2023-06-23 13:43:55
Valentina Oropeza Colmenares* – @orovalentiBBC News World
3 hours
The abortion access map in the United States has changed dramatically in the past year.
Of the 50 states that make up the country, 14 totally prohibit abortion, indicates Abortion Finder, a directory of sexual and reproductive health services in the United States.
Another 12 impose restrictions in a range that covers from week 6 to 26 of gestation, as well as limitations on access to abortion services. In eight of them, the absolute or severe prohibition remains blocked by decisions of federal judges.
Light restrictions apply in five states, while in 20 states, plus Puerto Rico and Washington DC, abortion is legal in advanced stages of pregnancy or with no limits on the weeks of pregnancy.
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A right of half a century
On June 24, 2022, the US Supreme Court struck down the constitutional protection of the right to abortion, backed by a landmark 1973 ruling known as Roe v. Wade.
After protecting this right for nearly 50 years, the high court issued its ruling in Dobbs v. the women’s health organization Jackson, with which he delegated to courts and state authorities the power to restrict or protect access to the termination of pregnancy, a decision that affects approximately 36 million women of reproductive age in the US.
The measure led to three fundamental changes: first, the south of the country became a vast field of abortion restrictions, which prevent women living in those states from legally undergoing the procedure.
Second, it sparked legal disputes between governors who passed restrictive laws and judges who blocked those decisions in state supreme courts and put the new bans on hold, in some cases temporarily and in others indefinitely.
Finally, it motivated the states that preserve the right to abortion to promote broader protection clauses, as a way to counteract the restrictive trend in other localities.
image copyrightEPA
Caption,
Activists for and against abortion rally in front of the Supreme Court in Washington DC
Weeks of pregnancy and exceptions
From a legal perspective, the restrictions on abortion are applied according to two parameters: the limit week of the pregnancy in which it can be performed and the exceptions, which authorize the procedure in cases of rape, incest, risk to the life of the mother and her health. or if fetal survival is unfeasible.
“No restriction based on the number of weeks responds to medical criteria,” says epidemiologist Liza Fuentes, director of research for equity in health access at the Boston Medical Center.
Depending on the state, the current restrictions occur from weeks 6, 12, 15, 18, 20, 22, 24, 26, 27 and 28 of gestation.
Abortion has become one of the most polarized debates between Democrats and Republicans, with opposing views on principles such as the right to life or women’s reproductive rights.
For this reason, a heated discussion is expected in the electoral race for the presidency of the United States in 2024.
Below we analyze the most important changes that have occurred in access to abortion in the US You can click on the maps to display information for each state.
the red desert
Among the states that impose the most restrictions on abortion, 14 prohibit the procedure in all or with few exceptions. These are Alabama, Arkansas, North Dakota, South Dakota, Idaho, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee, Texas, West Virginia, and Wisconsin.
Most of them are in the southern United States.
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Wisconsin is the most extreme case. All abortion services were suspended due to an old law that absolutely prohibits the termination of pregnancy and that state authorities can enforce.
North Dakota, for example, allows exceptions for rape and incest, but only up to the sixth week of pregnancy.
In Idaho, a federal judge blocked part of the law that prohibits abortion, authorizing doctors to perform the procedure in emergencies to protect the life of the patient.
In addition, health care providers sued the state attorney general in April after he wrote a legal opinion calling for a ban on Idaho doctors from referring patients to other states that have abortion services.
In the Texas case, not only medical personnel who perform abortions can be sued, but also family members, friends, or anyone who helps the patient achieve the procedure.
A Texas federal judge took the strategy to eliminate access to abortion one step further by suspending the Food and Drug Administration’s (FDA) approval of mifepristone, one of the most widely used abortion pills. used in the US together with misoprostol.
However, the Supreme Court ruled in favor of the use of the pill and halted the restriction, at least temporarily, after the Joe Biden administration filed an emergency petition with the highest court to stop the ban.
The Texas initiative was a trial that comes close to one of the goals of anti-abortion groups in the US: to win passage of a federal law banning abortion throughout the country.
Marjorie Dannenfelser, president of the largest anti-abortion organization in the US, Susan B. Anthony Pro-Life America, has said her group hopes to win commitment from Republican presidential hopefuls to federal legislation banning abortion by except after the 15th week of gestation.
image copyrightGetty Images
Caption,
Protests against the repeal of Roe vs. Wade spread across the country.
The state of Georgia, also in the south of the country, prohibits abortion from the sixth week, while Nebraska condemns it after the 12th week and Florida from the 15th.
Florida Gov. Ron DeSantis signed a new law in April banning abortion after the sixth week, a move that experts see as an almost absolute restriction, since many women are still unaware that they are pregnant by that date.
The measure has not gone into effect and is being evaluated by the Florida Supreme Court.
In addition, DeSantis signed the controversial Heartbeat Protection Act, which prohibits abortions if a heartbeat can be detected in the fetus.
“The map that we currently see in the United States means that many people do not have the power to decide about pregnancy. There are people forced to carry on even if they do not want to or cannot face it,” says epidemiologist Liza Fuentes.
He cautions that statistics indicate that one-third of women in the United States will have an abortion before the age of 45. Therefore, in their opinion, access to pregnancy termination constitutes a primary health service.
image copyrightCourtesy of Liza Fuentes
Caption,
Liza Fuentes investigates inequities in access to healthcare in the US at the Boston Medical Center.
Based on her research, Fuentes affirms that the lack of access to doctors and clinics that offer abortions in the southern United States deepens inequality and especially penalizes black, Latino, and undocumented women, for being more vulnerable and having less economic resources and social support to face the search for a procedure in another state.
“The cost of abortion is one of the biggest barriers to access. This situation forces the person to request permission to be absent from work and travel to other states, pay for hotels and nannies who stay with the older children,” he explains.
“It is a logistics that many cannot assume.”
The Guttmacher Institute, which researches sexual and reproductive health and rights policies around the world, points out that an abortion in the first trimester of pregnancy costs an average of US$550 in the US, about half the monthly income of a person who lives below the federal poverty line.
The legal battles
Court decisions block the ban on abortion in eight states: Arizona, South Carolina, Indiana, Iowa, Montana, Ohio, Utah and Wyoming, according to monitoring by the US newspaper The New York Times.
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In Arizona, for example, state law allows the procedure up to the 15th week of pregnancy. However, an appeals court blocked an attempt to apply a law written in 1864, which prohibits abortion in all cases and establishes penalties of between two and five years in prison for the doctor who performs the procedure without the life of the woman. mother is at risk.
In the case of South Carolina, state legislators approved a ban from the sixth week of pregnancy, which was temporarily blocked by a judge. At this time, abortion is permitted in the state until the 22nd week of gestation.
One of the restrictions that apply in South Carolina is that abortion pills cannot be delivered by mail or prescribed by telemedicine, as is the case in states that protect abortion rights.
The only possibility is to administer the medication personally.
image copyrightReuters
Caption,
Access to abortion pills has also been restricted in some states.
“When the doctor is not completely sure if the procedure is legal or not, he prefers not to do it because nobody wants to lose their medical license,” warns Fuentes.
In these contexts, “physicians fear that emergencies during pregnancy are not enough to justify an abortion under the law. It is more difficult to define when the patient’s life is at risk and when it is not.”
According to Fuentes, legal ambiguity or confusion can also lead state prosecutors to open investigations against doctors.
Abortion Right Protections
Of the 25 states where abortion is legal beyond the 22nd week or without limits depending on the stage of pregnancy, Oregon, in the northwest of the country, is the locality with the greatest protections for the right to abortion.
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In Oregon, the procedure can be performed no matter what week of pregnancy, state Medicaid funds cover the surgery, qualified health professionals, not just doctors, are allowed to perform abortions, and anyone is protected from harassment to enter an abortion clinic, indicates monitoring by the Guttmacher Institute.
In other states, abortion is authorized until the fetus is viable, usually between 24 and 26 weeks of gestation.
In New York, abortion was legalized in 1970, three years before Roe v. Wade. After the repeal of the sentence last year, the interruption of pregnancy continues to be considered a basic health right and guarantees are offered to avoid discrimination of patients who require medical service.
In response to the Dobbs ruling, late last year the California Supreme Court added new protections for reproductive freedom, including abortion, to the state Constitution.
On the other hand, in the territory of Puerto Rico the right to access abortion is maintained during the first and second trimesters of pregnancy.
Liza Fuentes explains that a positive effect of the restrictions is that they have led to improvements in the states committed to the right to abortion, by approving new guarantees that include legal protection for doctors.
An emblematic case is Minnesota, bordering Canada, where all restrictions were repealed as they were considered unconstitutional.
For its part, the Biden government has promoted measures to eliminate the Hyde Amendment, a federal regulation that prohibits using public money to finance abortions, except in the case of incest or rape.
* With the collaboration of Camilla Costa and the Visual Journalism team.
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