The Supreme Court’s ruling in the Dobbs v. Jackson case, the Women’s Health Organization, dramatically and rapidly changed the landscape of access to abortion in the United States. to repeal the almost half-century-old precedent set in Roe v. Wade, which guarantees the constitutional right to abortion. With Dobbs’ decision, states have the ability to set their own limits, so where people live will determine their level of access to abortion.
The majority opinion, written by Judge Samuel Alito, states that “the Constitution does not provide for the right to abortion; Rowe and Casey [Planned Parenthood v. Casey, 1992] are canceled; and the power to regulate abortion is returned to the people and their elected representatives. “
Almost immediately after the release of the decision, protests and celebrations began outside the court and across the country – highlighting specks of laws and restrictions that will now take effect. Conservative government officials have said they will take swift action to curb abortion, while in other states some officials have vowed to retain the right of access.
Here are five key points that will affect access to abortion.
1. Where is abortion still legal?
The Supreme Court ruling means that access to abortion will soon be very uneven.
Sixteen states plus the District of Columbia have laws that protect the right to abortion. In two other states, courts ruled that the state constitution established this right. These countries are concentrated on the east and west coasts.
Across the spectrum, 13 states have “trigger” laws that will quickly ban almost all abortions, and at least half a dozen moved on Friday to enforce them, including Arkansas, Kentucky, Missouri and South Dakota. Four more have bans before Roe, which will take effect again. Three other states have book laws that will ban abortions after about six weeks of pregnancy.
Access to abortion is likely to develop in other countries. Kansas and Montana, which are among the states that have abortion rights enshrined in their constitutions, can see the repeal of these protections through a Kansas voting measure and legal challenge by the Montana Attorney General. In at least eight states, the right to abortion is not explicitly protected or prohibited by state law.
And in Michigan, a 1931 state law banned almost all abortions, but its application was suspended by a court decision in May. Michigan Attorney General Dana Nessel, a Democrat, said she would not enforce the law, but questions remain as to whether it will be for local prosecutors.
As was the case before the 1973 Roe Supreme Court ruling, people seeking abortion care will also be subject to various restrictions even in countries where the procedure is still legal. These include gestational boundaries outlining the maximum time during pregnancy for an abortion, requirements for patients to receive prior consultation, waiting periods and rules for notifying parents of minors.
2. What can the Biden administration do?
President Joe Biden said his administration was investigating the actions of the executive branch to counter the impact of the decision. In remarks after the ruling, Biden said it was a “sad day” and that without Rowe, “the health and lives of women in this nation are now at risk.”
But in short, without a new law from Congress, he has limited options.
Biden vows to defend abortion rights following Supreme Court ruling 1:27 p.m.
Proponents of abortion rights and Democrats in Congress have urged the administration to make it easier for women to have a medical abortion, which is available up to 10 weeks of pregnancy and involves taking two pills, considering whether services can be provided in federal ownership even in that they prohibit the procedure and increase digital privacy to protect patients.
Medical abortion is becoming an increasing share of the total number of abortions performed in the United States According to the Gutmacher Institute, a research organization that supports abortion rights, pills account for more than half of all abortions in 2020, the largest part.
Under the Biden administration, the Food and Drug Administration has already lifted a major restriction. Patients can now receive mifepristone, the first drug used in the series, by mail. Mary Ziegler, a professor at the University of California at Davis Law School and an abortion historian, said that even when conservative states seek to restrict access to medical abortion, the Biden administration may argue that FDA rules and guidelines outperform mifepristone. all state laws that criminalize this method. Attorney General Merrick Garland took the position in a statement issued shortly after the decision was announced: “The FDA has approved the use of Mifepristone. States cannot ban Mifepristone based on disagreement with the FDA’s expert assessment of its safety and efficacy. “Biden reinforced this message in his speeches.
Commenting before the judges’ decision was announced, Zeigler said the position was “the biggest thing they can do.” However, the FDA’s approach is uncertain, both legally and because a future Republican administration could easily overturn any action Biden employees take. “If it works, it won’t be permanent and it may not work,” she added. The Biden administration may also expand the number of pharmacies that can dispense the drug.
3. Will people in states where abortion is illegal have access to medical abortion?
For now, as a result of Dobbs’ decision, the ban on abortion is likely to impose restrictions or bans on abortion pills. But some advocates note that people in these states can still get abortion pills and have a “self-administered” abortion at home, which carries some added risk if the woman has a complication (although complications are very rare). And abortion pills will still be available in states where abortion is allowed.
Packages of drugs used to terminate an early pregnancy sit on a table at a planned parenting clinic on October 29, 2021 in Fairview Heights, Illinois. Jeff Roberson / AP
Before Roe was repealed, many states had already imposed restrictions on receiving abortion pills, including banning pills from being mailed and not allowing patients to be prescribed the drug through a telemedicine appointment. But people have found workarounds – a practice that is likely to continue. These actions – such as traveling to neighboring states to secure the medicine or sending it to a friend’s house or mailbox elsewhere – may carry the risk of criminal charges, again depending on the specifics of state law.
Abortion rights activists are also concerned that states that ban abortion could go even further and criminalize travel to another state to have an abortion, although this is an untested legal limit and is likely to be tied. in court.
In his speech, Biden took a firm stand on the issue, saying that nothing in the court’s decision prevented a woman living in a state that prohibits abortion from traveling to a state that allowed it. “Women must remain free to travel safely to another state to seek the care they need,” he said, adding that his administration “will defend this basis.” He also noted that doctors in states that continue to allow abortions can provide abortions to women in other jurisdictions.
4. How will this affect doctors’ ability to provide care?
In many countries that ban abortions, obstetricians, emergency physicians, and all types of physicians caring for pregnant women are likely to be subject to the law and face criminal charges if they provide abortion services.
This will have a severe effect on reproductive health care, Dr. Nicky Zeit, an obstetrician-gynecologist in Knoxville, Tennessee, recently told KHN. The Tennessee Act triggers that abortions are only allowed to prevent death or “to prevent a serious risk of significant and irreversible damage to a pregnant woman’s basic bodily function.”
“But exactly how much risk there should be is not clear,” Zite said. “Different doctors practicing in different institutions will have different interpretations of this law.”
There are also gray areas that the law does not address. In some very early pregnancies, the fertilized egg is placed outside the uterus – most commonly in the fallopian tube – a potentially life-threatening situation called an ectopic pregnancy. If this type of pregnancy continues, the woman may bleed to death.
Patients who have a miscarriage also sometimes need to take abortion medications or have dilation and curettage surgery – known as D&C – to remove tissue that remains in the uterus.
“The challenge is that the treatment of abortion and the treatment of miscarriage are exactly the same,” Dr. Sarah Prager told KHN recently. Prager is a professor of obstetrics and gynecology at the University of Washington in Seattle and an expert on early pregnancy loss.
Doctors may be reluctant to perform D&C for the treatment of miscarriages for fear that someone will accuse them of performing a secret abortion.
“Doctors should not be afraid of being criminalized for patient care,” Zite said. “I think there will be countless unintended consequences. I think people will lose their lives. I also think there will be people in terrible …
Add Comment