- Overturning Roe v. Wade would further exacerbate reproductive health access.
- Restricted health laws have disproportionately impacted low-income individuals and people of color.
- Reproductive health care includes not only abortion, but access to affordable birth control, in vitro fertilization, and preventative screenings such as pap smears.
- There are ways to support reproductive health access in your community like voting or donating to local funds.
The current landscape of reproductive health care access in the United States is under threat. On Monday, October 26, 2020, Amy Coney Barrett was confirmed to the Supreme Court, making her the sixth conservative justice currently on the court.
Barrett has previously expressed her moral opposition toward abortion, leaving many wondering where Roe v. Wade’s future lies. In 2016, Barrett implied the Supreme Court likely wouldn’t overturn the overall decision on the 1973 case, which grants women the right to an abortion, but rather would change specifics on restrictions and access.
Although Roe v. Wade does not guarantee access to abortion, it provides people the legal right. “Overturning Roe would further dismantle abortion access in this country and make it harder to stop policies that exacerbate disparity,” Bonyen Lee-Gilmore, director of state media campaigns at Planned Parenthood Action Fund, tells Verywell. “If Roe were to fall, 25 million women of reproductive age would live in a state where abortion would be outlawed.”
While Roe v. Wade in its current state isn’t perfect, overturning the landmark case will only exacerbate abortion access issues across the country, especially for people who are low-income.
What Is the Current State of Reproductive Health Access?
In the U.S., nearly one million women choose to end a pregnancy each year. However, with restrictive abortion laws in certain states, some women face barriers when accessing care.
Bonyen Lee-Gilmore, Director of State Media Campaigns, Planned Parenthood Action Fund
Overturning Roe would further dismantle abortion access in this country and make it harder to stop policies that exacerbate disparity.
— Bonyen Lee-Gilmore, Director of State Media Campaigns, Planned Parenthood Action Fund
Strict legislation continues to undermine the availability of reproductive health services, including abortion. In the U.S., 33 states require that women receive counseling before an abortion is performed. Twenty-five of these states also require women to wait a specific amount of time between the counseling and their abortion procedure, referred to as waiting periods.
In a literature review conducted by the Guttmacher Institute, waiting periods served no medical purpose and were intended to make abortions less accessible. Because pregnancy is a timely event, longer waiting periods can push pregnant women to have abortions later on which can be costly and cause greater health risks.
In addition to waiting requirements, targeted restrictions on abortion providers (TRAP) laws are not uncommon. TRAP laws can hinder reproductive health access in many ways such as requiring abortion providers to meet building regulations, obtain specific licensing, and pay exorbitant fees to register the clinic.
Beyond waiting periods and TRAP laws, there are multiple factors that currently make abortion inaccessible, including but not limited to:
- Lack of health insurance coverage and funds to afford an abortion
- Geographic location and access to abortion services
What This Means For You
If you are seeking an abortion, check your state laws for information on waiting periods and access. You can find a provider on the National Abortion Federation website. If you are seeking to support reproductive health access in your community, you can make informed choices about who you vote for or donate to state funds that provide abortion funding and help cover lodging and travel expenses.
How Would Overturning Roe v. Wade Impact Access?
June Ayers, RN, director of Reproductive Health Services (RHS), an abortion clinic in Montgomery, Alabama, has worked at RHS for over 42 years. Since RHS’s inception in 1978, the clinic has provided abortion services to patients from lower Mississippi to Florida. Ayers tells Verywell overturning Roe v. Wade would decimate abortion access in many of these areas.
“Alabama would fall and most of the southern states would go back to pre-Roe,” Ayers says. “It would be like it was before. It’s a war on women.”
If Roe v. Wade was overturned, there would be a massive surge of travel. Women located in states where abortion is banned would have to fly or drive to other states such as New York or California. But there may not be enough providers in these states to account for such an influx.
Calla Hales, Executive Director, Preferred Women’s Health Center
Roe is pretty much the floor. It’s the bare minimum of what we could do to protect abortion access.
— Calla Hales, Executive Director, Preferred Women’s Health Center
For low-income women, traveling creates an additional barrier. “They’re not going to have the money to be able to access a local airport to get on a plane to go someplace else,” Ayers says. “If they don’t have access within a five-hour range of their home, then patients are just not going to be served. Their reproductive rights are going to be denied.”
A 2019 study found that if Roe v. Wade were overturned or abortion access was further restricted, 39% of women in the U.S. ages 15 to 44 would experience increases in travel, ranging in distance from one to 791 miles.
Since 2011, legislators from all 50 states introduced more than 1,100 reproductive health and rights-related provisions, an unprecedented amount. The overturning of Roe v. Wade would not only ban abortion, but restrict access to other reproductive health services such as in vitro fertilization, affordable birth control, and pap smears.
“When she [Amy Coney Barrett] got confirmed, I burst into tears,” Alicia*, a birth doula and abortion counselor at Allegheny Reproductive Health Center, tells Verywell. “Anti-choice activists are foaming at the mouth excited about how real it looks that we might be living in a post-Roe world. For folks like me, that’s terrifying.”
How Do Restrictive Abortion Laws Impact Low-income Women?
In 2010, Alicia was 16 years old when she got pregnant. At that time, she was a teenager in Ohio. The state did not have a judicial bypass—a law that allows people under 18 to get an abortion without notifying their parents.
“Being a teenager in the state of Ohio at that time, I had no choice but to tell my mother,” Alicia says. “The biggest hurdle was my relationship with my mom. I wanted to keep it private to myself.” States without judicial bypass often interfere with a woman’s autonomy.
When Alicia became pregnant for the second time during her sophomore year in 2014, she was not able to afford the abortion.
According to the Guttmacher Institute, abortion is more common among low-income women than among women with higher incomes. But low-income women often struggle to come up with the money to pay for the procedure and often lack insurance coverage.
Access becomes an issue because health insurance options are limited. “It’s limited access for people that don’t have private health insurance where their abortion is covered, or don’t have the connections to have their abortion covered,” Nikkole Terney, back team lead of Allegheny Reproductive Health Center tells Verywell. “It’s really going to impact a lot of low-income people.”
In the U.S., Medicaid is the largest health insurance program. Due to the Hyde Amendment, federal dollars are not allowed to be used for abortion. Unless the pregnancy is life-threatening or is a result of rape or incest, women on Medicaid are not allowed to use their insurance for abortion care. According to Lee-Gilmore, the Hyde Amendment disproportionately impacts people of color.
“Black and brown women and women, in general, rely heavier on public-funded healthcare programs because of racist and discriminatory systems,” Lee-Gilmore says. “The Hyde Amendment is a targeted law that falls heaviest again on Black and brown people.”
Currently, 32 states ban the use of Medicaid funding for abortions except for the aforementioned circumstances.
In addition to a lack of health insurance, restrictive waiting laws add to low-income women’s stress. In Alabama, women seeking an abortion must wait 48 hours before receiving abortion care. For low-income women, this waiting period can be detrimental.
“Logistically, it is difficult for patients, especially our patients that are low-income, to get to the office because they have to get a ride that they don’t have, get someone else to bring them when they have the procedure done, then wait 48 hours, and come back,” Ayers says, adding roughly 65% of her clinic’s patients were below the federal poverty line. “The obstacles can be almost surmounting.”
Due to financial and staffing constraints, the RHS can only offer abortion services on Mondays. “It leads to more than just a 48-hour waiting period because if a patient can’t get down on Monday, that bumps her into the next week,” Ayers says. “So what started out as a two-day waiting period becomes a seven or nine-day waiting period.” Other states such as Arkansas, Missouri, and North Carolina have waiting periods of 72 hours.
The Pandemic Poses New Challenges
On top of waiting periods, the pandemic exacerbated the economic viability of abortion clinics. “You immediately become very aware of how much all of your supplies are costing,” Calla Hales, executive director of a Preferred Women’s Health Center, tells Verywell. “The cost of everything has skyrocketed. A lot of us are now facing massive issues with their budgets because it’s expensive to provide safe care.”
During the pandemic, governors in multiple states such as Texas, Louisiana, Mississippi, Alabama, and Oklahoma have called for the cessation of medical and surgical abortion. Due to the time-sensitive nature of safe abortion care, the American College of Obstetricians and Gynecologists (ACOG) along with other reproductive health organizations issued a statement in March disapproving of delayed or canceled abortion procedures. Politicians have argued that the closure of abortion clinics would increase the availability of personal protective equipment (PPE) for medical staff treating COVID-19, which in turn would hamper abortion access.
For abortion clinics like Hales’, every budget item is a battle, especially during the pandemic. The Women’s Health Center does not receive outside funding for operations. Therefore, staff shortages can be an issue.
“We are dealing with shortages of staff because of things like lack of childcare, whether folks are sick themselves, the inability to take time away from their families. They have loved ones that need assistance,” Hales says. “There’s just so many additional factors that are now impacting staff in a way that I had never imagined before.”
Supporting Access to Reproductive Health Care
According to Terney, you can support people seeking reproductive health care by donating to your local abortion fund. “We use that to lower the costs for patients, help pay for travel, and pay for lodging,” Terney says.
People can also support their community by voting. “People that are making the law for mainly women’s bodies and trans bodies are people that will never step into our shoes,” Terney says. “As a society, we have to get out and vote. We can’t want change and not act for change.”
Lee-Gilmore calls on people to not only vote, but to do so by staying informed about candidates and the policies they support. “It’s very important that people go to the polls and vote in their best interest,” Lee-Gilmore says. “Make educated decisions about who they’re voting for and pay close attention to the names on their ballot. These laws are the same laws that end up in the court system, and make their way to the Supreme Court.”
With Amy Coney Barrett’s confirmation to the Supreme Court, not only is the future of abortion access on the line, so is access to reproductive health care like in vitro fertilization and access to contraception. “It’s not only a woman’s rights issue, it is a human issue,” Alicia says.
The overturning of Roe v. Wade could dismantle reproductive health care and abortion clinics across the U.S., especially those located in the South. “Roe is pretty much the floor,” Hales says. “It’s the bare minimum of what we could do to protect abortion access.”
*In order to respect their privacy, Alicia’s last name is not included.