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The USA and abortion, why 2023 may be crucial

After the suspension of the right to terminate a pregnancy, the battle goes on in the US. Acrimonia's New York correspondent explains what the current situation is and why, within 12 months, it can change radically


Abortion has marked American politics throughout 2022 and we can expect the same in 2023. Since the suspension of Roe v. Wade last June, millions of women in America have seen their right to abortion, hitherto federally guaranteed, pass into the hands of the individual state. The result? Termination of pregnancy soon became illegal in 13 of the US states, and in as many it is now very difficult to have recourse to it even a few weeks after conception. In Georgia, for example, abortion is only possible within six weeks, while Arizona goes up to 15. Despite the fact that 65% of adults in America are against this Supreme Court decision, the battle to reinstate Roe v. Wade is still a long one, and 2023 will be a crucial time to decide the outcome.

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How the suspension of Roe v. Wade came about:

In 1973, the Supreme Court had decided that abortion was a constitutional right, voting in favour of Norma McCorvey, known by her legal pseudonym Jane Roe. Roe sued lawyer Henry Wade, claiming that the Texas law preventing her from aborting what was her third pregnancy was unconstitutional. Falling within the Fourteenth Amendment's right to privacy, pregnancy termination was thus guaranteed for American women. Until last June, when the Court ruled in favour of Gov. Dobbs v. Jackson Women's Health Organisation, holding that the right to abortion is not 'rooted in the history or even the tradition of this Nation'.

The wave began in Mississippi. In a state where the population is close to 3 million, 51% of whom are women, the Jackson Women's Health Organisation has remained the only clinic to perform abortions. The resulting legal complications led it to clash with the government to continue helping Mississippi women terminate unwanted pregnancies last summer. Also supporting her is the Center for Reproductive Rights, the organisation most active nationwide in protecting women's reproductive rights. 

Clear from the outset that this case would have federal consequences whatever the outcome, Mississippi's appeal landed it in the hands of the Supreme Court. In an unexpected verdict, the Court sided with Gov. Dobbs, effectively ending Roe v. Wade after almost 50 years. 

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What happened next:

The country's reaction was a wave of astonishment, fear and protest. The Center for Reproductive Rights never stopped fighting to restore every American woman's right to an abortion, legally defying all state-imposed bans. The result was the suspension of the bans in at least 10 states, although some came back into force shortly afterwards.

The most visible effect is that in the latter part of 2022 thousands of clinics were closed or moved to states considered more abortion-friendly, leaving Mississippi, Louisiana and West Virginia, among others, completely without. But above all, it puts thousands of women in the position of having to travel to suspend their unwanted pregnancies, increasing the socio-economic problems associated with this practice. 

Another problematic consequence of the suspension of Roe v. Wade is the exponential increase in demand in abortion-friendly states. Many of the states that allow abortion to and protect practising doctors have in fact been swarmed by non-residents looking for someone who can help them get an abortion. In Illinois, only two months after the Supreme Court's decision, 86% of patients were from other states and the wait had risen to three weeks. A period of time that not all patients, sometimes at high health risk, can afford to wait.

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“The fastest way to restore Roe is to vote for the Democrats in the mid-term elections”, President Biden had said at the dawn of the decision. Criticised for not doing enough, it must nevertheless be acknowledged that Biden was right. Indeed, abortion was a key issue in November's Midterm Elections, so much so that some pundits believe it was the only deterrent to the “red wave”

that was predicted to favour the Republicans. Although the latter still won, they did so by too small a margin to leave them in absolute control of the House. Indeed, in Congress it will be a fight for (almost) every new legislature, at least until the presidential elections in 2024.

What will happen?

In short, the battle in Washington, in courts and in public squares across the country continues and will continue throughout 2023, a crucial year for deciding the reproductive rights of American women. But what can we expect to happen next?

The activists are pursuing the protest on several fronts and with several permutations. Primarily on the legal front, continuing to sue states or organisations that prevent abortion. Although not always successful, this strategy keeps abortion constantly at the centre of the public debate, thus raising awareness but above all slowing down or pausing the bans.

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At the same time, the many ongoing fundraisers help women in socio-economically disadvantaged circumstances to carry out their abortions, e.g. by paying travel expenses to abortion-friendly states. The consternation over the decision has been such that enormous resources have been mobilised across the country (and beyond) to ensure that women from states where they would be legally persecuted are instead protected and supported throughout the journey and even afterwards.

The latest news is only a few days old and could be a first victory for supporters of women's reproductive rights in the new year. The Food and Drug Administration (FDA) would indeed seem to be willing to make a change to the regulation that would allow abortion pills to be purchased in pharmacies. Until now, these pills, to be used during the first 10 weeks of pregnancy, could only be distributed by doctors in person or by mail. With this change, however, it could be the pharmacies themselves that distribute them without further prescriptions, incredibly increasing access.

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Despite this, thousands of women remain at risk, vulnerable to pregnancy-related complications. The University of Colorado Boulder released a study showing that maternity deaths would increase by 24% if a nationwide ban were imposed.

In a patchwork of legislatures and battles, the US will once again have to deal with its internal polarisation.


Images Manny Becerra on Unsplash