For decades while Roe v. Wade was the law of the land, abortion rights groups tried to shore up support for the decision by declaring that “abortion is medical care.”
Two years after the Supreme Court struck down constitutional abortion rights and just six months before the presidential election, this slogan is finally becoming a reality.
As the impact of abortion bans hit the news, the public discussion of abortion expanded to include the complexities of pregnancy and reproduction. The issues were no longer just about whether you could have an abortion, but whether you could get an abortion if you went into septic shock due to complications during pregnancy, whether you could find an obstetrician as many women fled from ban states, whether your hospital would send you home to bleed if you had a miscarriage, whether you could undergo IVF with your partner, etc.
The shift helps explain why record percentages of Americans are now declaring themselves independent policy supporters on abortion rights, especially among black voters, Democrats, women and voters between the ages of 18 and 29. Republican women increasingly believe the party’s opposition to abortion is too extreme, and Democrats are campaigning on the issue after years of running away from it.
“When Dobbs happened, I told friends, somewhat jokingly but not entirely jokingly, that America was going to be subjected to lengthy seminars on obstetrics,” said Elaine Kamark, a fellow at the Brookings Institution, referring to the Supreme Court decision that overturned Roe v. Wade.
Abortion opponents argue that stories of women facing medical complications are exaggerated and that women who genuinely need an abortion for medical reasons can get one through exceptions to the ban.
Still, an April poll found that 46% of voters had heard of a woman who had to travel across state lines to get a needed abortion because of pregnancy complications, up 11 points from September. In the most recent abortion case before the Supreme Court, justices on both ideological ends of the aisle forced Idaho lawyers to explain why the state could deny an abortion to a woman whose waters would not stop bleeding after breaking prematurely.
The Biden campaign has sent six women to battleground states in an effort to mobilize voters ahead of the two-year anniversary Monday of the Roe overturning decision. Five were denied abortions after going into septic shock, losing consciousness, miscarrying or discovering their fetus had no skull. The sixth was unable to complete her plan to have a second child through IVF because an Alabama Supreme Court ruling closed clinics in her state.
Tressa Andem, who has been polling people on abortion for 25 years, estimates that before the Supreme Court’s Dobbs v. Jackson decision that overturned Roe, fewer than 15 percent of the public considered abortion personally important — that is, the percentage of women who could become pregnant and would choose an abortion.
“It’s about pregnancy now. Everybody knows someone who’s had a baby, who wants to have a baby, or who might be pregnant,” she said. “For the vast majority of the population, this is a very personal issue.”
In her polls and focus groups, voters associate abortion with safety, health and medical concerns: 73% of independents who support abortion rights said stories of women nearly dying because of abortion bans would influence their voting behavior.
“People used to say that politicians want to control our bodies,” she says, “but now we see that politicians shouldn’t be involved in medical decisions. They don’t have medical expertise. They make the laws, but the laws aren’t based on medicine or science.”
Americans are generally hazy on the finer points of reproduction: When Andem asked adults in an August 2020 poll whether it was true that most women get their period on the first of each month, 75% gave the right answer (i.e., wrong), but a notable 21% said they didn’t know. Two months after Dobbs’ poll, 22% of adults said they didn’t know whether eggs in women’s ovaries have shells (they don’t).
But over the past two years, more women have spoken out publicly and on social media about pregnancy complications that could have led to or have led to abortions, including many with experiences similar to those of model Chrissy Teigen, who announced in September 2022 that she belatedly realized that a procedure she had described in previous social media posts as a miscarriage at 20 weeks pregnant was in fact an abortion due to pregnancy complications.
Abortion opponents have countered by trying to distinguish between “selective abortion” for unwanted pregnancies (which they want to ban) and “separation of the mother and fetus” in medical emergencies (the medical procedure is the same).
“Rather than giving women the facts they deserve, pro-life Democrats are using fear mongering to advance their extreme anti-abortion agenda,” said Marjorie Dannenfelser, president of Susan B. Anthony Pro-Life USA.
Still, anti-abortion efforts to establish that life begins at conception have exacerbated concerns about how an abortion ban would affect common medical procedures. Republican lawmakers rushed to defend IVF after the Southern Baptist Convention voted against it this month. Men and women at the convention tearfully recounted how IVF has helped them add to their families and pleaded with other church members to support the procedure.
Opponents have long charged that abortion is something irresponsible women do for birth control or because they value their careers more than having children. “Shifting the focus to the dangers that abortion bans pose to pregnant women makes it easier for Americans to talk about abortion,” said Reva Siegel, a Yale constitutional law professor who has written extensively about the U.S. abortion conflict.
It’s not just that stories about pregnancy complications are getting more airtime: technology and criminal laws are changing the landscape, she says.
Abortion is currently out of reach for millions of women, especially the poor, but women with unwanted pregnancies can use home tests that can detect the pregnancy early or order abortion pills online.
But women with pregnancy complications face new hurdles. Before Roe legalized abortion nationwide in 1973, the law was more tolerant of what was considered a “therapeutic abortion.” Doctors, often in private practice, could perform abortions in good faith. Even the Southern Baptist Convention supported abortion in cases of fetal abnormalities or when a woman’s physical or mental health was at risk.
Now, the threat of prosecution, $100,000 fines and loss of medical licenses discourages doctors and hospital systems from treating women with pregnancy complications. In some states, lawyers often make the decisions.
“People are starting to realize how much of an impact this has beyond so-called abortion care,” said Dr. Nisha Verma, a Georgia multifamily planning expert and fellow at the American College of Obstetricians and Gynecologists who has testified before Congress.
In Georgia, she said, more voters opposed the state’s law banning abortions after six weeks of pregnancy because it was explained to them that it meant two weeks after the average woman’s period is late, not six weeks after conception, as her partner believed. Some voters believe six weeks means six weeks after a woman realizes she’s pregnant, she said.
“We don’t want to single out any one type of abortion as being valuable,” Dr. Verma said, but she added, “‘Our body, our choice’ — we’ve been doing that for a long time, and it hasn’t worked. The historic message of our movement is meaningful, but for people who struggle with the complexities of abortion — the majority of Americans — it can be deeply divisive.”
