Reproductive Health Care Is At Risk in Post-Roe U.S.

OOn Friday, the Supreme Court declared that the Constitution doesn’t protect abortion rights. It overturned nearly 50 years of precedents and allowed states to end abortion at any time during pregnancy. The decision will result in devastating consequences for those who need abortion care. Many will now have to make a difficult choice. Can they travel to a state where abortion is allowed (which most people can’t afford), manage their abortion at home (which could come with legal risk), or are forced into a pregnancies against their will? This has both long-term and serious financial implications.

The coming destruction will not stop at those who are seeking to have an abortion. It is not possible to overrule Roe People who have suffered from pregnancy complications or loss will be also affected. In real-time, we are going to find out that abortion is illegal IsBecause without reproductive health care, all patients will be affected.

Continue reading: Anti-Abortion Pregnancy Clinics are Collecting Troves Data Which Could Be Used against Women

Texas is a grim example of the future. Starting in September, Texas’s SB8 effectively banned abortion after six weeks. Since then, some people have been denied treatment for miscarriages, ectopic pregnancies, and severe pregnancy complications–all because of the treatments’ relationship to abortion.

Medical interventions offered for missed or incomplete miscarriage—miscarriages where the body has not registered the pregnancy loss or has not fully expelled the tissue—involve the same medications and procedures used for abortion. There is only one difference: the fetal hearts have stopped before or after. Many doctors offer medication to these women to induce or increase contractions and speed up miscarriage. This is preferred by many patients over waiting as the body can take several weeks or even months to perform this procedure.

On June 23, 2022, supporters and foes of abortion rights gathered outside the U.S. Supreme Court Building in Washington D.C.

Shuran Huang for TIME

These medications were also prescribed for abortion in Texas, and many Texas pharmacies no longer dispense them after SB8. Pharmacists don’t know whether the patient will use the drug for abortion or miscarriage and are therefore refusing to fill prescriptions. The concern is that if the medication is used for abortion, the pharmacy or its employees could be liable for “aiding and abetting” an abortion under SB8 or for failing to adhere to Texas’s onerous regulation of medication abortion under SB4. Other countries ban abortion. We also know that doctors and surgeons may only offer medical or surgical intervention for missed miscarriages after weeks, months, or even years. This could prolong the miscarriage, increase medical risks and worsen the emotional and physical side effects.

Learn More: Meet the Pharmacist Expanding Access for Abortion Pills across the U.S.

Some Texas doctors stopped offering intervention for unplanned pregnancy losses due to SB8. One patient who had an ectopic baby, which means that the eggs were implanted outside of the uterus by fertilized egg, has traveled at least 12-15 hours to get care in another state. Some Texas providers are afraid to treat an ectopic pregnancy when fetal cardiac activity is present because it would terminate the pregnancy, albeit a non-viable pregnancy that threatens the pregnant person’s life. Some patients who are suffering from early labor in previable pregnancy, in which abortion is medically recommended to prevent infection, sepsis and death, also travel to other states when they need to get medical attention. In these cases, pregnancy loss is almost inevitable. Because the fetal heart is still beating, these pregnant women are either left with no choice but to wait or to travel outside of their state in order to get care. Women have been killed waiting for their fetal hearts to stop in countries such as Poland and Ireland, even though the laws contained an exception that would save the lives of the mothers.

Patients in abortion-legal states should be prepared to face increased scrutiny regarding their loss and possible criminalization. You cannot tell the difference in someone who caused an abortion using medication from someone who experienced a natural termination. Every loss of pregnancy is therefore suspect.

Continue reading: The State of Abortion Rights in the World

We already know that suspicion will be more likely with certain pregnant people—poor people and people of color. Negative pregnancy outcomes have been criminalized for decades. At most 75% of all prosecutions of conduct during pregnancy were against women of colour. Post RoeThis criminalization is expected to grow rapidly. The most likely people to suspect abortion are the ones who display the expected social grief response, and have sought treatment before and during pregnancy. People who have sought care before they become pregnant are far more likely than those without insurance to get educated or to be of white race to obtain medical coverage.

This scrutiny, whether conscious or unconscious, will have an impact on medical care for pregnant loss. The standards of care could be lowered if causation has been established. Pregnancy loss is a serious issue. It’s important to have high quality health care. Communication and empathy are essential. Research has shown that the loss of a baby is made more difficult by negative medical treatment. There are guidelines for caring, such as allowing parents to spend time with their child and letting them hold it. Past examples like Chelsea Becker have demonstrated that doctors can refuse proper care to a pregnant woman if they suspect the cause of their loss.

Continue reading: The World’s Most ‘Pro-Life’ Nations Offer a Grim Preview of America’s Future

Final note: As the crisis in treatment for pregnancies grows worse, so can we expect even more loss. Increased abortion rates mean that there are more pregnancies and therefore more losses. Pregnancies can end in miscarriage up to 25%, which could increase if the pregnancies aren’t terminated. Because many of these fetuses wouldn’t have been alive if they were not terminated for fetal abnormality, stillbirths and late miscarriage will rise. These additional abortions will most likely be in the marginalized population. Black and low-income women are most likely to have an abortion. The rates of miscarriage in these marginalized groups is also higher. Black women are at double risk for late miscarriage (between 10- 20 weeks), and stillbirth.

Because of stigma, abortion has been isolated from traditional healthcare systems for a long time. This creates the illusion that bans on abortion will only affect those who are seeking them. But that’s incorrect. We’re about to see just how widespread the effects will be.

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