Jan. 22 marks 49 years since the U.S. Supreme Court ruled that access to safe, legal abortions is a constitutional right in the landmark case, Roe v. Wade. As the ultraconservative Supreme Court is slated to rule on the future of abortion rights this year, I fear that that this anniversary very well may be its last. In the 1973 ruling, the high court explained that abortion was protected by the privacy rights outlined in the 14th Amendment of the U.S. Constitution. The Supreme Court ruled that “A person may choose to have an abortion until a fetus becomes viable, based on the right to privacy contained in the Due Process Clause of the Fourteenth Amendment…” and that viability is generally determined to be between 24 and 28 weeks of gestation.
Did you know that nearly one in four women will have an abortion by the age of 45? Abortion isn’t uncommon — it is simply a medical procedure that many women will have. So while legal abortion faces attacks, it is necessary that we speak about its benefits, as well as have conversations with friends and family about their experiences related to ending unwanted pregnancies.
When Roe v. Wade became law, the United States looked very much like a patchwork quilt of states with liberal and restrictive abortion laws. About 30 states had criminalized abortion, forcing women to travel lengthy distances to states where abortion was legal. For example, in 1972, 100,000 women left their home state to obtain a legal abortion in New York, which did not have residency requirements like Alaska, Hawaii and Washington, which also had more liberal laws, did. An analysis by the Guttmacher Institute looking at 1972 statistics estimated that 50,000 women traveled more than 500 miles for an abortion in New York City; roughly 7,000 women traveled more than 1,000 miles, and about 250 traveled more than 2,000 miles from places like Arizona, Idaho and Nevada. Of course, this was only an option for more affluent, overwhelmingly white women who had connections and the means to travel and take time off of work or school. Data from the New York City Department of Health showed that eight in 10 nonresidents obtaining abortion care in the city between July 1971 and July 1972 were white, whereas seven in 10 city residents who underwent the procedure during that time were nonwhite.
Those who were unable to travel to obtain a legal abortion sought clandestine measures. In fact, before Roe v. Wade, more than 1 million women sought an illegal abortion, either self-induced or “back alley” abortions. These methods included ingesting toxins, throwing oneself down a flight of stairs, or inserting coat hangers, knitting needles and scissors to abort. This was common. Approximately 30 percent of all illegal abortions were self-induced. For back alley abortions, women were often “blindfolded, driven to remote areas, and passed off to people they did not know and could not even see during the process,” who may or may not have had medical training. As a result, more than 200 women died each year from these underground procedures. Black and Hispanic women’s mortality rates were 12 times higher than that of white women.
Before Roe, abortion was highly stigmatized. My mother, who graduated high school in 1972 in Wisconsin, recalled how she had overheard her mother talking with friends about someone who had collected money to “go on vacation to visit their aunt.” As she explained to me, “Women talked about abortion in a secretive code — they never used the word, but everyone knew what they meant.” This code was so secretive that my mother wasn’t even supposed to know about it: “I heard it all by mistake.” The silence surrounding abortion came to a halt the following year when Roe v. Wade was handed down.
In the nearly five decades since abortion became legal in all 50 states, conversations about abortion have become more commonplace. “I know women who have had abortions,” my older sister tells me in a manner-of-fact manner. I hear her pacing to her office, getting ready for her next conference call, while my niece and nephew clamor in the background. As she reflects on friendships throughout her young adulthood, she describes an atmosphere that was supportive of personal choice surrounding abortion. “Abortion was a health care tool and, for some of us, it was seen as a good option.”
And she is not wrong. With the legalization of abortion came the dramatic reduction in abortion-related deaths. An editorial in the New England Journal of Medicine explains that not only are there fewer abortions per 1,000 reproductive-age women per year than immediately after Roe v. Wade, but deaths due to abortion procedures in the United States “have been essentially eliminated.” Ninety percent of abortions are done within the first trimester of pregnancy “when the risk of maternal mortality is less than one tenth of that associated with carrying a pregnancy to term.”
Paradoxically, the World Health Organization estimates that there are 25 million unsafe abortions each year with 97 percent of them in developing countries where abortion is either illegal, heavily restricted, or largely inaccessible.
It is safe to say that when physicians are able to practice reproductive medical procedures safely and legally, abortion (and contraception) saves lives. Medical science is truly incredible. The fact that my sister and I could have a candid, on-the-fly discussion about abortion is a testament to this change.
But abortion is still highly stigmatized. In fact, President Biden, a pro-choice president, refused to talk about abortion or even say the word for the first 224 days of his presidency, despite relentless attacks on reproductive health care. People have been stigmatized when speaking about the benefits of abortion. Perhaps that’s what made Anne Nicol Gaylor, co-founder of the Freedom From Religion Foundation and an early abortion rights activist, so radical when she wrote the book Abortion is a Blessing in April 1975. In it, she explained “I have become impatient not only with those religious zealots who tiresomely hiss ‘Murderers,’ but with those apologists who, while granting the right to abortion, insist that somehow a woman must feel guilt and remorse. I have come to suspect that the persons who refer to abortion as ‘a tragic option,’ or ‘a terrible alternative,’ hold allegiance not to women’s freedom but to a male-dominated world gone by.”
As the future of Roe v. Wade hangs in the balance, we face a future where abortion soon may become illegal in many parts of the country. If it does, this would lead to a 21 percent increase in pregnancy-related deaths overall and a 33 percent increase among Black women, according to recent research at the University of Colorado Boulder.
Currently only 16 states and the District of Colombia protect legal abortion in their respective constitutions, which would leave millions of women without any abortion care should Roe v. Wade fall. We are already seeing this in Texas, where abortion has been effectively outlawed. While Texan women rush to surrounding states for abortion care at overworked and overcrowded clinics, religious legislators are eager to copy this draconian law and render abortion a criminal activity in their own state. And while the liberalization of Mifepristoine, the abortion pill, by the Food and Drug Administration is an important step, 19 states have already banned its distribution by mail.
Beyond supporting measures like the congressional Women’s Health Protection Act, what can we do to stand up for abortion rights on the 49th anniversary of Roe v. Wade?
We can tell our stories and speak to our friends and family. I acknowledge that it is unfair that women so often feel compelled to publicly disclose their abortion stories in order to have legislative justice. But since we live in a country where Christian nationalism is overtaking abortion rights, it is vital that we do not revert back to the “hush-hush” environment of the generations that preceded us. Speaking out is what we must do to stand up for ourselves and for one another.