have sex, form families. One in three women has an abortion at some point in her life. Six in ten women having an abortion have at least one child.

    Because of Roe, abortion is one of the safest medical procedures. This is one of the most important benefits of legalization.

    After 40 years, the availability of safe medical care is the minimum we should expect. To fulfill the promise of Roe, we still need public policies that truly promote women’s right to decide whether and when to become mothers, including policies that ensure access to abortion and policies that support raising children.


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    January 22, 2013 at 5:57 pm by Nicole

    I was neutral on abortion until I spent a day in a neo-natal intensive care unit. I watched those children, young enough to be legally aborted in certain parts of the country, fight for their life. That day changed my life.

    Abortion as healthcare is an argument I cannot respect after looking at those children fight for life. As a woman and a mother, I find the celebration of abortion by women as offensive and an extremely sad commentary on our society and on women. I do agree that we need to work together to make the option of choosing life more attractive to pregnant woman. After reading your article that’s a commitment I plan to make for the rest of my life … loving those in need of love so that life may be produced.


    January 21, 2013 at 1:26 pm by Tim

    In 1993 there were over 2000 abortion clinics in the US. Today there are just over 600. Access to abortion is being reduced even more. Alabama Supreme court has ruled in favor of personhood for the unborn. Mississippi has one remaining abortion clinic. Fairfax, VA’s abortion clinic was closed last week. Virginia has passed regulations that force Abortion clinics to be retro-fit their facilities to adhere to the same building standards as newly constructed hospitals. These modifications will cost thousands thus potentially causing more facilities to closed. Funding for Planned Parenthood by states is being reduced and cut all together. The evidence shows that our youth are deciding to turn away from the idea that abortion is equated to choice and are leaning to pro-life ideas.

    There are many, many, many more strories in which access to legal abortionis are being reduced across the US. Thank GOD for those who are willing to fight for the rights of the unborn. This is direct result of the warriors for those who are completly defenseless sickness of abortion. Research the history of eugenics and the Birth Control League and you will see it’s direct association to genocide. Look at the abortion numbers. Specifically blacks make up 13% of the US population and 30% of abortions are black. Over 50% of abortions are minority. Abortion has absolutely nothing to do with the health of a women but more to do with the inconvenience on their lives of pregnant or raising a child. A women is no more or less healthy if she is pregnant. I know you will not post this because truth is not what you want people to know.

    Just like with slavery once people realize that we are talking about human beings and not things or animals this sickness will end. Eventually access to legal abortions will extremely limited and I thank GOD. The Pro-choice movement is losing the battle. Sorry but the end result will be in favor of the unborn. The Pro-choice movement will soon be on life support and eventually dead all together.


    Rachel Reply:

    Dear Tim,

    You and I are not likely to change each other’s minds about the morality of abortion in this type of forum. We may agree on other issues, like supporting full implementation of the Affordable Care Act, as well as early childhood education and other programs that help families to thrive.

    In the spirit of education that MomsRising seeks to foster, I would like to offer some additional information. On the matter of African American women’s abortion rates, I recommend that people visit the website of Trust Black Women to learn what this coalition of individuals and organizations has to say about abortion.

    On the matter of health, the recent death of Savita Halappanavar, who died of blood poisoning after a hospital in Ireland denied her an abortion that could have saved her life, demonstrates that abortion does indeed have something to do with women’s health.

    All the world over, maternal morbidity and mortality are higher where abortion is illegal. The World Health Organization lists unsafe abortion as one of the major causes of maternal death.


    Anita Reply:

    Rachel, thank you so much for your thoughtful and sensitive comment on this.


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