Sneha Jiju, BASIS Awhatukee, Phoenix, Arizona, USA
Summary
In the midst of the fervent political climate that has plagued the U.S. following the Supreme Court decision in Dobbs v. Jackson Women’s Health Organization, many researchers have turned their attention to assessing how this ruling will impact the physical and emotional health of pregnant individuals living in states with differing abortion policies. Experts acknowledge that this decision will induce the establishment of restrictive abortion policies in almost half of the states in the U.S., forcing many individuals to carry through with unfavorable pregnancies or resort to unsafe, potentially life-threatening abortions. The impact of this Supreme Court decision is vast, as researchers believe that it will even adversely affect the experience levels of OB/GYN specialists working in miscarriage management and specific forms of emergency care. Furthermore, many expect this ruling to exacerbate the racial disparity in maternal mortality, as women of color are likely to face the most financial and geographical barriers to receiving safe abortion services. The anti-abortion actions taken by the U.S. will likely fuel opposition towards sexual and reproductive rights worldwide, establishing precedent that will continuously impact maternal health around the globe.
On June 24, 2022, the final decision for Dobbs v. Jackson Women’s Health Organization, a landmark decision of the U.S. Supreme Court in which the Court ruled that the Constitution does not confer a right to abortion, was issued. The Court revoked the constitutional right to an abortion by upholding the constitutionality of a Mississippi state law prohibiting abortions after the fifteenth week of pregnancy, except in cases of medical emergencies or fetal abnormalities (Williams & Finn, 2022). It is clear that the question of abortion legality has an immense impact on the physical and emotional well-being of pregnant individuals. Unsafe abortions, which are a last resort for many pregnant individuals under governments making anti-abortion rulings, are one of the leading causes of maternal mortality (“Abortion,” 2021). Healthcare data regarding maternal health in the U.S. demonstrates how the abortion policy in a state directly impacts maternal mortality rates; a more restrictive abortion policy climate in a state is shown to result in a higher rate of unsafe abortions, and thus higher maternal mortality rates (Ravi, 2018).
A maternal death is defined by the Centers for Disease Control and Prevention (CDC) as “a death while pregnant or within 42 days of the end of pregnancy, from any cause related to or aggravated by the pregnancy or its management, but not from accidental or incidental causes'' (“Pregnancy Mortality,” 2022). Researchers have found that such a death is roughly 14 times more likely to occur during childbirth than during an abortion procedure, so the health of women carrying unfavorable pregnancies is estimated to deteriorate in countries where abortions are limited (Raymond & Grimes, 2012). Many individuals who carry an unintended pregnancy and believe that they are unequipped to deliver the offspring have to resort to unsafe abortions due to an inability to access safe and affordable abortion services. Researchers acknowledge that this global dilemma arises much too often, with an estimated 45% of abortions during each year between 2010 and 2014 being life-threatening. Furthermore, developing countries in South and Central Asia, Latin America, and Africa bear the burden of 97% of these unsafe abortions (“Abortion,” 2021).
Keying in on the eleven developed nations around the world, the U.S. ranks the lowest in maternal care, with the highest maternal mortality rate, a lack of sufficiently available maternity care providers, and no reliable access to paid parental leave during the postpartum period or to provider home visits. Maternal deaths have been increasing in the United States since the year 2000, and although approximately 700 women die annually as a result of pregnancy or its complications, two-thirds of these deaths are known to be preventable (Mellilo, 2020). Experts expect the U.S. maternal mortality rate to undoubtedly rise following the Supreme Court decision overturning Roe v. Wade (Chuck, 2022). In addition to making safe abortions much less accessible in the U.S., this decision will curtail the opportunities for OB/GYN specialists to practice potentially life-saving procedures relating to abortions and miscarriage management, which are heavily intersecting areas in healthcare. Limiting doctors’ hands-on experience with abortion practices and skewing the states where OB/GYN workers choose to live could compromise the health of the pregnant individuals in several states (Weiner, 2022).
Furthermore, this Supreme Court decision will disproportionately harm black women, forcing many to carry through with life-threatening pregnancies or undergo unsafe abortions as a last resort. This is because women of color tend to face more obstacles with eliminating unfavorable pregnancies, as many lack the financial resources needed for travelling to a location where abortions are safe and affordable, and many are unable to get off work in order to actually have an abortion procedure executed. Thus, researchers believe that the fall of Roe will further exacerbate the racial disparity in maternal deaths (Schreiber, 2022).
Figure 1 Graph depicting how maternal mortality rates have increased during 2018-2020 (attributed to anti-abortion rulings in several states) and how the maternal health disparities between races have worsened (“Maternal Mortality,” 2022).
The decision for Dobbs v. Jackson Women’s Health Organization will reverberate around the entire globe, sending the strongest signals to nations with changing or controversial abortion policies. Experts believe that this ruling will provide adequate precedent for other nations to establish policies restricting sexual and reproductive rights. With the U.S. advocating for gender and healthcare equity, human rights, and justice, many believe that this Supreme Court decision will likely contradict the values that the U.S. has been working to encourage abroad. The global effects of this decision have already been brought to light; within 24 hours after the draft opinion for this case was leaked, a local organization in Bangladesh openly acknowledged it as a signal that their government should not protect abortion rights (Saldinger 2022).
The impact of the Supreme Court decision extends beyond influencing the well-being of pregnant individuals, as it also tests the social fabric of the U.S. in the face of controversy. In order to eliminate the stark barrier that has divided U.S. citizens following the fall of Roe, it is crucial that government officials reach a compromise that does not unjustly neglect the health of any one party. Although data suggests that maternal health will inevitably deteriorate due to this ruling, it is still a priority for society to mitigate this issue and ensure that fatalities are cautiously avoided.
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