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Ross Douthat

The Case Against Abortion

By Ross Douthat

Opinion Columnist

A striking thing about the American abortion debate is how little abortion itself is actually debated. The sensitivity and intimacy of the issue, the mixed feelings of so many Americans, mean that most politicians and even many pundits really don’t like to talk about it.

The mental habits of polarization, the assumption that the other side is always acting with hidden motives or in bad faith, mean that accusations of hypocrisy or simple evil are more commonplace than direct engagement with the pro-choice or pro-life argument.

And the Supreme Court’s outsize role in abortion policy means that the most politically important arguments are carried on by lawyers arguing constitutional theory, at one remove from the real heart of the debate.

But with the court set this week to hear Dobbs v. Jackson Women’s Health Organization, a direct challenge to Roe v. Wade, it seems worth letting the lawyers handle the meta-arguments and writing about the thing itself. So this essay will offer no political or constitutional analysis. It will simply try to state the pro-life case.

At the core of our legal system, you will find a promise that human beings should be protected from lethal violence. That promise is made in different ways by the Constitution and the Declaration of Independence; it’s there in English common law, the Ten Commandments and the Universal Declaration of Human Rights. We dispute how the promise should be enforced, what penalties should be involved if it is broken and what crimes might deprive someone of the right to life. But the existence of the basic right, and a fundamental duty not to kill, is pretty close to bedrock.

There is no way to seriously deny that abortion is a form of killing. At a less advanced stage of scientific understanding, it was possible to believe that the embryo or fetus was somehow inert or vegetative until so-called quickening, months into pregnancy. But we now know the embryo is not merely a cell with potential, like a sperm or ovum, or a constituent part of human tissue, like a skin cell. Rather, a distinct human organism comes into existence at conception, and every stage of your biological life, from infancy and childhood to middle age and beyond, is part of a single continuous process that began when you were just a zygote.

We know from embryology, in other words, not Scripture or philosophy, that abortion kills a unique member of the species Homo sapiens, an act that in almost every other context is forbidden by the law.

This means that the affirmative case for abortion rights is inherently exceptionalist, demanding a suspension of a principle that prevails in practically every other case. This does not automatically tell against it; exceptions as well as rules are part of law. But it means that there is a burden of proof on the pro-choice side to explain why in this case taking another human life is acceptable, indeed a protected right itself.

One way to clear this threshold would be to identify some quality that makes the unborn different in kind from other forms of human life — adult, infant, geriatric. You need an argument that acknowledges that the embryo is a distinct human organism but draws a credible distinction between human organisms and human persons , between the unborn lives you’ve excluded from the law’s protection and the rest of the human race.

In this kind of pro-choice argument and theory, personhood is often associated with some property that’s acquired well after conception: cognition, reason, self-awareness, the capacity to survive outside the womb. And a version of this idea, that human life is there in utero but human personhood develops later, fits intuitively with how many people react to a photo of an extremely early embryo ( It doesn’t look human, does it? ) — though less so to a second-trimester fetus, where the physical resemblance to a newborn is more palpable.

But the problem with this position is that it’s hard to identify exactly what property is supposed to do the work of excluding the unborn from the ranks of humans whom it is wrong to kill. If full personhood is somehow rooted in reasoning capacity or self-consciousness, then all manner of adult human beings lack it or lose it at some point or another in their lives. If the capacity for survival and self-direction is essential, then every infant would lack personhood — to say nothing of the premature babies who are unviable without extreme medical interventions but regarded, rightly, as no less human for all that.

At its most rigorous, the organism-but-not-person argument seeks to identify some stage of neurological development that supposedly marks personhood’s arrival — a transition equivalent in reverse to brain death at the end of life. But even setting aside the practical difficulties involved in identifying this point, we draw a legal line at brain death because it’s understood to be irreversible, the moment at which the human organism’s healthy function can never be restored. This is obviously not the case for an embryo on the cusp of higher brain functioning — and if you knew that a brain-dead but otherwise physically healthy person would spontaneously regain consciousness in two weeks, everyone would understand that the caregivers had an obligation to let those processes play out.

Or almost everyone, I should say. There are true rigorists who follow the logic of fetal nonpersonhood toward repugnant conclusions — for instance, that we ought to permit the euthanizing of severely disabled newborns, as the philosopher Peter Singer has argued. This is why abortion opponents have warned of a slippery slope from abortion to infanticide and involuntary euthanasia; as pure logic, the position that unborn human beings aren’t human persons can really tend that way.

But to their credit, only a small minority of abortion-rights supporters are willing to be so ruthlessly consistent. Instead, most people on the pro-choice side are content to leave their rules of personhood a little hazy, and combine them with the second potent argument for abortion rights: namely, that regardless of the precise moral status of unborn human organisms, they cannot enjoy a legal right to life because that would strip away too many rights from women.

A world without legal abortion, in this view, effectively consigns women to second-class citizenship — their ambitions limited, their privacy compromised, their bodies conscripted, their claims to full equality a lie. These kind of arguments often imply that birth is the most relevant milestone for defining legal personhood — not because of anything that happens to the child but because it’s the moment when its life ceases to impinge so dramatically on its mother.

There is a powerful case for some kind of feminism embedded in these claims. The question is whether that case requires abortion itself.

Certain goods that should be common to men and women cannot be achieved, it’s true, if the law simply declares the sexes equal without giving weight to the disproportionate burdens that pregnancy imposes on women. Justice requires redistributing those burdens, through means both traditional and modern — holding men legally and financially responsible for all the children that they father and providing stronger financial and social support for motherhood at every stage.

But does this kind of justice for women require legal indifference to the claims of the unborn? Is it really necessary to found equality for one group of human beings on legal violence toward another, entirely voiceless group?

We have a certain amount of practical evidence that suggests the answer is no. Consider, for instance, that between the early 1980s and the later 2010s the abortion rate in the United States fell by more than half . The reasons for this decline are disputed, but it seems reasonable to assume that it reflects a mix of cultural change, increased contraception use and the effects of anti-abortion legal strategies, which have made abortion somewhat less available in many states, as pro-choice advocates often lament.

If there were an integral and unavoidable relationship between abortion and female equality, you would expect these declines — fewer abortions, diminished abortion access — to track with a general female retreat from education and the workplace. But no such thing has happened: Whether measured by educational attainment, managerial and professional positions, breadwinner status or even political office holding, the status of women has risen in the same America where the pro-life movement has (modestly) gained ground.

Of course, it’s always possible that female advancement would have been even more rapid, the equality of the sexes more fully and perfectly established, if the pro-life movement did not exist. Certainly in the individual female life trajectory, having an abortion rather than a baby can offer economic and educational advantages.

On a collective level, though, it’s also possible that the default to abortion as the solution to an unplanned pregnancy actually discourages other adaptations that would make American life friendlier to women. As Erika Bachiochi wrote recently in National Review , if our society assumes that “abortion is what enables women to participate in the workplace,” then corporations may prefer the abortion default to more substantial accommodations like flexible work schedules and better pay for part-time jobs — relying on the logic of abortion rights, in other words, as a reason not to adapt to the realities of childbearing and motherhood.

At the very least, I think an honest look at the patterns of the past four decades reveals a multitude of different ways to offer women greater opportunities, a multitude of paths to equality and dignity — a multitude of ways to be a feminist, in other words, that do not require yoking its idealistic vision to hundreds of thousands of acts of violence every year.

It’s also true, though, that nothing in all that multitude of policies will lift the irreducible burden of childbearing, the biological realities that simply cannot be redistributed to fathers, governments or adoptive parents. And here, too, a portion of the pro-choice argument is correct: The unique nature of pregnancy means that there has to be some limit on what state or society asks of women and some zone of privacy where the legal system fears to tread.

This is one reason the wisest anti-abortion legislation — and yes, pro-life legislation is not always wise — criminalizes the provision of abortion by third parties, rather than prosecuting the women who seek one. It’s why anti-abortion laws are rightly deemed invasive and abusive when they lead to the investigation of suspicious-seeming miscarriages. It’s why the general principle of legal protection for human life in utero may or must understandably give way in extreme cases, extreme burdens: the conception by rape, the life-threatening pregnancy.

At the same time, though, the pro-choice stress on the burden of the ordinary pregnancy can become detached from the way that actual human beings experience the world. In a famous thought experiment, the philosopher Judith Jarvis Thomson once analogized an unplanned pregnancy to waking up with a famous violinist hooked up to your body, who will die if he’s disconnected before nine months have passed. It’s a vivid science-fiction image but one that only distantly resembles the actual thing that it describes — a new life that usually exists because of a freely chosen sexual encounter, a reproductive experience that if material circumstances were changed might be desired and celebrated, a “disconnection” of the new life that cannot happen without lethal violence and a victim who is not some adult stranger but the woman’s child.

One can accept pro-choice logic, then, insofar as it demands a sphere of female privacy and warns constantly against the potential for abuse, without following that logic all the way to a general right to abort an unborn human life. Indeed, this is how most people approach similar arguments in other contexts. In the name of privacy and civil liberties we impose limits on how the justice system polices and imprisons, and we may celebrate activists who try to curb that system’s manifest abuses. But we don’t (with, yes, some anarchist exceptions) believe that we should remove all legal protections for people’s property or lives.

That removal of protection would be unjust no matter what its consequences, but in reality we know that those consequences would include more crime, more violence and more death. And the anti-abortion side can give the same answer when it’s asked why we can’t be content with doing all the other things that may reduce abortion rates and leaving legal protection out of it: Because while legal restrictions aren’t sufficient to end abortion, there really are a lot of unborn human lives they might protect.

Consider that when the State of Texas put into effect this year a ban on most abortions after about six weeks, the state’s abortions immediately fell by half. I think the Texas law, which tries to evade the requirements of Roe v. Wade and Planned Parenthood v. Casey by using private lawsuits for enforcement, is vulnerable to obvious critiques and liable to be abused. It’s not a model I would ever cite for pro-life legislation.

But that immediate effect, that sharp drop in abortions, is why the pro-life movement makes legal protection its paramount goal.

According to researchers at the University of Texas at Austin, who surveyed the facilities that provide about 93 percent of all abortions in the state, there were 2,149 fewer legal abortions in Texas in the month the law went into effect than in the same month in 2020.

About half that number may end up still taking place, some estimates suggest, many of them in other states. But that still means that in a matter of months, more than a thousand human beings will exist as legal persons, rights-bearing Texans — despite still being helpless, unreasoning and utterly dependent — who would not have existed had this law not given them protection.

But, in fact, they exist already. They existed, at our mercy, all along.

The Times is committed to publishing a diversity of letters to the editor. We’d like to hear what you think about this or any of our articles. Here are some tips . And here’s our email: [email protected] .

Follow The New York Times Opinion section on Facebook , Twitter (@NYTOpinion) and Instagram .

Ross Douthat has been an Opinion columnist for The Times since 2009. He is the author of several books, most recently, “The Deep Places: A Memoir of Illness and Discovery.” @ DouthatNYT • Facebook

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5.1: Arguments Against Abortion

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• Page ID 35918

• Nathan Nobis & Kristina Grob
• Morehouse College & University of South Carolina Sumter via Open Philosophy Press

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We will begin with arguments for the conclusion that abortion is generally wrong , perhaps nearly always wrong . These can be seen as reasons to believe fetuses have the “right to life” or are otherwise seriously wrong to kill.

5.1.1 Fetuses are human

First, there is the claim that fetuses are “human” and so abortion is wrong. People sometimes debate whether fetuses are human , but fetuses found in (human) women clearly are biologically human : they aren’t cats or dogs. And so we have this argument, with a clearly true first premise:

Fetuses are biologically human.

All things that are biologically human are wrong to kill.

Therefore, fetuses are wrong to kill.

The second premise, however, is false, as easy counterexamples show. Consider some random living biologically human cells or tissues in a petri dish. It wouldn’t be wrong at all to wash those cells or tissues down the drain, killing them; scratching yourself or shaving might kill some biologically human skin cells, but that’s not wrong; a tumor might be biologically human, but not wrong to kill. So just because something is biologically human, that does not at all mean it’s wrong to kill that thing. We saw this same point about what’s merely biologically alive.

This suggests a deficiency in some common understandings of the important idea of “human rights.” “Human rights” are sometimes described as rights someone has just because they are human or simply in virtue of being human .

But the human cells in the petri dish above don’t have “human rights” and a human heart wouldn’t have “human rights” either. Many examples would make it clear that merely being biologically human doesn’t give something human rights. And many human rights advocates do not think that abortion is wrong, despite recognizing that (human) fetuses are biologically human.

The problem about what is often said about human rights is that people often do not think about what makes human beings have rights or why we have them, when we have them. The common explanation, that we have (human) rights just because we are (biologically) human , is incorrect, as the above discussion makes clear. This misunderstanding of the basis or foundation of human rights is problematic because it leads to a widespread, misplaced fixation on whether fetuses are merely biologically “human” and the mistaken thought that if they are, they have “human rights.” To address this problem, we need to identify better, more fundamental, explanations why we have rights, or why killing us is generally wrong, and see how those explanations might apply to fetuses, as we are doing here.

It might be that when people appeal to the importance and value of being “human,” the concern isn’t our biology itself, but the psychological characteristics that many human beings have: consciousness, awareness, feelings and so on. We will discuss this different meaning of “human” below. This meaning of “human” might be better expressed as conscious being , or “person,” or human person. This might be what people have in mind when they argue that fetuses aren’t even “human.”

Human rights are vitally important, and we would do better if we spoke in terms of “conscious-being rights” or “person-rights,” not “human rights.” This more accurate and informed understanding and terminology would help address human rights issues in general, and help us better think through ethical questions about biologically human embryos and fetuses.

5.1.2 Fetuses are human beings

Some respond to the arguments above—against the significance of being merely biologically human—by observing that fetuses aren’t just mere human cells, but are organized in ways that make them beings or organisms . (A kidney is part of a “being,” but the “being” is the whole organism.) That suggests this argument:

Fetuses are human beings or organisms .

All human beings or organisms are wrong to kill.

Therefore, fetuses are wrong to kill, so abortion is wrong.

The first premise is true: fetuses are dependent beings, but dependent beings are still beings.

The second premise, however, is the challenge, in terms of providing good reasons to accept it. Clearly many human beings or organisms are wrong to kill, or wrong to kill unless there’s a good reason that would justify that killing, e.g., self-defense. (This is often described by philosophers as us being prima facie wrong to kill, in contrast to absolutely or necessarily wrong to kill.) Why is this though? What makes us wrong to kill? And do these answers suggest that all human beings or organisms are wrong to kill?

Above it was argued that we are wrong to kill because we are conscious and feeling: we are aware of the world, have feelings and our perspectives can go better or worse for us —we can be harmed— and that’s what makes killing us wrong. It may also sometimes be not wrong to let us die, and perhaps even kill us, if we come to completely and permanently lacking consciousness, say from major brain damage or a coma, since we can’t be harmed by death anymore: we might even be described as dead in the sense of being “brain dead.” 10

So, on this explanation, human beings are wrong to kill, when they are wrong to kill, not because they are human beings (a circular explanation), but because we have psychological, mental or emotional characteristics like these. This explains why we have rights in a simple, common-sense way: it also simply explains why rocks, microorganisms and plants don’t have rights. The challenge then is explaining why fetuses that have never been conscious or had any feeling or awareness would be wrong to kill. How then can the second premise above, general to all human organisms, be supported, especially when applied to early fetuses?

One common attempt is to argue that early fetuses are wrong to kill because there is continuous development from fetuses to us, and since we are wrong to kill now , fetuses are also wrong to kill, since we’ve been the “same being” all along. 11 But this can’t be good reasoning, since we have many physical, cognitive, emotional and moral characteristics now that we lacked as fetuses (and as children). So even if we are the “same being” over time, even if we were once early fetuses, that doesn’t show that fetuses have the moral rights that babies, children and adults have: we, our bodies and our rights sometimes change.

A second attempt proposes that rights are essential to human organisms: they have them whenever they exist. This perspective sees having rights, or the characteristics that make someone have rights, as essential to living human organisms. The claim is that “having rights” is an essential property of human beings or organisms, and so whenever there’s a living human organism, there’s someone with rights, even if that organism totally lacks consciousness, like an early fetus. (In contrast, the proposal we advocate for about what makes us have rights understands rights as “accidental” to our bodies but “essential” to our minds or awareness, since our bodies haven’t always “contained” a conscious being, so to speak.)

Such a view supports the premise above; maybe it just is that premise above. But why believe that rights are essential to human organisms? Some argue this is because of what “kind” of beings we are, which is often presumed to be “rational beings.” The reasoning seems to be this: first, that rights come from being a rational being: this is part of our “nature.” Second, that all human organisms, including fetuses, are the “kind” of being that is a “rational being,” so every being of the “kind” rational being has rights. 12

In response, this explanation might seem question-begging: it might amount to just asserting that all human beings have rights. This explanation is, at least, abstract. It seems to involve some categorization and a claim that everyone who is in a certain category has some of the same moral characteristics that others in that category have, but because of a characteristic (actual rationality) that only these others have: so, these others profoundly define what everyone else is . If this makes sense, why not also categorize us all as not rational beings , if we are the same kind of beings as fetuses that are actually not rational?

This explanation might seem to involve thinking that rights somehow “trickle down” from later rationality to our embryonic origins, and so what we have later we also have earlier , because we are the same being or the same “kind” of being. But this idea is, in general, doubtful: we are now responsible beings, in part because we are rational beings, but fetuses aren’t responsible for anything. And we are now able to engage in moral reasoning since we are rational beings, but fetuses don’t have the “rights” that uniquely depend on moral reasoning abilities. So that an individual is a member of some general group or kind doesn’t tell us much about their rights: that depends on the actual details about that individual, beyond their being members of a group or kind.

To make this more concrete, return to the permanently comatose individuals mentioned above: are we the same kind of beings, of the same “essence,” as these human beings? If so, then it seems that some human beings can be not wrong to let die or kill, when they have lost consciousness. Therefore, perhaps some other human beings, like early fetuses, are also not wrong to kill before they have gained consciousness . And if we are not the same “kind” of beings, or have different essences, then perhaps we also aren’t the same kind of beings as fetuses either.

Similar questions arise concerning anencephalic babies, tragically born without most of their brains: are they the same “kind” of beings as “regular” babies or us? If so, then—since such babies are arguably morally permissible to let die, even when they could be kept alive, since being alive does them no good—then being of our “kind” doesn’t mean the individual has the same rights as us, since letting us die would be wrong. But if such babies are a different “kind” of beings than us, then pre-conscious fetuses might be of a relevantly different kind also.

So, in general, this proposal that early fetuses essentially have rights is suspect, if we evaluate the reasons given in its support. Even if fetuses and us are the same “kind” of beings (which perhaps we are not!) that doesn’t immediately tell us what rights fetuses would have, if any. And we might even reasonably think that, despite our being the same kind of beings as fetuses (e.g., the same kind of biology), we are also importantly different kinds of beings (e.g., one kind with a mental life and another kind which has never had it). This photograph of a 6-week old fetus might help bring out the ambiguity in what kinds of beings we all are:

In sum, the abstract view that all human organisms have rights essentially needs to be plausibly explained and defended. We need to understand how it really works. We need to be shown why it’s a better explanation, all things considered, than a consciousness and feelings-based theory of rights that simply explains why we, and babies, have rights, why racism, sexism and other forms of clearly wrongful discrimination are wrong, and , importantly, how we might lose rights in irreversible coma cases (if people always retained the right to life in these circumstances, presumably, it would be wrong to let anyone die), and more.

5.1.3 Fetuses are persons

Finally, we get to what some see as the core issue here, namely whether fetuses are persons , and an argument like this:

Fetuses are persons, perhaps from conception.

Persons have the right to life and are wrong to kill.

So, abortion is wrong, as it involves killing persons.

The second premise seems very plausible, but there are some important complications about it that will be discussed later. So let’s focus on the idea of personhood and whether any fetuses are persons. What is it to be a person ? One answer that everyone can agree on is that persons are beings with rights and value . That’s a fine answer, but it takes us back to the initial question: OK, who or what has the rights and value of persons? What makes someone or something a person?

Answers here are often merely asserted , but these answers need to be tested: definitions can be judged in terms of whether they fit how a word is used. We might begin by thinking about what makes us persons. Consider this:

We are persons now. Either we will always be persons or we will cease being persons. If we will cease to be persons, what can end our personhood? If we will always be persons, how could that be?

Both options yield insight into personhood. Many people think that their personhood ends at death or if they were to go into a permanent coma: their body is (biologically) alive but the person is gone: that is why other people are sad. And if we continue to exist after the death of our bodies, as some religions maintain, what continues to exist? The person , perhaps even without a body, some think! Both responses suggest that personhood is defined by a rough and vague set of psychological or mental, rational and emotional characteristics: consciousness, knowledge, memories, and ways of communicating, all psychologically unified by a unique personality.

A second activity supports this understanding:

Make a list of things that are definitely not persons . Make a list of individuals who definitely are persons . Make a list of imaginary or fictional personified beings which, if existed, would be persons: these beings that fit or display the concept of person, even if they don’t exist. What explains the patterns of the lists?

Rocks, carrots, cups and dead gnats are clearly not persons. We are persons. Science fiction gives us ideas of personified beings: to give something the traits of a person is to indicate what the traits of persons are, so personified beings give insights into what it is to be a person. Even though the non-human characters from, say, Star Wars don’t exist, they fit the concept of person: we could befriend them, work with them, and so on, and we could only do that with persons. A common idea of God is that of an immaterial person who has exceptional power, knowledge, and goodness: you couldn’t pray to a rock and hope that rock would respond: you could only pray to a person. Are conscious and feeling animals, like chimpanzees, dolphins, cats, dogs, chickens, pigs, and cows more relevantly like us, as persons, or are they more like rocks and cabbages, non-persons? Conscious and feeling animals seem to be closer to persons than not. 13 So, this classificatory and explanatory activity further supports a psychological understanding of personhood: persons are, at root, conscious, aware and feeling beings.

Concerning abortion, early fetuses would not be persons on this account: they are not yet conscious or aware since their brains and nervous systems are either non-existent or insufficiently developed. Consciousness emerges in fetuses much later in pregnancy, likely after the first trimester or a bit beyond. This is after when most abortions occur. Most abortions, then, do not involve killing a person , since the fetus has not developed the characteristics for personhood. We will briefly discuss later abortions, that potentially affect fetuses who are persons or close to it, below.

It is perhaps worthwhile to notice though that if someone believed that fetuses are persons and thought this makes abortion wrong, it’s unclear how they could coherently believe that a pregnancy resulting from rape or incest could permissibly be ended by an abortion. Some who oppose abortion argue that, since you are a person, it would be wrong to kill you now even if you were conceived because of a rape, and so it’s wrong to kill any fetus who is a person, even if they exist because of a rape: whether someone is a person or not doesn’t depend on their origins: it would make no sense to think that, for two otherwise identical fetuses, one is a person but the other isn’t, because that one was conceived by rape. Therefore, those who accept a “personhood argument” against abortion, yet think that abortions in cases of rape are acceptable, seem to have an inconsistent view.

5.1.4 Fetuses are potential persons

If fetuses aren’t persons, they are at least potential persons, meaning they could and would become persons. This is true. This, however, doesn’t mean that they currently have the rights of persons because, in general, potential things of a kind don’t have the rights of actual things of that kind : potential doctors, lawyers, judges, presidents, voters, veterans, adults, parents, spouses, graduates, moral reasoners and more don’t have the rights of actual individuals of those kinds.

Some respond that potential gives the right to at least try to become something. But that trying sometimes involves the cooperation of others: if your friend is a potential medical student, but only if you tutor her for many hours a day, are you obligated to tutor her? If my child is a potential NASCAR champion, am I obligated to buy her a race car to practice? ‘No’ to both and so it is unclear that a pregnant woman would be obligated to provide what’s necessary to bring about a fetus’s potential. (More on that below, concerning the what obligations the right to life imposes on others, in terms of obligations to assist other people.)

5.1.5 Abortion prevents fetuses from experiencing their valuable futures

The argument against abortion that is likely most-discussed by philosophers comes from philosopher Don Marquis. 14 He argues that it is wrong to kill us, typical adults and children, because it deprives us from experiencing our (expected to be) valuable futures, which is a great loss to us . He argues that since fetuses also have valuable futures (“futures like ours” he calls them), they are also wrong to kill. His argument has much to recommend it, but there are reasons to doubt it as well.

First, fetuses don’t seem to have futures like our futures , since—as they are pre-conscious—they are entirely psychologically disconnected from any future experiences: there is no (even broken) chain of experiences from the fetus to that future person’s experiences. Babies are, at least, aware of the current moment, which leads to the next moment; children and adults think about and plan for their futures, but fetuses cannot do these things, being completely unconscious and without a mind.

Second, this fact might even mean that the early fetus doesn’t literally have a future: if your future couldn’t include you being a merely physical, non-conscious object (e.g., you couldn’t be a corpse: if there’s a corpse, you are gone), then non-conscious physical objects, like a fetus, couldn’t literally be a future person. 15 If this is correct, early fetuses don’t even have futures, much less futures like ours. Something would have a future, like ours, only when there is someone there to be psychologically connected to that future: that someone arrives later in pregnancy, after when most abortions occur.

A third objection is more abstract and depends on the “metaphysics” of objects. It begins with the observation that there are single objects with parts with space between them . Indeed almost every object is like this, if you could look close enough: it’s not just single dinette sets, since there is literally some space between the parts of most physical objects. From this, it follows that there seem to be single objects such as an-egg-and-the-sperm-that-would-fertilize-it . And these would also seem to have a future of value, given how Marquis describes this concept. (It should be made clear that sperm and eggs alone do not have futures of value, and Marquis does not claim they do: this is not the objection here). The problem is that contraception, even by abstinence , prevents that thing’s future of value from materializing, and so seems to be wrong when we use Marquis’s reasoning. Since contraception is not wrong, but his general premise suggests that it is , it seems that preventing something from experiencing its valuable future isn’t always wrong and so Marquis’s argument appears to be unsound. 16

In sum, these are some of the most influential arguments against abortion. Our discussion was brief, but these arguments do not appear to be successful: they do not show that abortion is wrong, much less make it clear and obvious that abortion is wrong.

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Article Contents

I. the hope that abortion bans will deter abortion, ii. the hope that abortion bans will send a message, iii. the hope that abortion bans will be competently implemented and enforced, iv. conclusion, acknowledgements, ethics approval statement.

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What will and won’t happen when abortion is banned

Katharine & George Alexander Professor of Law, Santa Clara University School of Law.

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• Figures & tables
• Supplementary Data

Michelle Oberman, What will and won’t happen when abortion is banned, Journal of Law and the Biosciences , Volume 9, Issue 1, January-June 2022, lsac011, https://doi.org/10.1093/jlb/lsac011

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For the past 50 years, abortion opponents have fought for the power to ban abortion without little attention to how things might change when they won. The battle to make abortion illegal has been predicated on three nebulous assumptions about how abortion bans work. First, supporters believe banning abortion will deter it. Second, they hope bans will send a message about abortion—specifically, that abortion is immoral. And third, they expect bans to be competently implemented and enforced. Drawing on empirical work from within and outside of the U.S., this Article offers an evidence-based assessment of each of these assumptions. Part One examines the question of deterrence by exploring findings from countries with relatively high and relatively low abortion rates. After explaining why restrictive abortion laws alone do not reduce aggregate abortion rates, I consider the matter of individual deterrence. By identifying those most likely to be deterred by U.S. abortion bans, I illustrate how abortion bans intersect with structural inequalities to disproportionately impact poor women of color and their children. Part Two tests the idea that abortion bans send a message. I consider the bans’ meaning in context with U.S. laws and policies affecting families, exposing the difference between laws discouraging abortion, and those encouraging childbirth. Then, drawing from literature on the expressive function of the law, I assess the limits on the message-sending capacity of abortion bans in a society divided over abortion and over its commitment to children living in poverty. Part Three turns to the expectation that abortion bans will be competently enforced, noting the legitimacy struggles arising from law enforcement patterns, along with the administrative challenges inherent in overseeing the various exceptions to abortion bans. This article concludes by considering why the consequences and limitations of abortion bans should matter to supporters and opponents, alike.

For the past 50 years, abortion opponents have fought for the power to ban abortion without paying much mind to the details of how things might change when they won. The battle to make abortion illegal has been waged over a surprisingly nebulous assumption that banning abortion would, in itself, lead to meaningful changes in the practice of abortion in America. It has been a policy based on hopes and prayers, rather than on actual evidence about how restrictive abortion laws work in practice.

When the law on the ‘books’ changes in the United States, what might the law on the ground look like? Drawing on empirical work from within and outside of the USA, this article offers an evidence-based answer to the question of what will and would not happen where abortion is banned.

In the spirit of full disclosure, like almost everyone who engages with the abortion war, I have a bias: I am an unambivalent supporter of abortion rights. Nonetheless, I strive in this article to maintain a tone that I hope will permit readers who disagree with me to hear my message. I do so because those on all sides of our abortion war should care about it. For 50 years, the USA abortion war has been fought almost exclusively around the issue of legalization. 1 Yet all evidence suggests the changes likely to be wrought by banning abortion should leave even ardent supporters of abortion bans not just disappointed, but profoundly disturbed by their downstream consequences.

The question of how abortion bans work in practice is a live one among abortion-rights advocates, with many, (including myself), working to identify what happens, and to whom, so as to permit advocates and policy makers to mitigate their harsh impact on the vulnerable. 2 By contrast, anti-abortion Americans who have spent decades working to enact such laws have paid relatively little attention to how things actually change when abortion is illegal. Instead, they have rested their support for outlawing abortion on three general assumptions about how abortion bans will work. First, they believe banning abortion will deter it. 3 Second, they hope the bans will send a message about abortion—specifically, that abortion is immoral. 4 And third, they expect the laws will be competently implemented and enforced. 5

This article interrogates each of these expectations. Part One begins its consideration of the question of deterrence by exploring research from countries with relatively high and relatively low abortion rates. This comparison offers powerful evidence that restrictive abortion laws alone do not reduce abortion rates. But while outlawing abortion is unlikely to cause an aggregate decline in abortion rates, bans will cause some to carry to term pregnancies they might otherwise have aborted. 6 This section concludes with an examination of how abortion bans intersect with structural inequalities to disproportionately impact poor women of color and their children–already the most vulnerable and marginalized Americans.

Part Two tests the assumption that outlawing abortion will send a message that abortion is morally wrong, thereby helping to foster a culture that rejects abortion as an option. This section considers the messages sent by US abortion bans by placing them in context with our laws and policies that inform when and whether people seek abortions. Then, drawing from literature on the expressive function of the law, this section explores the practical and symbolic limits on the message-sending capacity of abortion bans in a society divided over abortion and over its commitments to children living in poverty.

Part Three moves to the expectation that abortion bans will be competently enforced. Here, I examine the legitimacy struggles arising from law enforcement patterns, along with the administrative challenges inherent in overseeing the various exceptions to abortion bans.

This article concludes with a consideration of why the consequences and limitations of abortion bans should matter to supporters and opponents, alike.

Abortion opponents anticipate that banning abortion will deter it. That said, they are not overly sanguine about this hope; anti-abortion advocates acknowledge that abortions will continue to take place, even if illegal. 7 But their support for abortion bans rests firmly on the expectation that there will be fewer of them, once abortion is a crime. 8 In this section, I explore the question of deterrence, first considering the population-wide impact of bans on abortion rates, and then describing the Americans most likely to be deterred by abortion bans.

I.A. Deterrence, in the Aggregate

To think about whether abortion can be deterred by outlawing it, we must begin by reflecting on what leads people to have abortions. Abortion demand is driven by a host of factors—health status, relationship status, job status—but the most commonly cited concern is lack of money. 9 Half of all US abortions go to the 13 per cent of Americans living below the poverty line–which in 2022, means living on less than $13,590. 10 Those living in poverty or near poverty make up a full 76 per cent of abortions every year. 11 These are people whose abortion decisions are motivated, at least in part, because they cannot afford the costs of child rearing. 12

Rather than focusing on reducing abortion demand by offsetting the costs of having children, abortion bans aim to deter abortion solely by reducing access to legal abortion. Even a cursory glance at worldwide abortion rates suggests that strategy might not work. Abortion rates vary dramatically by region. In Latin America, (home to countries with the world’s strictest abortion bans), we find some of the highest abortion rates in the world: 32 abortions for every 1000 women. 13 At the other end of the spectrum, Western Europe, (with relatively liberal abortion laws), has the world’s lowest abortion rates: only 12 abortions per 1000 women. 14

The variation in abortion rates is best understood as an artifact of variation in rates of unintended pregnancy. 15 The single biggest predictor of abortion rates is not the legal status of abortion, but rather, the percentage of pregnancies that occur among those who were not looking to have a baby. In 2014, the most recent year for which data is available, 44 per cent of pregnancies globally were unintended. 53 per cent of those unintended pregnancies ended in abortion. 16 Rates of both unintended pregnancy and abortion vary by a country’s wealth status. In the world’s wealthier nations, over the past quarter century, rates of unintended pregnancies dropped by 30 per cent, triggering a decline in abortion rates from 46 abortions per 1000 women of reproductive age to an average of 27. 17 By contrast, over the same time frame in the developing world, unintended pregnancy rates fell by only 16 per cent, while abortion rates remained static. 18

Like other wealthy countries, U.S. abortion rates have dropped significantly in recent decades. 19 The decline is evident across almost every demographic in the country—younger, older, Northern, Southern. With one exception: abortion rates have remained constant among the poorest Americans. 20 This finding underscores the significance of unintended pregnancy in driving abortion rates: nearly half of all pregnancies in the United States are unintended—a higher rate than in many other developed countries. 21 These rates vary dramatically by class: a poor woman in the USA is more than five times as likely as an affluent woman to have an unintended pregnancy. 22

The single most effective way to help people avoid unwanted pregnancies, thereby deterring abortion, is by increasing contraception rates. When the Affordable Care Act mandated insurance coverage for contraception, the unintended pregnancy rate dropped from 44.7 to 37.9 per cent. 23 And yet, the anti-abortion movement has opted to oppose efforts to increase access to contraception. 24 Indeed, abortion opponents vigorously fought the Affordable Care Act’s birth control mandate, which the Supreme Court ultimately struck down in 2014. 25

If the goal of banning abortions is to deter them, a strategy that fails to focus on reducing unintended pregnancy seems limited, at best. But even if one accepts that abortion opponents are too ambivalent about promoting contraception to center the goal of deterring abortion by reducing unwanted pregnancy, the plan to deter abortion by banning it is flawed for a second reason. Specifically, owing to the ready availability of abortion medicines, abortion bans cannot effectively restrict access to a safe, effective, and affordable means to end a pregnancy.

The widespread availability of abortion medicines has completely transformed the world of illegal abortion. Unlike the pre-Roe era, medication abortion solves the problem of finding a doctor to perform an illegal abortion, while simultaneously reducing the health risks. 26 The most common and widely available abortion medicine is misoprostol. 27 Although less effective than the FDA-approved combination of mifepristone and misoprostol typically used in medical abortions in the USA, misoprostol alone causes an abortion in approximately 90 per cent of cases. 28 Efforts to restrict access to misoprostol are complicated for two reasons. It is both cheap and easy to manufacture, costing only pennies to make, and it also is an important life-saving medicine. 29 Indeed, the World Health Organization lists misoprostol as an ‘essential medicine,’ owing in part to its vital role in reducing deaths from postpartum hemorrhages, miscarriages, and illegal abortions. 30

There is a robust international market in misoprostol across the world today—particularly in countries where abortion is strictly banned. 31 Even in Central America, which boasts the world’s strictest abortion bans, one in three pregnancies ends in abortion, largely induced by medicines purchased online or on the street. 32 Americans familiar with the black market in opioids should have little trouble imagining how a market in abortion medicines will proliferate, where abortion is banned. As is all too evident from the scope of the opiate problem, it is unrealistic to think the government can prosecute away the expanding market in abortion medicines. 33

Outlawing abortion may lead to a short-term decline in US abortion rates, while people adjust to new market conditions. 34 But as we learn from the experiences of countries throughout the world, this decline is unlikely to be sustained. If anything, given the availability of reliable online information and buying options, it should take far less time for people to adapt to accessing illegal abortion than was true for alcohol access after Prohibition. 35

I.B. Deterrence, in the Specific

Even if abortion bans are unlikely to cause an aggregate decline in abortion rates–at least not independently of other trends 36 –we can predict that they will cause some to carry to term pregnancies they might otherwise have aborted. 37 In fact, we have a surprisingly clear picture of those who the bans are most likely to deter: they will be disproportionately young, poor, Black, and brown women. Abortion bans come as one in a long list of factors that circumscribe the reproductive lives and life options of these Americans. 38 They are more likely to experience unintended pregnancy, and where abortion is outlawed, they are more likely to struggle with accessing abortion, whether by traveling to a legal jurisdiction, or by identifying reliable information about how to safely end an unwanted pregnancy with abortion medications. 39

Those who support abortion bans on deterrence grounds have yet to fully grapple with what happens to those for whom abortion, legal or otherwise, is out of reach. The standard response is to promote the solution of placing newborn babies for adoption. Justice Amy Coney Barrett nodded to this viewpoint at oral argument in the Dobbs case, correcting the assertion that abortion bans amount to ‘forced motherhood’ by noting that safe haven laws permit them to surrender their newborns without legal consequences. 40 Adoption proponents point to the ways in which open adoptions have become the norm, hopeful that the prospect of staying involved in their baby’s life will encourage more people to place them for adoption. 41 Banning abortion, as they see it, can be a ‘win-win-win’ situation, in which the baby survives, the mother gets to go on with her life, and a married couple or family gets to raise the child. 42

Yet all available evidence suggests that banning abortion is unlikely to transform adoption from an outlier into a commonplace response to unwanted pregnancy. Even in the years prior to Roe, when the stigma of unwed motherhood led some facing pregnancy to place their babies, only 9 per cent of women chose adoption. 43 Much of that rate was driven by white women, because the two-parent family norm was less entrenched among Black and brown Americans. Today, the stigma is gone: 40 per cent of all children are born out of wedlock. 44 When faced with an unintended pregnancy, fewer than 5 per cent of people seriously consider adoption, and of those, fewer than 2 per cent ultimately place their children with adoptive families. 45

The best indication of what is likely to happen to those unable to access abortion is found in the Turnaway study, a 10-year longitudinal investigation of the impact of being denied an abortion. 46 That study followed hundreds of women who sought abortions, but were turned away because they were beyond the clinic’s gestational limits. 47 Fully 91 per cent of them opted to raise their child. 48

The Turnaway study also tells us about the consequent intensification of poverty for these families:

[C]hildren of women who are denied an abortion had greater odds (72 vs 55%) of living in poverty compared to children of women who received a wanted abortion. Similarly, existing children were more likely (87 vs 70%) to live in a household in which their mother is not able to afford necessary living expenses such as food, housing, and transportation compared to children of women who received a wanted abortion. 49

As we look to understand what happens when an abortion ban ‘works’ by deterring abortion, the only question is how broad a lens to use. More than one in three single-mother families lived in poverty in 2016. 50 Poverty is not color-blind. Instead, far more women of color live in poverty than do their white counterparts: close to 25 per cent of all American Indian or Alaskan native and 20 per cent of all Black and Hispanic women live in poverty, compared to only 9 per cent of their white counterparts. 51

So severe are the downstream consequences for children born into poverty that the American Academy of Pediatrics issued a statement decrying the short and long-term consequences of the ‘medicalization of poverty’:

Children who experience poverty, particularly during early life or for an extended period, are at risk of a host of adverse health and developmental outcomes through their life course. Poverty has a profound effect on specific circumstances, such as birth weight, infant mortality, language development, chronic illness, environmental exposure, nutrition, and injury. Child poverty also influences genomic function and brain development…. Children living in poverty are at increased risk of difficulties with self-regulation and executive function, such as inattention, impulsivity, defiance, and poor peer relationships. Poverty can make parenting difficult, especially in the context of concerns about inadequate food, energy, transportation, and housing. Child poverty is associated with lifelong hardship. Poor developmental and psychosocial outcomes are accompanied by a significant financial burden, not just for the children and families who experience them but also for the rest of society…. 52

We should read these statistics as a forecast. To the extent abortion bans deter abortion, we will likely see a disproportionate increase in the number of poor families of color experiencing the devastating consequences of living in poverty. Abortion bans work by leveraging existing inequalities. 53

Abortion opponents are of two minds about how to respond to the poor predicted outcomes for those who opt to raise children after being unable to access abortion. Small numbers of advocates–largely drawn from the volunteer ranks of pregnancy support or ‘crisis pregnancy’ centers–advocate helping women who are in desperate straits by offering housing, counseling, job training, and other support. 54 But the dominant voice of the anti-abortion movement–those advocates engaged in political activism and law reform, rather than direct service–focuses not on supporting poor mothers, but instead, on promoting adoption. 55

The suggestion that adoption is the optimal solution to a poorly timed pregnancy is as convenient as it is naïve. It allows abortion opponents to avoid a reckoning with consequences of having made the Republican party their political home. 56 The GOP’s historical and ongoing objection to family-friendly government policies 57 will make it hard, in the years to come, for abortion opponents to gain much traction for laws aimed at blunting the crushing impact of poverty on those whom the bans deter from having abortions.

Those who support abortion bans do not rest their support solely on the expectation that such laws will deter abortion. Instead, abortion opponents often invoke the belief that changing the law will send a message, thereby promoting culture change. 58 This section first considers the nature of that message, and then turns to whether it will be received.

It is helpful, when considering the message sent by outlawing abortion, to note the difference between an anti-abortion message (one that condemns abortion) and a pro-natal message (one that urges people to have babies). This distinction is easiest to observe when contrasting U.S. laws with those of countries that actively encourage childbearing.

Consider the case of Israel, which makes abortion a crime unless the person can prove to an official ‘pregnancy termination committee’ that they qualify for one of the statute’s exceptions. 59 This law would send a message that, outside of exceptional circumstances, abortion is wrong. 60 But it also exists alongside a host of laws and policies that encourage people to have children. 61 In Israel, there is guaranteed paid maternity leave—you can leave your job for 26 weeks, still get paid, and your employer cannot fire you. 62 Parents enjoy access to local neighborhood, government-subsidized day care. 63 In addition to tax deductions, the Israeli government pays everyone—rich and poor alike—a small monthly allowance for each child under eighteen. 64

In addition to the ways in which these policies help offset some of the most immediate costs associated with having a child, they send a message about how the government feels not just about abortion but also about babies. Israel’s laws send a message that the government wants people to have babies.

By contrast, US laws reflect little interest in encouraging people to have babies, particularly ones they cannot afford to raise. There is no paid parental leave, and no job security at all beyond the first 12 weeks of unpaid leave. 65 There is no child allowance. The Covid-related child income tax break, which reduced child poverty by 30 per cent, was permitted to lapse after a single year. 66 The goal of providing universal access to quality day care and preschool remains a pipedream. 67 The federal assistance program, Temporary Assistance to Needy Families, is so under-funded that no state’s subsidy amounts to more than 60 per cent of the federal poverty line, with the result that even in states with relatively generous monthly allocations, families cannot afford modest rent. 68

Those who believe abortion bans promote a culture of life might do well to recognize that any message sent by an abortion ban is necessarily entwined with the messages sent by government laws and policies that set the price of having a child. The message of an abortion ban on its own says little about embracing life, and instead merely suggests that abortion is wrong. 69

As to whether that message will be received, the answer is complicated. For all that, it is common to suggest the law can send messages, there is surprisingly little evidence for how it might do so. Professor Richard McAdams, one of the leading authorities on the ‘expressive function’ of the law, posits that an expressive law reveals the lawmakers’ beliefs, which in turn causes individuals to update their beliefs and ultimately to change their behaviors, usually in the direction of compliance. 70 He points to the example of indoor smoking bans by way of illustration. In the face of mounting evidence on the harmfulness of secondhand smoke, lawmakers enacted indoor smoking bans that served, in part, to send the message that tobacco was dangerous. In turn, these bans helped shift the culture away from smoking. 71

According to McAdams, smoking bans succeeded because lawmakers had a clear, credible message. But government credibility is not automatic; rather, it is earned. To send a message, government actors must offer some reason why the public should trust their conclusions. McAdams suggests the government earned credibility by persuading the public they were acting on data showing that the hazards of secondary smoke inhalation required nothing less. 72

Unlike smoking bans, abortion bans address themselves to a question of morality—one that cannot be settled by aggregated data or special expertise. A government hoping to persuade the public that abortion is immoral will struggle simply because it lacks the expertise needed to settle the question. 73

The challenge of sending a message by banning abortion is intensified by the impact of the ongoing battle over abortion’s legality. When it comes to the law’s ability to send a message, Professor McAdams notes, background noise can be fatal:

Individuals are constantly being bombarded by information from sources other than the law: the print media, Internet, social acquaintances, etc. For expression to change beliefs, there must be some factor that makes the legal signal strong enough to stand out against this background. 74

To send a message, abortion bans must compete for air time with a world of counter-messages. After all, the fight over abortion does not end with abortion bans. Together with the likelihood that abortion remains commonplace, even where banned, and remains legal in almost half the country, the message-sending capacity of abortion bans is more akin to that of marijuana bans than to indoor smoking bans. 75

At the end of the day, perhaps the most that can be said for the message-sending capacity of abortion bans is that, where popularly embraced by an anti-abortion electorate, the bans might contribute to a broader cultural message that abortion is wrong. As Katrina Kimport forcefully demonstrates in her book, No Real Choice , the ‘abortion as killing’ narrative can combine with structural constraints like legal barriers and cost to render abortion ‘unchoosable.’ 76

The final set of expectations harbored by those who support outlawing abortion involves tacit baseline assumptions about how the law will work, in practice. Specifically, supporters assume that abortion bans will be competently implemented and enforced—that the laws will have integrity. Competent implementation and enforcement are not abstract ideals, but rather, are necessary preconditions for a law to be considered a legitimate exercise of state authority. The failure to competently implement an abortion ban will undercut its legitimacy, thereby undermining both the law’s capacity to deter abortion and also its ability to send a message.

To understand the practical considerations relevant to enforcing abortion bans, begin by noting what is required in order to implement them. The standard form of US abortion bans includes a general prohibition, accompanied by a small number of exceptions. 77 This structure gives rise to two implementation and enforcement questions, both of which will determine whether the laws are ultimately seen as legitimate exercises of government authority. When and how will prosecutors endeavor to enforce the bans, and by what mechanisms will states evaluate cases involving exceptions to the bans?

Let us examine each of these in turn.

III.A. Enforcing Abortion Bans

Supporters of abortion bans have given relatively little thought to the question of how abortion laws will be enforced. In late 2021, movement leader Marjorie Dannenfelser, President of the Susan B. Anthony List (a nonprofit that supports pro-life politicians) explained how she views the question of enforcement:

[M]y view, and the view of the entire movement—without any exception that I’m aware of—is that the doctor, the one who has been planning to break the law, is the guilty party. The law is enforced against that person, not the woman. 78

But illegal abortion today need not involve a doctor or any third party besides an overseas pharmacy, outside the easy reach of US laws. 79 Given abortion medicines, the reality is that there are no doctors to prosecute.

When abortion becomes a crime, the question of who is the criminal will require an answer. And rather than being answered by movement leaders, the decision will rest in the hands of locally-elected prosecutors. No county can afford to prosecute every crime–far from it–so local District Attorneys set priorities when enforcing the law. 80 Their choices may be informed by many factors: staff resources, strength of evidence, heinousness of crime, perception of public will, or say, pro-choice or anti-abortion sentiment. As Judge Stephanos Bibas notes, there is no check on ‘idiosyncratic prosecutorial discretion.’ 81

A quick review of abortion prosecutions both historically and today helps us understand what idiosyncratic abortion prosecutions might look like. Historian Leslie Regan’s work documents the episodic nature of abortion prosecutions in the years prior to Roe , showing how they tended to be sporadic—an occasional crackdown, motivated by a zealous prosecutor, rather than a comprehensive effort at enforcement. 82

A similar pattern is seen today in places where abortion is outlawed. For example, consider El Salvador, which bans abortion without exception. In the 10 years from 2000–2010, there were 129 prosecutions. 83 This number suggests enforcement is relatively rare—just over 10 prosecutions per year—when, by the government’s own estimates, the country sees tens of thousands of abortions every year. 84 But there is a pattern to the prosecutions. Those charged with abortion crimes are drawn from the most vulnerable, marginalized sectors of society. 85 Almost half were illiterate; only a quarter had attended high school. 86

In the U.S. we already see a version of this pattern: abortion-related prosecutions are brought by zealous prosecutors 87 , and they disproportionately target Black and brown women. 88 The work of National Advocates for Pregnant Women helps us to understand the scope of abortion-related prosecutions in the years since Roe legalized abortion. They have tracked 1600 USA such cases since 1973. 89 These cases involve a range of allegations, linked by the common thread of alleged harm to a pregnancy. 90 The prosecutions overwhelmingly target poor people, and in particular, poor Black pregnant women. Of 413 cases arising from 1973 to 2005, 71 per cent involved low income women, of whom 59 per cent were women of color, with 52 per cent identifying as Black. 91

These patterns in abortion-related prosecutions tell us two important things. First, we can expect abortion bans to be enforced against those who end their own pregnancies. 92 And second, abortion prosecutions are likely to target the most marginalized, vulnerable members of society—those whom prosecutors view, or at least believe others will be willing to view, not as victims but rather, as villains. 93

Supporters of abortion should stop insisting that bans won’t be enforced against women, and should start figuring out what to do about the fact that, when abortion bans are enforced, the defendants will likely be Black and brown. It is, of course, unfair to make one subset of the population pay the price for acts that go unpunished when committed by others. Furthermore, as we learn from racial disparities in drug law enforcement, such patterns undermine the legitimacy of the law, and have downstream corrosive effects both on the people disproportionately targeted by the law and on society as a whole. 94

III.B. The Return of Conditional Abortion Access

Setting aside the question of prosecution, abortion laws also must be fully implemented in the regulatory sense of the word. A law that limits abortion access to patients with qualifying conditions presupposes an adjudicatory mechanism for determining eligibility. And barring a dramatic evisceration of the right to life for those who are pregnant, every state will have to make at least one exception to their abortion bans, for life-threatening pregnancies. 95

How will a patient establish their right to an abortion when they are experiencing a life-threatening pregnancy?

There are a variety of models by which states might screen such claims, ranging from relatively formal proceedings, such as those seen in cases involving termination of government benefits, to loosely structured processes like school disciplinary hearings. 96 Indeed, we already have a model for abortion-related adjudications in the judicial bypass system, by which minors can seek permission to end a pregnancy without parental involvement. 97

Each model is fraught, when it comes to screening for abortion eligibility. Formal judicial hearings pose challenges in terms of accuracy (there is surprisingly little agreement on what constitutes a life-threatening pregnancy) 98 and efficiency (given the urgent, technical nature of the inquiry). 99 A judge could not conceivably rule on such petitions without expert testimony, which raises numerous questions about process and evidence.

Prior to Roe , rather than ask judges to decide these cases, states delegated the determination to doctors, essentially leaving the medical profession to devise its own ways of complying with the law. 100 For reasons ranging from lack of consensus about qualifying conditions, 101 to concern over the legal implications of their decisions (which might trigger prosecution on the one hand, or a wrongful death suit if the pregnant patient dies, on the other), 102 doctors eschewed this responsibility. By the mid-20th century, hospitals around the country used so-called ‘therapeutic abortion committees’ to establish eligibility. 103 These committees were marked by inconsistent outcomes, stemming from a lack of consensus over what constituted a ‘valid’ reason for terminating a pregnancy, whether legally or morally. 104 Rather than standardizing the application of the law, the committee process facilitated ad hoc decision-making. 105

As states set about banning abortion, it is urgent that they erect a scientifically sound, impartial process by which to evaluate cases involving potentially life-saving abortions. Given that the vast majority of Americans support abortion in cases of life-threatening pregnancy, we can expect an enormous outcry from all quarters in the case of an incompetent oversight process, let alone a highly publicized death. 106

Yet the struggle to define what constitutes a life-threatening pregnancy, (or depending upon the law, a qualifying rape or fetal anomaly), is just the start. Which parties’ interests will be represented at these adjudicatory proceedings; however, they are configured? Will the pregnant patient be entitled to a lawyer? 107 Will the fetus? If unhappy with the outcome, can either side appeal? Will there be an expedited appeals process? By what criteria will adjudicators be chosen? Will these be adversarial proceedings, with experts from the state and from the pregnant patient’s medical team, or will the patient’s doctor’s testimony suffice? How will the government determine whose interests it represents: those of the patient in peril, or those of the fetus?

These are serious questions, made all the more so because they implicate vital interests and therefore trigger Constitutional due process rights. 108 Surely, there will be litigation over the answers in the years to come. But what is interesting about these questions is not so much their answers, but instead, the reality that they demand answers now. We are past the time when those who support banning abortion can respond to such questions about how the laws will be implemented with vague references to ‘traditional means of enforcement.’ 109 And the quality of those answers matters because inconsistent, incompetent or otherwise corrupt law enforcement cannot help but undermine the legitimacy of abortion bans.

We have spent half a century reckoning with abortion largely in abstractions, fighting over rights rather than focusing on the people whose lives are affected by those rights. If nothing else, the impact of abortion bans seems likely to put human faces on the abortion war. And if we stay true to the patterns laid out in this essay, those faces will be disproportionately poor, Black and brown women and children.

Abortion bans are not color blind.

It has become common for abortion opponents to invoke allegations of eugenics and racism when talking about abortion rates among Black Americans. 110 That rhetoric–already contested 111 –will become strained as the country witnesses the actual racist impact of abortion bans: their disparate impact on poor Black families, coupled with the disparate rates of prosecution of Black women for acts that go largely unpunished when committed by whites. 112

By bringing into focus the struggles facing the most vulnerable among us, abortion bans have the potential to transform the abortion war by forcing a direct engagement with the structural forces driving abortion, poverty, and racism. We are approaching a moment of truth for advocates on all sides of the abortion war.

For advocates of abortion rights, there will be a reckoning with the question of whether being pro-choice simply means supporting the right to abortion, rather than a commitment to working to offset the forces that constrain all reproductive options–including having a child. As Sister Song, a leading voice of the reproductive justice movement puts it, the commitment is to support, ‘the human right to maintain personal bodily autonomy, have children, not have children, and parent the children we have in safe and sustainable communities.’ 113 As the impact of abortion bans brings structural inequality into sharp focus, will pro-choice movement leaders stay focused on legalizing abortion, or will the movement commit to this more robust understanding of reproductive autonomy?

For abortion opponents, the question is whether the term ‘pro-life’ has come to mean anything beyond one’s support for abortion bans. The years ahead likely will pose an existential challenge for people who have supported abortion bans, but who cannot help but be disturbed by the ways in which they fall short of expectations. Perhaps this result will embolden those who care deeply about deterring abortion, and find them laboring to craft policies that might actually help those contemplating abortion to continue their pregnancies. 114

Certainly, anti-abortion movement leaders are aware of the need to do something proactive in response to the impact of abortion bans on the poor. As Marjorie Dannenfelser, of the Susan B. Anthony Fund, put it: ‘Speaking for the pro-life movement, which is obviously attempting to lead Republicans, we absolutely, without question, have a responsibility to serve the needs of women and children as we pass ambitious laws. There’s no question about it.’ At the same time, Dannenfelser is aware that such policies are unlikely to fly, at least not in states dominated by a Republican party that has long opposed family-friendly government programs. 115

There’s a quote I keep on my desk these days: “How will we go when we’re faced with this? I don’t think it’s predetermined, and a great human moral drama is being played out in front of us.” 116 It is from a historian of pandemics, written in the early days of Covid-19. I keep it there because it speaks to me as we navigate the era of abortion bans. There is comfort in the invitation to step back and notice that we are in a time of high moral drama, in which things are in flux. But there is also, within it, a call to action. “How will we go when we’re faced with this?”

For helpful suggestions and conversation, I’m grateful to Diana Greene Foster, Julia Hejduk, Carole Joffe, Katrina Kimport, Larry Marshall, and my anonymous reviewers. I was particularly lucky to work with Jenai Howard (SCU Law, 2022), who provided outstanding research assistance. All errors are my own.

Human Subjects Research for this article was approved by Santa Clara University’s IRB, Protocol 17-03-950.

Research was funded in part by a Hackworth Grant (Santa Clara University, Markkula Ethics Center).

See Mary Ziegler, After Roe: The Lost History Of The Abortion Debate (2015), for a rich history of the anti-abortion movement in the early years after Roe v. Wade, illustrating among other things the way the anti-abortion movement shifted its focus from efforts to support pregnant women to the narrow issue of criminalization.

See generally Michelle Oberman, How Abortion Laws Do and Don’t Work , 36 Wis. J. L. Gender & Soc’y 163 (2022); see also Michelle Oberman, Her Body, Our Laws: On The Front Lines Of The Abortion War, From El Salvador To Oklahoma (2018); Diana Greene Foster, The Turnaway Study: Ten Years, A Thousand Women, And The Consequences Of Having Or Being Denied An Abortion (2020) [hereinafter, greene foster, the turnaway study]; Ushma Upadhyay, Alice F. Cartwright, and Daniel Grossman, Barriers to Abortion Care and Incidence of Attempted Self-Managed Abortion Among Individuals Searching Google for Abortion Care: A National Prospective Study , 106 Contraception 49 (2021); Lizzie Widdecombe, What Does an At-Home Abortion Look Like in 2021 , The New Yorker (Nov. 11, 2021), https://www.newyorker.com/news/news-desk/what-does-an-at-home-abortion-look-like-in-2021 (profiling self-managed abortion researcher, Abigail Aiken).

For example, see Ross Douthat, The Case Against Abortion , N.Y. Times (Nov. 30, 2021), https://www.nytimes.com/2021/11/30/opinion/abortion-dobbs-supreme-court.html (celebrating the impact of Texas’ S.B. 8, credited with causing a 93 per cent drop in the number of abortions taking place in the state).

See eg Richard Garnett, One Untrue Thing , Nat’l Rev. (Aug. 1, 2007), ( https://www.nationalreview.com/2007/08/one-untrue-thing-nro-symposium/ (‘The point of criminalization, after all, is not merely to put people in prison, or deter people from engaging in harmful behavior. It is, instead, to make a statement—a public statement, in the community’s voice—that certain actions, or certain harms caused, are morally blameworthy.’). See also Oberman, supra note 2, at 85–86 (quoting an anonymous Oklahoma state senator):

The purpose of the law is to stop abortion. To send a moral message. To get the message out via the law, to spark a debate in the population. The government’s responsibility is to give people education. It is up to the government to tell them that abortion is wrong. It’s not an acceptable solution.

This assumption is largely a tacit one, inherent in assertions about how abortion bans will be received by the public, and how they are likely to inspire others states to follow suit. See eg Issac Chotiner, The Pro-Life Movement Plans for a Future Without Roe , The New Yorker (Dec. 7, 2021), https://www.newyorker.com/news/q-and-a/the-pro-life-movement-plans-for-a-future-without-roe (interviewing Marjorie Dannenfelser, president of the Susan B. Anthony List, on her expectations for passing abortion bans in 30 states).

See Diane Greene Foster, Stop Saying That Making Abortion Illegal Won’t Stop People From Having Them , Rewire News Group (Oct. 4, 2018) [hereinafter Green Foster, Stop Saying ], https://rewirenewsgroup.com/article/2018/10/04/stop-saying-that-making-abortion-illegal-doesnt-stop-them/ ; see generally Greene Foster, The Turnaway Study, supra note 2.

See eg Stephanie Ranade Krider, Pro-life Advocates Focused on Legal Battles. They’re Not Enough to End Abortion , Wash. Post (Oct. 15, 2021), https://www.washingtonpost.com/outlook/pro-life-after-roe/2021/10/15/7e2a059e-2cf8-11ec-985d-3150f7e106b2_story.html (Krider, an abortion opponent, acknowledges that while ‘the end of Roe would be a victory and a cause for celebration for those…who oppose abortion, [it] would not end the practice nationwide.’).

See Douthat, supra note 3.

See Biggs, M. Antonia, Heather Gould & Diana Greene Foster, Understanding why Women Seek Abortions in the US , 13 BMC Women’s Health 1–13 (2013); see also Sophia Chae et al., Reasons Why Women Have Induced Abortions: A Synthesis of Findings From 14 Countries , 96 Contraception 233–41 (2017). (Analyzing data from 14 countries to identify the primary reasons given for seeking abortion, and finding that, although people often listed several reasons, the dominant reason involved socioeconomic concerns).

See Annual Update of the HHS Poverty Guideline, 87 Fed. Reg. 3315, 3316 (Jan. 21, 2021).

See Rachel K. Jones & Jenna Jerman, Population Group Abortion Rates and Lifetime Incidence of Abortion: United States, 2008–2014, 107 Am. J. Publ. Health 1904–909 (2017), https://ajph.aphapublications.org/doi/10.2105/AJPH.2017.304042 ; see also Abortion Rates by Income Level , Infographic , Guttmacher Inst. (Oct. 19, 2017), https://www.guttmacher.org/infographic/2017/abortion-rates-income .

More accurately, because almost 60% of those having an abortion already have at least one child, they cannot afford the costs of another child. Jerman J, Jones RK & Onda T, Characteristics of U.S. Abortion Patients in 2014 and Changes Since 2008 , Guttmacher Inst. (2016), https://www.guttmacher.org/report/characteristics-us-abortion-patients-2014 .

Bearak J et al., Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019 , 8 lancet global health 9 (2020).

An unintended pregnancy is one that occurred when a woman wanted to become pregnant in the future but not at the time she became pregnant (‘wanted later’) or one that occurred when she did not want to become pregnant then or at any time in the future (‘unwanted’). See Unintended Pregnancy in the United States , Guttmacher Inst. (Jan. 2017), https://www.guttmacher.org/fact-sheet/unintended-pregnancy-united-states . In recent years, this frame has been problematized by calling into view the reality that, for many people, pregnancies are not so much planned as they are responded to. That is to say, the relevant question is not whether it was intended, but whether it is wanted or unwanted. See Abigail R.A. Aiken, et al., Rethinking the Pregnancy Planning Paradigm: Unintended Conceptions or Unrepresentative Concepts? , 48 Perspect Sex Reprod Health 147–151 (2016).

See generally Unintended Pregnancy Rates Declined Globally from 1990 to 2014 , Guttmacher Inst. (Mar. 5, 2018), https://www.guttmacher.org/news-release/2018/unintended-pregnancy-rates-declined-globally-1990-2014 .

Between the 1990s and 2020, abortion rates declined by almost 40%. See Sabrina Tavernise, Why Women Getting Abortions Now Are More Likely to Be Poor , N.Y Times (July 9, 2019), https://www.nytimes.com/2019/07/09/us/abortion-access-inequality.html . In the years since 2010 alone, rates have declined by almost 20%. Elizabeth Nash & Joerg Dreweke, The U.S. Abortion Rate Continues to Drop: Once Again, State Abortion Restrictions Are Not the Main Driver , Guttmacher Inst. (Sept. 18, 2019), https://www.guttmacher.org/gpr/2019/09/us-abortion-rate-continues-drop-once-again-state-abortion-restrictions-are-not-main . Scholars are divided in their explanations for the decline, which vary from increasingly effective contraceptive practices to declines in rates of sexual activity. See Pam Belluck, America’s Abortion Rate Has Dropped to its Lowest Ever , N.Y. Times (Sept. 20, 2019), https://www.nytimes.com/2019/09/18/health/abortion-rate-dropped.html ; see also Diana Greene Foster, Dramatic Decreases in US Abortion Rates: Public Health Achievement or Failure? , 107 Am J. Public Health 1860 (2017); Alia E. Dastagir, Fewer Women are having abortions. Why? , USA Today (June 13, 2019), https://www.usatoday.com/story/news/nation/2019/06/13/abortion-law-fewer-women-having-abortions-why/1424236001/ ; Doug Stanglin, US Abortion Rate is at its Lowest, but Restrictive Laws aren’t the Likely Cause, Study Says , USA Today (Sept. 18, 2019), https://www.usatoday.com/story/news/nation/2019/09/18/number-of-abortions-us-drops-guttmacher-institute-study/2362316001/ .

See U.S. Abortion Rate Continues to Decline, Hits Historic Low, Guttmacher Inst. (Jan. 17, 2017), https://www.guttmacher.org/news-release/2017/us-abortion-rate-continues-decline-hits-historic-low .

See Guttmacher Inst., supra note 15. Although poor Americans have higher rates of unintended pregnancy for a range of reasons, central among them is that they struggle to access contraception. See Michele Troutman, Saima Rafique & Torie Comeaux Plowden, Are Higher Unintended Pregnancy Rates Among Minorities a Result of Disparate Access to Contraception? , Contracept Reprod Med 5, no. 16 (2020), https://doi.org/10.1186/s40834-020-00118-5 (describing the factors underlying the disparate rates of unintended pregnancy by race and class). One finds evidence of this struggle in the data on contraceptive use among sexually active women not seeking pregnancy. While 90% of those covered by private health insurance and 87% of those covered by Medicaid use contraception, that figure drops to 81% for those who have no insurance coverage. Megan L. Kavanaugh & Emma Pliskin, Use of Contraception Among Reproductive-aged Women in the United States , 2014 and 2016 , Guttmacher Inst. (July, 2020). On the cost of contraception, see Eliana Kosova, How Much Do Different Kinds of Birth Control Cost Without Insurance? , Nat’l Women’s Health Network (Nov. 17, 2017), https://nwhn.org/much-different-kinds-birth-control-cost-without-insurance/ (noting that the most effective methods, long-acting implants and devices, cost upwards of $800, and that oral contraceptives can cost up to $600 per year).

Cost is not the only barrier to contraception, ranging from cost to personal preferences. For example, Black women tend to report higher rates of dissatisfaction with existing contraceptive options, putting them at further disadvantage in terms of risk of unwanted pregnancy. Andrea V. Jackson, Deborah Karasek, Christine Dehlendorf, and Diana Greene Foster, Racial and Ethnic Differences in Women’s Preferences for Features of Contraceptive Methods , 93 Contraception 406–411 (2016).

See Colleen L. MacCallum-Bridges & Claire Margerison, The Affordable Care Act Contraception Mandate & Unintended Pregnancy in Women of Reproductive Age: An Analysis of the National Survey of Family Growth, 2008–2010 v. 2013–2015 , 101 Contraception 34–39 (2020) (Overall, the odds of experiencing unintended pregnancy decreased 15% from the pre-mandate to post-mandate period); See also Susan Christiansen, The Impact of the Affordable Care Act Contraceptive Mandate on Fertility and Abortion Rates (Dec. 2020) (Ph.D. dissertation, Johns Hopkins University), https://jscholarship.library.jhu.edu/handle/1774.2/63939 (last visited Jan. 28, 2022).

See Molly Jong-Fast, The Anti-Birth Control Movement Is the New Anti-Abortion Movement , Vogue (July 1, 2021), https://www.vogue.com/article/anti-birth-control-movement .

Burwell v. Hobby Lobby Stores, Inc., 573 U.S. 682 (2014) (striking down the ACA’s contraception mandate because it ‘created a substantial burden’ on Hobby Lobby’s religious freedom and it was not the ‘least restrictive means of satisfying the government’s interests.’) . See eg Tom Cohen, Hobby Lobby Ruling Much More Than Abortion , Cnn Politics (July 2, 2014), https://www.cnn.com/2014/07/02/politics/scotus-hobby-lobby-impacts/index.html (describing anti-abortion advocates opposition to contraception mandates).

See Carole Joffe, Failing to Embed Abortion Care in Mainstream Medicine Made it Politically Vulnerable , Wash. Post (Jan. 11, 2022), https://www.washingtonpost.com/outlook/2022/01/11/failing-embed-abortion-care-mainstream-medicine-made-it-politically-vulnerable/ (describing the range in quality of abortion providers when abortion was illegal).

See Elizabeth G. Raymond et al., Efficacy of Misoprostol Alone for First-Trimester Medical Abortion: A Systematic Review , 133 Obstet Gynecol 133–147 (2019).

Id. (This consolidated report of existing research finds that misoprostol alone successfully terminates a pregnancy in 93% of cases).

See How to Buy Abortion Pills That Are Safe and Effective , https://www.ipas.org/our-work/abortion-self-care/abortion-with-pills/how-to-buy-abortion-pills-that-are-safe-and-effective/ (Noting that manufacturers sell the pills to pharmacies for very little cost—less than $0.05 per pill—and that the highest sales price found in a recent study was $2 per pill).

See eg Celina Schocken, Business Case: Investing in Production of High Quality Misoprostol for Low-Resource Settings , Concept. Found. (Dec. 2014), https://www.conceptfoundation.org/wp-content/uploads/2015/06/BusinessCase_Misoprostol_web.pdf (describing misoprostol’s vital role in treating postpartum hemorrhage); see also Essential Medicines List includes Misoprostol tablets for use during pregnancy, childbirth and postpartum care , World Health Organization, https://www.who.int/data/gho/indicator-metadata-registry/imr-details/essential-medicines-list-includes-misoprostol-tablets-for-use-during-pregnancy-childbirth-and-postpartum-care .

Beverly Winikoff & Wendy Sheldon, Use of Medicines Changing the Face of Abortion , Guttmacher Inst. (Sept. 2012), https://www.guttmacher.org/journals/ipsrh/2012/09/use-medicines-changing-face-abortion . For a description of the misoprostol market in countries where abortion is illegal, see Michelle Oberman, What Happens When Abortion is Banned? , N.Y. Times (May 31, 2018), https://www.nytimes.com/2018/05/31/opinion/sunday/abortion-banned-latin-america.html .

See Gilda Sedgh et al., Induced Abortion: Incidence and Trends Worldwide from 1995 to 2008 , 379 The Lancet 625, 625 (2012) (comparing the one out of three pregnancies in Central America end in abortion with one out of five in the United States); see also Susheela Singh et al., Abortion Worldwide: A Decade of Uneven Progress , Guttmacher Inst. (Oct. 2009), http://www.guttmacher.org/pubs/Abortion-Worldwide.pdf .

There is evidence of an expanding market in misoprostol in the U.S. See Caroline Kitchener, Self-Managed Abortion Could be the Future—But it’s Very Hard to Talk About , The Lily (Dec. 20, 2021), https://www.thelily.com/self-managed-abortion-could-be-the-future-but-its-very-hard-to-talk-about/ . See also, Erica Hellerstein, The Rise of the DIY Abortion in Texas , The Atlantic (June 27, 2014), https://www.theatlantic.com/health/archive/2014/06/the-rise-of-the-diy-abortion-in-texas/373240/ .

Kari White et al., Initial Impacts of Texas’ Senate Bill 8 on Abortions in Texas and at Out-of State Facilities , Texas Policy Evaluation Project (Oct. 2021), http://sites.utexas.edu/txpep/files/2021/11/TxPEP-brief-SB8-inital-impact.pdf .

In the immediate aftermath of Prohibition–evidenced by mortality rates, mental health, and crime statistics–alcohol consumption fell to approximately 30% of its pre-Prohibition level. But this drop in alcohol consumption was short-lived. Within a few years after Prohibition, alcohol consumption had increased to 60–70% of its pre-Prohibition level. See Annika Nekalson, Prohibition was a Failed Experiment in Moral Governance, The Atlantic (Jan. 16, 2020), https://www.theatlantic.com/ideas/archive/2020/01/prohibition-was-failed-experiment-moral-governance/604972/ .

See Nash & Dreweke, supra note 19, regarding the various reasons behind declining abortion rates.

See Greene Foster, Stop Saying , supra note 6; see also Greene Foster, The Turnaway Study, supra note 2.

Hence the insistence of the reproductive justice movement that advocates center the goals of racial justice. RJ Squared. For a detailed description of the ways in which structural inequities circumscribe the reproductive choices of poor women and women of color, see Jamila K. Taylor, Structural Racism and Maternal Health Among Black Women , 48 Journal Of Law, Medicine & Ethics 506–517 (2020).

See generally, Katrina Kimport, No Real Choice: How Culture And Politics Matter For Reproductive Autonomy (2021) (positing that for the most marginalized Americans faced with an unwanted pregnancy, the question is not whether to have an abortion or have a baby, but rather, whether they can actually get an abortion or not).

At oral argument, Justice Barrett said, “Both Roe and Casey emphasized the burdens of parenting, and insofar as you and many of your amici focus on the ways in which the forced parenting, forced motherhood would hinder women’s access to the workplace and to equal opportunities, it’s also focused on the consequences of parenting and the obligations of motherhood that flow from pregnancy. Why don’t the safe haven laws take care of that problem?” Transcript of Oral Argument at 56, Dobbs v. Jackson Women’s Health, No. 19–1392. For a compelling analysis and indictment of safe haven laws, see Laury Oaks, Giving Up Baby: Safe Haven Laws, Motherhood, And Reproductive Justice (2015); see also Lizzie Widdicombe, The Baby-Box Lady of America , The New Yorker (Dec. 18, 2021) https://www.newyorker.com/news/news-desk/the-baby-box-lady-of-america .

See Mardie Caldwell, Open Adoption is a Win-Win Situation (Apr. 7, 2018), https://mardiecaldwell.com/open-adoption-is-a-win-win-situation/ ; see also Julia D. Hejduk, Gift Motherhood, the Prius, and the Peace Corps: Reducing Abortion by Incentivizing Adoption , The Public Discourse (Sept. 27, 2017), https://www.thepublicdiscourse.com/2017/09/20054/ .

Id . On the merits, what limited scholarly evidence there is on adoption runs counter to this rosy characterization of adoption’s outcomes, at least for birth mothers. See eg Are Birth Mothers Satisfied with Decisions to Place Children for Adoption? , Science Daily (June 8, 2018), https://www.sciencedaily.com/releases/2018/06/180608131605.htm (a longitudinal study of birth mothers that found women reported a mean satisfaction of 3.11 on a scale of 1–5). See also Gretchen Sisson, ‘Choosing Life’: Birth Mothers on Abortion and Reproductive Choice , 25 Women’s Health Issues 349–54 (2015) (a study involving in-depth interviews with 40 women who had placed infants for adoption from 1962 to 2009. The majority of the participants–many of whom placed their babies in closed adoptions, which are less typical today–described their adoption experiences as ‘predominantly negative,’ a response that Sisson attributes in part to the reality that adoption is not a preferred course of action, but rather, something chosen by those who feel they have no other options).

Olga Khazan, Why So Many Women Choose Abortion Over Adoption , The Atlantic (May 20, 2019). ( https://www.theatlantic.com/health/archive/2019/05/why-more-women-dont-choose-adoption/589759 ; S ee also Olga Khazan, The New Question Haunting Adoption , The Atlantic (Oct. 22, 2020), https://www.theatlantic.com/politics/archive/2021/10/adopt-baby-cost-process-hard/620258/ (‘Since the mid-1970s—the end of the so-called baby-scoop era, when large numbers of unmarried women placed their children for adoption—the percentage of never-married women who relinquish their infants has declined from nearly 9% to less than 1%.’).

See Elizabeth Wildsmith, Jennifer Manlove et al., Dramatic Increase in the Proportion of Births Outside of Marriage in the United States from 1990 to 2016 , Child Trends (Aug. 8, 2018), https://www.childtrends.org/publications/dramatic-increase-in-percentage-of-births-outside-marriage-among-whites-hispanics-and-women-with-higher-education-levels#:∼:text=Recent%20estimates%20show%20that%20about , worldwide%20(Chamie%2C%202017). The most rapid growth is among white women: as of 2016, 28% of all births to white women were non-marital. See also Khazan , supra note 43 (Starting in the 1970s, single white women became much less likely to relinquish their babies at birth: nearly a fifth of them did so before 1973; by 1988, just 3% did).

Khazan, Id .

The Turnaway Study is a longitudinal study examining the effects of unintended pregnancy on women’s lives. For the study and its findings, see Greene Foster, The Turnaway Study, supra note 2.

See id . See also Diana Greene Foster, What Happens When It’s Too Late to Get an Abortion , N.Y. Times (Nov. 22, 2021), https://www.nytimes.com/2021/11/22/opinion/abortion-supreme-court-women-law.html .

See Gretchen Sisson, Lauren Ralph, Heather Gould & Diana Greene Foster, Adoption Decision Making among Women Seeking Abortion, 27 Women’s Health Issues 136 (2017).

See Women’s Access to Abortion Improves Children’s Lives , Ansirh (Jan. 2019), https://www.ansirh.org/sites/default/files/publications/files/womens_access_to_abortion_improves_childrens_lives.pdf .

See generally Kayla Patrick, National Snapshot: Poverty Among Women & Families , National Women’s Law Center, https://nwlc.org/wp-content/uploads/2017/09/Poverty-Snapshot-Factsheet-2017.pdf . (The poverty rate for female-headed families with children was 36.5%, compared to 22.1% for male-headed families with children and 7.5% of families headed by married couples with children).

Robin Bleiweis, Diana Boesch & Alexandra C. Gaines, The Basic Facts About Women in Poverty , American Progress (Aug. 3, 2020), https://www.americanprogress.org/article/basic-facts-women-poverty/ .

See American Academy of Pediatrics, Council on Community Pediatrics, Poverty and Child Health in the United States , Pediatrics 137 no. 4 (2016): e20160339.

See kimport, supra note 39, at 37, and generally.

See Leah Outten, Birth Mothers and the Adoption Option , Focus On The Family (Nov. 9, 2021), https://www.focusonthefamily.com/pro-life/the-adoption-option-birth-mothers-need-your-support/ ; Stephanie McCrummen, A Maternity Ranch is Born: How Evangelical Women in Texas are Mobilizing for a Future Without Abortion , Wash. Post (Nov. 16, 2021), https://www.washingtonpost.com/nation/2021/11/16/evangelical-women-texas-abortion/?utm_campaign=wp_post_most&utm_medium=email&utm_source=newsletter&wpisrc=nl_most&carta-url=https%3A%2F%2Fs2.washingtonpost.com%2Fcar-ln-tr%2F354c967%2F6193e9909d2fdab56b8e7f16%2F5a1f90909bbc0f4d5203bb72%2F8%2F73%2F6193e9909d2fdab56b8e7f16 . see also Michelle Oberman, The Women the Abortion War Leaves Out , N.Y. Times (Jan. 11, 2018), https://www.nytimes.com/2018/01/11/opinion/sunday/abortion-crisis-pregnancy-centers.html (describing Oklahoma City’s Rose Home, a pro-life organization that houses up to five pregnant women and their children at any given time).

See Outten, supra note 54. See also Eleanor Bartow, 12 Pro-Life Truths to Counter Every Abortion Myth , The Federalist (Oct. 11, 2021) https://thefederalist.com/2021/10/11/12-pro-life-truths-to-counter-every-abortion-myth/ (where Bartow asserts adoption is ‘a better option than killing an unborn child’ because there are many ‘loving, screened, financially stable parents [who] are waiting to adopt babies.’).

See Sue Halpern, How Republicans Became Anti-Choice , The N.Y. Rev. (Nov. 8, 2018), https://www.nybooks.com/articles/2018/11/08/how-republicans-became-anti-choice/ (reviewing Reversing Roe , a documentary film directed and produced by Ricki Stern and Annie Sundberg).

See Robert Reich, Republicans, So Called party of Family Values, Do Not Support Needy Families , The Guardian (Jul. 18, 2021), https://www.theguardian.com/commentisfree/2021/jul/18/child-allowance-payments-american-rescue-plan-republicans

See eg Richard Garnett, supra note 4. See also Hadley Arkes, in One Untrue Thing , Nat’l Rev. (Aug. 1, 2007), https://www.nationalreview.com/2007/08/one-untrue-thing-nro-symposium/ , (‘[T]he law does not need to invoke the harshest penalties for the sake of teaching moral lessons.’).

§315, Penal Law, 5737–1977, LSI Special Volume (1977), as amended (Isr.),

https://knesset.gov.il/review/data/eng/law/kns8_penallaw_eng.pdf [ https://perma.cc/N9QZ-8JEV ].

Or at least it would do so if the law were interpreted in a way that strictly limited abortion access. Instead, as I explain elsewhere, the committees close to 100% of the requests they receive, making legal abortion readily available in the country. See Oberman, supra note 2, at 172.

And they do. Recall that Israel has the highest fertility rates of any country in the OECD. Families have an average of 3.1 children. See Family Database: Fertility Rates , Org. Econ. Coop. Dev., https://www.oecd.org/els/family/SF_2_1_Fertility_rates.pdf [ https://perma.cc/5J2Y-YGWG ] (last updated June 2021).

See Maternity Leave , Kol Zchut, https://www.kolzchut.org.il/en/Maternity_Leave [ https://perma.cc/Q29Q-T6Q6 ] (last visited June 19, 2021).

See Childcare in Israel , Expat.Com (Sept. 18, 2017) https://www.expat.com/en/guide/middle-east/israel/15420-childcare-in-israel.html [ https://perma.cc/2Z7S-SJCK ] (describing the relative level of state support that young Israeli families receive, compared to the U.S.). See also, Register to State Recognized Daycare and Afternoon Care, and Request State Participation in Tuition Fees , Gov. IL, https://www.gov.il/en/service/registration_for_day_care_centers_and_nurseries1 (last updated Feb. 7, 2020) (Israeli government website describing eligibility for state supported day care). Rates of enrollment in both day care and preschool are among the highest in the developed world. Indeed, preschool enrollment rates are double that of the OECD average. https://issuu.com/bernardvanleerfoundation/docs/publication_taub_center_early_childhood_education_ (at 27).

See, eg Children , Nat’l Ins. Inst. Of Isr., https://www.btl.gov.il/English%20Homepage/Benefits/Children/Pages/default.aspx [ https://perma.cc/8KE2-3K8L ] (last visited on Dec. 19, 2021). Although these policies may not significantly offset the costs of having a child, surely, they are a benefit to Israel’s poorest families.

The only government support for those who have babies lies in family medical leave, which promises twelve weeks of unpaid leave time after the birth of a child. See Family and Medical Leave Act (FMLA), 29 U.S.C. § 2612.

Ben Casselman, Child Tax Credit’s Extra Help Ends, Just as Covid Surges Anew , N.Y. Times (last updated Jan. 3, 2022), https://www.nytimes.com/2022/01/02/business/economy/child-tax-credit.html .

Ali Safawi & Cindy Reyes, States Must Continue Recent Momentum to Further Improve TANF Benefit Levels , Cntr on Budget & Pol’y Priorities (updated Dec. 2, 2021), https://www.cbpp.org/research/family-income-support/states-must-continue-recent-momentum-to-further-improve-tanf-benefit .

For signs that anti-abortion advocates are beginning to grapple with the need to take systemic realities into account, see Tish Harrison Warren, The Systemic Realities Created by Legal Abortion , N.Y. Times (Jan. 22, 2022), https://www.nytimes.com/2022/01/22/opinion/roe-legal-abortion.html .

See Richard H. McAdams , A Focal Point Theory of Expressive Law, 86 V.A. L. Rev.1649, 1713–28 (2000) (applying expressive law theory to smoking bans and landlord liability law). See generally Richard H. McAdams, The Expressive Powers Of Law: Theories And Limits (2015).

He offers little evidence, by way of proof. However, numerous studies both domestically and worldwide document an association between smoking bans and an overall decline in smoking rates, including a reduction in smoking by smokers. See eg Thomas W. Carton, Michael Dardon, et al., Comprehensive Indoor Smoking Bans and Smoking Prevalence: Evidence from the BRFSS , 2 J Health Econ. 535–56 (2016); see also Silke Anger, Michael Kvasnicka, Thomas Seidler, One Last Puff? Public Smoking Bans and Smoking Behavior , 30 J Health Econ. 591–601 (2011).

See McAdams, supra note 70, at 197.

These lawmakers also must contend with considerable public opposition to their position. As of 2020, 79% of Americans say that the decision to have an abortion is best left to women, not lawmakers, according to a Kaiser Family Foundation study from 2020. See Ariana Eunjung Cha & Emily Guskin, Most Americans Want Abortion to Remain Legal, but Back S ome State Restrictions , Wash. Post (Jan. 22, 2020), https://www.washingtonpost.com/health/2020/01/22/most-americans-want-abortion-remain-legal-back-some-state-restrictions/ .

See McAdams, supra note 70, at 180.

Recreational cannabis is legal in 18 states, while 11 states criminalize it. (See https://disa.com/map-of-marijuana-legality-by-state for a breakdown of the various jurisdictions’ laws). Experts estimate that at least 15 states will keep abortion legal, and perhaps even expand abortion rights, regardless of the absence of a Constitutional right. https://www.guttmacher.org/state-policy/explore/abortion-policy-absence-roe .

Kimport, supra note 37, at 28 and 62–69.

See eg Anna North, All the Near-Total Abortion Bans Passed This Year Have Now Been Blocked in Court, Vox (updated Oct. 29, 2019), https://www.vox.com/2019/10/2/20895034/alabama-abortion-ban-blocked-georgia-law ; see also Sean Murphy, Oklahoma Supreme Court Blocks 3 New Anti-Abortion Laws, ABC News (Oct. 25, 2021), https://abcnews.go.com/Health/wireStory/oklahoma-supreme-court-blocks-anti-abortion-laws-80779946 .

See Chotiner, supra note 5. See also O. Carter Snead, in One Untrue Thing , Nat’l Rev. (Aug. 1, 2007), https://www.nationalreview.com/2007/08/one-untrue-thing-nro-symposium/ (Offering a pragmatic justification for not punishing self-abortion: ‘[T]he public is more willing to accept a law that punishes doctors rather than mothers. Pro-lifers can thus achieve their goal of ending abortion without provoking a political backlash.’).

Although there are legal strategies a government might employ in response to overseas entities that sell abortion medicines to U.S. consumers (eg border patrol agents or diplomatic pressure), we learn from both the heroin and the fentanyl epidemics that the government’s options in the face of high demand are limited. See Claire Felter, Backgrounder: The U.S. Opioid Epidemic , The Council on Foreign Relations, (Sept. 8, 2021), https://www.cfr.org/backgrounder/us-opioid-epidemic .

Stephanos Bibas, Prosecutorial Regulation Versus Prosecutorial Accountability , 157 U. Pa. L. Rev. 959 (2009).

Stephanos Bibas, The Need for Prosecutorial Discretion , 19 Temp. Pol. & Civ. Rts. Rev. 369, 371 (2010).

See Leslie Reagan, When Abortion Was A Crime: Women, Medicine, And Law In The United States, 1867–1973 (1997), at 114, 164.

See From Hospital to Jail: The Impact on Women of El Salvador’s Total Criminalization of Abortion , 22 Repr. Health Matters 52–60 (2014); see also Oberman, supra note 2 , at 8–10 and 49–55 (describing similar patterns in Chile and El Salvador).

See Oberman , supra note 2, at 44.

See Repr. Health Matters, supra note 83.

See eg Chelsea Becker’s prosecution for murder, following stillbirth allegedly caused by methamphetamine use. Judge Dismisses Murder Charge Against Califronia Mother After Stillbirth , N.Y. Times (May 21, 2021), https://www.nytimes.com/2021/05/20/us/chelsea-becker-stillbirth-murder-charges-california.html .

They may also conscript doctors into law enforcement. See Michelle Oberman, Abortion Bans, Doctors, and the Criminalization of Patients ,48 Hastings Ctr. Rep.5 (2018); see also Oberman, Her Body Our Laws, supra note 2, at 43–67 for a discussion of how reports from doctors to police in El Salvador overwhelmingly involve poor, marginalized women.

Priscilla Thompson & Alexandra Turcios Cruz, How an Oklahoma Women’s Miscarriage Put a Spotlight on Racial Disparities in Prosecutions , Nbc News (Nov. 5, 2021), https://www.nbcnews.com/news/us-news/woman-prosecuted-miscarriage-highlights-racial-disparity-similar-cases-rcna4583 . For a detailed discussion of these cases, see Lynn M. Paltrow & Jeanne Flavin, Arrests of and Forced Interventions on Pregnant Women in the United States, 1973–2005: Implications for Women’s Legal Status and Public Health , 38 J. Health Pol., Pol’y And L. 299, 304–05 (2013) (discussing these findings and the limitations of the research which led the authors to conclude that their findings represent a substantial undercount of cases). See also Michele Goodwin, Policing The Womb: Invisible Women And The Criminalization Of Motherhood (2020).

See Arrests and Prosecutions of Pregnant Women, 1973–2020 , Napw (Sept.18, 2021), https://www.nationaladvocatesforpregnantwomen.org/arrests-and-prosecutions-of-pregnant-women-1973-2020/ (summarizing the range of cases). See also Lynn M. Paltrow, Constitutional Rights for the ‘Unborn’ Would Force Women to Forfeit Theirs , Ms. Magazine (Apr. 15, 2021), https://msmagazine.com/2021/04/15/abortion-constitutional-rights-unborn-fetus-14th-amendment-womens-rights-pregnant/ (The rate of arrests and prosecutions is increasing. ‘From 2006–2020, we have documented over 1000 such arrests—more than double in half as many years. Black, Brown and low-income, rural white women are the typical targets of these arrests.’).

Thompson & Turcios Cruz, supra note 85 (noting that the Black defendants were also significantly more likely to be charged with felonies than white women, with 85% of Black women receiving felony charges compared to 71% of white women); see also Lynn M. Paltrow, Roe v. Wade and the New Jane Crow: Reproductive Rights in the Age of Mass Incarceration , 103 Am. J. Pub. Health 17, 19 (2013). Note that healthcare experts object strenuously to these prosecutions on the grounds that they deter people from seeking treatment essential both to their own welfare and to that of the fetus. See eg Katherine C. Arnold, Viewpoint: Criminalizing Young Women is not the Way to Improve Birth Outcomes , The Oklahoman (Dec. 26, 2021, 5:00 AM), https://www.oklahoman.com/story/opinion/2021/12/26/viewpoint-prosecuting-oklahoma-women-who-miscarry-wrong/8930865002/ .

While beyond the scope of this Article, it bears noting the range of options that state lawmakers have given prosecutors, when it comes to abortion crimes, outlawing things like purchasing abortion medicine, or aiding and assisting an abortion. See eg Emily Bazelon, A Mother in Jail for Helping her Daughter Have an Abortion , N.Y. Times (Sept. 22, 2014), https://www.nytimes.com/2014/09/22/magazine/a-mother-in-jail-for-helping-her-daughter-have-an-abortion.html . See also Sabrina Tavernese, Citizens, not the State, Will Enforce New Abortion Law in Texas , N.Y. Times (Nov. 1, 2021), https://www.nytimes.com/2021/07/09/us/abortion-law-regulations-texas.html (Describing the ways that Texas S.B. Eight criminalizes all those who aid and assist abortion, and quoting Prof. Melissa Murray, ‘If the barista at Starbucks overhears you talking about your abortion, and it was performed after six weeks, that barista is authorized to sue the clinic where you obtained the abortion and to sue any other person who helped you, like the Uber driver who took you there.’).

See Paltrow , supra note 91. See generally Michele Bratcher Goodwin, Invisible Women: Mass Incarceration’s Forgotten Casualties , 94 Tex. L. Rev. (2015).

See Race & Justice News: Eliminating Crack/Cocaine Sentencing Disparity The Sentencing Project (July 27, 2021), https://www.sentencingproject.org/news/race-justice-news-senate-hearing-crack-cocaine-sentencing-disparity/ (summarizing the ongoing work toward sentencing equality in drug crimes, starting with the 2010 Fair Sentencing Act). On the negative downstream consequences of race bias in drug law enforcement, Republican Governor Asa Hutchinson noted that racial disparities, “undermined community confidence in the fairness of the criminal justice system. I talked with drug task force officers and front-line agents at the DEA who said this sense of injustice had a real impact in the fight against illegal drugs; it made it more difficult for agents to build trust and work with informants in the areas most impacted by the crack epidemic. The disparity in sentencing led to more harm than help in our federal anti-crime efforts.” ( Gov. Asa Hutchinson: It’s Time to Fix an Old Wrong and End the Disparity Between Crack and Cocaine Offenses , Fox News (June 8, 2021)), https://www.foxnews.com/opinion/end-crack-cocaine-offenses-gov-asa-hutchinson .

See Caroline Kitchener, The Texas Abortion ban has a Medical Exception. But some Doctors Worry it’s too Narrow to use, The Lily, Oct. 22, 2021 (describing existing legal protections and the limitations of Texas S.B. 8’s ‘medical emergency’ exception to its abortion ban), https://www.thelily.com/the-texas-abortion-ban-has-a-medical-exception-but-some-doctors-worry-its-too-narrow-to-use/ .

See Michael Asimow, Federal, Administrative Adjudication Outside The Administrative Procedure Act 3–4 (2019) (classifying these hearings into three categories, according to level of formal process).

See Kari White, Subasri Narasimhan, Sophie A. Hartwig, Erin Carroll, Alexandra McBrayer, Samantha Hubbard, Rachel Rebouché, Melissa Kottke & Kelli Stidham Hall, Parental Involvement Policies for Minors Seeking Abortion in the Southeast and Quality of Care , Sexuality Rsch. & Soc. Pol’y (Jan. 18, 2021), https://link.springer.com/content/pdf/10.1007/s13178-021-00539-0.pdf .

See David S. Cohen & Carole Joffe, Obstacle Course: The Everyday Struggle To Get An Abortion In America 209 (2020) (quoting Ohio doctor Chrisse France, decrying this standard in U.S. practice today; ‘She cannot be seen at our public hospital unless pretty much she’s going to die today or maybe tomorrow’).

See Kari White, Subasri Narasimhan, Sophie A. Hartwig, Erin Carroll, Alexandra McBrayer, Samantha Hubbard, Rachel Rebouché, Melissa Kottke & Kelli Stidham Hall, Parental Involvement Policies for Minors Seeking Abortion in the Southeast and Quality of Care , Sexuality Rsch. & Soc. Pol’y (Feb., 2021) (noting the impact of these policies in delaying access to early abortion among those ultimately deemed eligible to end their pregnancies).

See Herbert L. Packer & Ralph J. Gampell, Therapeutic Abortion: A Problem in Law and Medicine , 11 Stan. L. Rev. 417, 418, 421 (1959). (Explaining that hospitals developed protocols at least in part as a defensive measure: to protect themselves from potential downstream criminal or civil liability). See also, Carole Joffe, Doctors Of Conscience 31 (1995) (describing how doctors who performed abortions illegally would do so outside of the hospital setting, but legal abortions that met the test of necessary to save life would necessarily have been performed in a hospital, thereby implicating both medical and hospital oversight).

See generally Packer & Gampell, id . at 418 . (Noting these questions, among others: Is the procedure limited to cases where its purpose is to avoid shortening the pregnant woman’s life? If so, how do we determine whether carrying the child to term will shorten life? If not, what other considerations are relevant? Is a threat to health necessarily a threat to life? Must the threat to life (or health) be on account of a somatic illness? Or is the woman’s mental condition also to be considered? If so, is a probability that suicide will ensue a justification for therapeutic abortion?). For a searing indictment of U.S. therapeutic abortion committee practices in the mid-twentieth century, see Rickie Solinger, ‘A Complete Disaster:’ Abortion and the Politics of Hospital Abortion Committees, 1950–1970 , 19 Feminist Stud. 241 (1993).

See Packer & Gampell, supra note 100, at 449. (‘[R]eputable members of the medical profession may well find it galling that their freedom from criminal and civil liability turns merely on the nonenforcement of provisions of the law which, on their face, appear to embrace the conduct in question.’). Texas’s S.B. 8 law employs such a threat by way of subjecting doctors who provide abortions after six weeks to civil suit. See Sabrina Tavernese, supra note 75.

Id. at 421 (citing Alan F. Guttmacher, The Shrinking Non-Psychiatric Indications for Therapeutic Abortion , in Therapeutic Abortion 12 (Rosen, ed. 1954)).

Id . at 430. Their study concluded with a call for law reform—a call that was echoed by their Canadian counterparts in the 1977 Badgley report, which found “gross inequities existed in the availability of therapeutic abortion to the women of Canada.” W.D.S. Thomas, The Badgley Report on the Abortion Law, 116 Can. Med. Ass’n. J. 966, 966 (1977).

See Carole Joffe and Jody Steinauer, Evan Texas Allows Abortions to Protect a Woman’s Life. Or Does It? , N.Y. Times (Sept. 12, 2021), https://www.nytimes.com/2021/09/12/opinion/abortion-texas-roe.html (describing how contemporary abortion bans will likewise challenge medical integrity).

See Oberman, supra note 2, at 13–42 (describing the highly public Salvadoran case of Beatriz, a woman forced to continue a life-threatening pregnancy until her doctors agreed that death was imminent, which then triggered her right to self-defense, permitting doctors to end her pregnancy).

For a thoughtful consideration of the constitutional protections owed to one who is pregnant, when abortion is illegal, see Meghan Boone, Reproductive Due Process , 88 Geo. Wash. L. Rev. 511, 526 (2020) (‘Beyond its flexibility and ability to evolve, a third feature of due process is simply its function as a catchall constitutional backstop for determining the fairness of government action’).

See Matthews v. Eldridge, 424 U.S. 319, 335 (1976) (“Identification of the specific dictates of due process generally requires consideration of three distinct factors: first, the private interest that will be affected by the official action; second, the risk of erroneous deprivation of such interest through the procedures used, and probable value, if any, of additional or substitute procedural safeguards; and, finally, the Government’s interest, including the function involved and the fiscal and administrative burdens that the additional or substitute procedural requirements would entail.”). See also Simona Grossi, Procedural Due Process , 13 Seton Hall Cir. Rev. 155, 158 (2017) (‘[A]…procedural law that is not supported by logic, fairness, and efficiency considerations,…violates due process.’).

See Chotiner, supra note 5, (citing Marjorie Dannenfelser).

See eg Box v. Planned Parenthood, 139 S. Ct. 1780 at 1783 (Thomas, J., concurring) (supporting an Indiana law banning abortion on grounds of fetal anomaly by invoking the state’s ‘compelling interest in preventing abortion from becoming a tool of modern-day eugenics.’).

See eg Eli Rosenberg, Clarence Thomas Tried to Link Abortion to Eugenics. Seven Historians Told the Post He’s Wrong , Wash. Post (May 30, 2019, 9:50 PM), https://www.washingtonpost.com/history/2019/05/31/clarence-thomas-tried-link-abortion-eugenics-sevenhistorians-told-post-hes-wrong [ https://perma.cc/5DNR-PJT5 ]; Imani Gandy, When It Comes to Birth Control and Eugenics, Clarence Thomas Gets It All Wrong , Rewire (May 29, 2019, 5:11 PM), https://rewire.news/ablc/2019/05/29/when-it-comes-to-birth-control-and-eugenics-clarencethomas-gets-it-all-wrong [ https://perma.cc/3HZ3-689B ]; Lydia O’Connor, What Justice Clarence Thomas Gets Wrong About Eugenics and Abortion , Huff. Post (May 29, 2019, 5:50 PM), https://www.huffpost.com/entry/clarence-thomas-eugenics-abortion_n_5ced6c87e4b0356205a07182 [ https://perma.cc/6AHJ-MS5U ].

See Melissa Murray, Race-ing Roe: Reproductive Justice, Racial Justice, and the Battle for Roe v. Wade , 134 Harv. L. Rev. 2025 (2021) (providing a compelling response to the eugenics charge); see also Jennifer L. Holland, Tiny You: A Western History Of The Anti-Abortion Movement (2020) (arguing that the goals of the anti-abortion movement are deeply entwined with those of the white supremacy movement). Indeed, one might find evidence of racism in the suggestion that adoption is the best solution for poor Black and brown babies, which echoes the U.S. Indian Adoption Project of 1958–1967, under which as many as one-third of indigenous children were separated from their families. 85% of those children were placed in non-native homes or institutions. See Stephanie Woodward, Native Americans Expose The Adoption Era and Repair Its Devastation , Indian Country Today (updated Sept. 13, 2018), https://indiancountrytoday.com/archive/native-americans-expose-the-adoption-era-and-repair-its-devastation .

Reproductive Justice–Sister Song   https://www.sistersong.net/reproductive-justice . See also, Mission and Vision , If, When, How, https://www.ifwhenhow.org/about/mission-vision/ [ https://perma.cc/3RRJ-LKT5 ] (last visited Dec. 21, 2021) (A leading reproductive justice organization, their vision statement reads: ‘We envision a transformation of the legal systems and institutions that perpetuate oppression into structures that realize justice, and a future when all people can self-determine their reproductive lives free from discrimination, coercion, or violence.’).

They might begin by looking to Germany. Not, as Chief Justice Roberts suggested in the Dobbs oral argument, because its law restricting abortion to 12 weeks’ gestation is a good compromise. (Transcript of Oral Argument at 53–55, Dobbs v. Jackson Women’s Health, No. 19-1392). Rather, because of the story of how anti-abortion German lawmakers concluded that the best way to deter abortion was to enact, along with a partial ban, “a suite of services that had to be made available to women and families as part of any law regulating abortion: financial assistance for stay-at-home parents; a guaranteed return to a parent’s prior job if he or she took off up to three years to care for a child; extended day care and extensive tax credits for day care costs; increases for child support payments; extended paid leave to care for sick children; reemployment guarantees for empty nesters; sex education services; and a host of other measures relating to adoption, housing and taxation.” Jamal Greene, How Rights Went Wrong: Why Our Obsession With Rights Is Tearing America Apart 130 (2021).

See Chotiner interview, supra note 5. (“We make sure there’s child care in the first few years of that child’s life that’s cheap or free. That’s going to look very different in Minnesota than it does in Georgia. In Minnesota, there very well may be a political appetite for passing more state-supported aid…. There is not a one-size-fits-all when it comes to…how the needs of women will be met. That is vital work for the pro-life movement, and the Republican Party.”).

See Isaac Chotiner, How Pandemics Change History , The New Yorker (Mar. 3, 2020), https://www.newyorker.com/news/q-and-a/how-pandemics-change-history (quoting Frank M. Snowden).

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• America’s Abortion Quandary

2. Social and moral considerations on abortion

Table of contents.

• Abortion at various stages of pregnancy 
• Abortion and circumstances of pregnancy 
• Parental notification for minors seeking abortion
• Penalties for abortions performed illegally 
• Public views of what would change the number of abortions in the U.S.
• A majority of Americans say women should have more say in setting abortion policy in the U.S.
• How do certain arguments about abortion resonate with Americans?
• In their own words: How Americans feel about abortion 
• Personal connections to abortion 
• Religion’s impact on views about abortion
• Acknowledgments
• The American Trends Panel survey methodology

Relatively few Americans view the morality of abortion in stark terms: Overall, just 7% of all U.S. adults say abortion is morally acceptable in all cases, and 13% say it is morally wrong in all cases. A third say that abortion is morally wrong in  most  cases, while about a quarter (24%) say it is morally acceptable most of the time. About an additional one-in-five do not consider abortion a moral issue.

There are wide differences on this question by political party and religious affiliation. Among Republicans and independents who lean toward the Republican Party, most say that abortion is morally wrong either in most (48%) or all cases (20%). Among Democrats and Democratic leaners, meanwhile, only about three-in-ten (29%) hold a similar view. About four-in-ten Democrats say abortion is morally  acceptable  in most (32%) or all (11%) cases, while an additional 28% say abortion is not a moral issue. 

White evangelical Protestants overwhelmingly say abortion is morally wrong in most (51%) or all cases (30%). A slim majority of Catholics (53%) also view abortion as morally wrong, but many also say it is morally acceptable in most (24%) or all cases (4%), or that it is not a moral issue (17%). And among religiously unaffiliated Americans, about three-quarters see abortion as morally acceptable (45%) or not a moral issue (32%).

There is strong alignment between people’s views of whether abortion is morally wrong and whether it should be illegal. For example, among U.S. adults who take the view that abortion should be illegal in all cases without exception, fully 86% also say abortion is always morally wrong. The prevailing view among adults who say abortion should be legal in all circumstances is that abortion is not a moral issue (44%), though notable shares of this group also say it is morally acceptable in all (27%) or most (22%) cases. 

Most Americans who say abortion should be illegal with some exceptions take the view that abortion is morally wrong in  most  cases (69%). Those who say abortion should be legal with some exceptions are somewhat more conflicted, with 43% deeming abortion morally acceptable in most cases and 26% saying it is morally wrong in most cases; an additional 24% say it is not a moral issue. 

The survey also asked respondents who said abortion is morally wrong in at least some cases whether there are situations where abortion should still be legal  despite  being morally wrong. Roughly half of U.S. adults (48%) say that there are, in fact, situations where abortion is morally wrong but should still be legal, while just 22% say that whenever abortion is morally wrong, it should also be illegal. An additional 28% either said abortion is morally acceptable in all cases or not a moral issue, and thus did not receive the follow-up question.

Across both political parties and all major Christian subgroups – including Republicans and White evangelicals – there are substantially more people who say that there are situations where abortion should still be  legal  despite being morally wrong than there are who say that abortion should always be  illegal  when it is morally wrong.

Asked about the impact a number of policy changes would have on the number of abortions in the U.S., nearly two-thirds of Americans (65%) say “more support for women during pregnancy, such as financial assistance or employment protections” would reduce the number of abortions in the U.S. Six-in-ten say the same about expanding sex education and similar shares say more support for parents (58%), making it easier to place children for adoption in good homes (57%) and passing stricter abortion laws (57%) would have this effect. 

While about three-quarters of White evangelical Protestants (74%) say passing stricter abortion laws would reduce the number of abortions in the U.S., about half of religiously unaffiliated Americans (48%) hold this view. Similarly, Republicans are more likely than Democrats to say this (67% vs. 49%, respectively). By contrast, while about seven-in-ten unaffiliated adults (69%) say expanding sex education would reduce the number of abortions in the U.S., only about half of White evangelicals (48%) say this. Democrats also are substantially more likely than Republicans to hold this view (70% vs. 50%). 

Democrats are somewhat more likely than Republicans to say support for parents – such as paid family leave or more child care options – would reduce the number of abortions in the country (64% vs. 53%, respectively), while Republicans are more likely than Democrats to say making adoption into good homes easier would reduce abortions (64% vs. 52%).

Majorities across both parties and other subgroups analyzed in this report say that more support for women during pregnancy would reduce the number of abortions in America.

More than half of U.S. adults (56%) say women should have more say than men when it comes to setting policies around abortion in this country – including 42% who say women should have “a lot” more say. About four-in-ten (39%) say men and women should have equal say in abortion policies, and 3% say men should have more say than women. 

Six-in-ten women and about half of men (51%) say that women should have more say on this policy issue. 

Democrats are much more likely than Republicans to say women should have more say than men in setting abortion policy (70% vs. 41%). Similar shares of Protestants (48%) and Catholics (51%) say women should have more say than men on this issue, while the share of religiously unaffiliated Americans who say this is much higher (70%).

Seeking to gauge Americans’ reactions to several common arguments related to abortion, the survey presented respondents with six statements and asked them to rate how well each statement reflects their views on a five-point scale ranging from “extremely well” to “not at all well.” 

The list included three statements sometimes cited by individuals wishing to protect a right to abortion: “The decision about whether to have an abortion should belong solely to the pregnant woman,” “If legal abortions are too hard to get, then women will seek out unsafe abortions from unlicensed providers,” and “If legal abortions are too hard to get, then it will be more difficult for women to get ahead in society.” The first two of these resonate with the greatest number of Americans, with about half (53%) saying each describes their views “extremely” or “very” well. In other words, among the statements presented in the survey, U.S. adults are most likely to say that women alone should decide whether to have an abortion, and that making abortion illegal will lead women into unsafe situations.

The three other statements are similar to arguments sometimes made by those who wish to restrict access to abortions: “Human life begins at conception, so a fetus is a person with rights,” “If legal abortions are too easy to get, then people won’t be as careful with sex and contraception,” and “If legal abortions are too easy to get, then some pregnant women will be pressured into having an abortion even when they don’t want to.” 

Fewer than half of Americans say each of these statements describes their views extremely or very well. Nearly four-in-ten endorse the notion that “human life begins at conception, so a fetus is a person with rights” (26% say this describes their views extremely well, 12% very well), while about a third say that “if legal abortions are too easy to get, then people won’t be as careful with sex and contraception” (20% extremely well, 15% very well).

When it comes to statements cited by proponents of abortion rights, Democrats are much more likely than Republicans to identify with all three of these statements, as are religiously unaffiliated Americans compared with Catholics and Protestants. Women also are more likely than men to express these views – and especially more likely to say that decisions about abortion should fall solely to pregnant women and that restrictions on abortion will put women in unsafe situations. Younger adults under 30 are particularly likely to express the view that if legal abortions are too hard to get, then it will be difficult for women to get ahead in society.

In the case of the three statements sometimes cited by opponents of abortion, the patterns generally go in the opposite direction. Republicans are more likely than Democrats to say each statement reflects their views “extremely” or “very” well, as are Protestants (especially White evangelical Protestants) and Catholics compared with the religiously unaffiliated. In addition, older Americans are more likely than young adults to say that human life begins at conception and that easy access to abortion encourages unsafe sex.

Gender differences on these questions, however, are muted. In fact, women are just as likely as men to say that human life begins at conception, so a fetus is a person with rights (39% and 38%, respectively).

Analyzing certain statements together allows for an examination of the extent to which individuals can simultaneously hold two views that may seem to some as in conflict. For instance, overall, one-in-three U.S. adults say that  both  the statement “the decision about whether to have an abortion should belong solely to the pregnant woman” and the statement “human life begins at conception, so the fetus is a person with rights” reflect their own views at least somewhat well. This includes 12% of adults who say both statements reflect their views “extremely” or “very” well. 

Republicans are slightly more likely than Democrats to say both statements reflect their own views at least somewhat well (36% vs. 30%), although Republicans are much more likely to say  only  the statement about the fetus being a person with rights reflects their views at least somewhat well (39% vs. 9%) and Democrats are much more likely to say  only  the statement about the decision to have an abortion belonging solely to the pregnant woman reflects their views at least somewhat well (55% vs. 19%).

Additionally, those who take the stance that abortion should be legal in all cases with no exceptions are overwhelmingly likely (76%) to say only the statement about the decision belonging solely to the pregnant woman reflects their views extremely, very or somewhat well, while a nearly identical share (73%) of those who say abortion should be  illegal  in all cases with no exceptions say only the statement about human life beginning at conception reflects their views at least somewhat well.

When asked to describe whether they had any other additional views or feelings about abortion, adults shared a range of strong or complex views about the topic. In many cases, Americans reiterated their strong support – or opposition to – abortion in the U.S. Others reflected on how difficult or nuanced the issue was, offering emotional responses or personal experiences to one of two open-ended questions asked on the survey. 

One open-ended question asked respondents if they wanted to share any other views or feelings about abortion overall. The other open-ended question asked respondents about their feelings or views regarding abortion restrictions. The responses to both questions were similar. 

Overall, about three-in-ten adults offered a response to either of the open-ended questions. There was little difference in the likelihood to respond by party, religion or gender, though people who say they have given a “lot” of thought to the issue were more likely to respond than people who have not. 

Of those who did offer additional comments, about a third of respondents said something in support of legal abortion. By far the most common sentiment expressed was that the decision to have an abortion should be solely a personal decision, or a decision made jointly with a woman and her health care provider, with some saying simply that it “should be between a woman and her doctor.” Others made a more general point, such as one woman who said, “A woman’s body and health should not be subject to legislation.” 

About one-in-five of the people who responded to the question expressed disapproval of abortion – the most common reason being a belief that a fetus is a person or that abortion is murder. As one woman said, “It is my belief that life begins at conception and as much as is humanly possible, we as a society need to support, protect and defend each one of those little lives.” Others in this group pointed to the fact that they felt abortion was too often used as a form of birth control. For example, one man said, “Abortions are too easy to obtain these days. It seems more women are using it as a way of birth control.” 

About a quarter of respondents who opted to answer one of the open-ended questions said that their views about abortion were complex; many described having mixed feelings about the issue or otherwise expressed sympathy for both sides of the issue. One woman said, “I am personally opposed to abortion in most cases, but I think it would be detrimental to society to make it illegal. I was alive before the pill and before legal abortions. Many women died.” And one man said, “While I might feel abortion may be wrong in some cases, it is never my place as a man to tell a woman what to do with her body.” 

The remaining responses were either not related to the topic or were difficult to interpret.

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Why Abortion Should Be Banned

• Categories: Abortion

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Words: 688 |

Published: Jan 30, 2024

Words: 688 | Pages: 2 | 4 min read

Table of contents

Introduction, background information, ethical arguments against abortion, legal arguments against abortion, medical arguments against abortion, social and economic arguments against abortion, rebuttal to counterarguments.

• National Institute of Health. (2021). Abortion. Retrieved from https://www.nlm.nih.gov/medlineplus/abortion.html
• Murphy, M. (2021). Supreme Court Won’t Hear Major Abortion Case This Term. The New York Times. Retrieved from https://www.nytimes.com/2021/01/11/us/politics/supreme-court-abortion-case.html
• Pew Research Center. (2020). Abortion. Retrieved from https://www.pewresearch.org/topics/abortion/

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The negative health implications of restricting abortion access

December 13, 2021— Ana Langer is professor of the practice of public health and coordinator of the Women and Health Initiative at Harvard T.H. Chan School of Public Health.

Q:  Roe v. Wade may soon be overturned by the Supreme Court, while at the same time other countries are loosening restrictions around abortion rights. What are your thoughts on the current climate around this issue?

A: The trend over the past several decades is clear: Safe and legal abortion has become more widely accessible to women globally, with nearly 50 countries including Mexico, Argentina, New Zealand, Thailand, and Ireland liberalizing their abortion laws. During the same period, however, a few countries have made abortion more restricted or totally illegal, including El Salvador, Nicaragua, and Poland.

In the U.S., legal frameworks are increasingly limiting access to abortion. Even while Roe is in place, many people are currently unable to receive abortion care.

If the Supreme Court were to limit or overturn Roe, abortion would remain legal in 21 states and could immediately be prohibited in 24 states and three territories. Millions of people would be forced to travel to receive legal abortion care, something that would be impossible for many due to a range of financial and logistical reasons.

This situation does not surprise me because of the deep polarization that characterizes public views on abortion, and the growing power and relentless efforts of anti-choice groups. Furthermore, it does not surprise me because of the important gender gap that exists in this country, which is to a great extent due to the lack of strong and consistent policies and legal frameworks to support women in their efforts to better integrate their reproductive and professional roles and responsibilities.

The U.S. legalized abortion nearly 50 years ago, at a time when it was legally restricted in many countries around the world, setting an important international precedent and example. It disappoints me to see that while important progress has been made towards equality in other culturally polarized areas such as same-sex marriage, women’s right to terminate an unwanted or mistimed pregnancy is now severely threatened.

Q:  How do laws that restrict abortion access impact women’s health? 

A: Restricting women’s access to safe and legal abortion services has important negative health implications. We’ve seen that these laws do not result in fewer abortions. Instead, they compel women to risk their lives and health by seeking out unsafe abortion care.

According to the World Health Organization, 23,000 women die from unsafe abortions each year and tens of thousands more experience significant health complications globally. A recent study estimated that banning abortion in the U.S. would lead to a 21% increase in the number of pregnancy-related deaths overall and a 33% increase among Black women, simply because staying pregnant is more dangerous than having an abortion. Increased deaths due to unsafe abortions or attempted abortions would be in addition to these estimates.

If the current trend in the U.S. persists, “back alley” abortions will be the last resource for women with no access to safe and legal services, and the horrific consequences of such abortions will become a major cause of death and severe health complications for some of the most vulnerable women in this country.

The legal status of abortion also defines whether girls will be able to complete their educations and whether women will be able to participate in the workforce, and in public and political life.

Improving social safety net programs for women reduces gender gaps and improves girls’ and women’s health and chances to fulfill their potential, and could help reduce the number of abortions over time. Women who are better educated, have better access to comprehensive reproductive health care , and are employed and fairly remunerated will be better positioned to avoid a mistimed and unwanted pregnancy, hence the need for termination will become less common.

Q: Should abortion be considered a human right?

A: Numerous international and regional human rights treaties and national-level constitutions around the world protect the right to safe and legal abortion as a fundamental human right. Access to safe abortion is included in a constellation of rights, including the rights to life, liberty, privacy, equality and non-discrimination, and freedom from cruel, inhuman, and degrading treatment. Human rights bodies have repeatedly condemned restrictive abortion laws as being incompatible with human rights norms.

While a supportive legal framework for abortion care is critical, it is not enough to ensure access for everyone who seeks the service. For universal access to become a reality, policies that cover the cost of abortion care and its integration into the health care system, in addition to societal measures that destigmatize the procedure, are needed.

— Amy Roeder

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Abortion bans and their impacts: A view from the United States

Laura j. frye.

1 Gynuity Health Projects, New York, NY, USA

Beverly Winikoff

A retrospective study of abortion facilities in and around Texas by White et al. 1 and a spatial analysis by Rader et al. 2 are combined to illustrate the detrimental effects of abortion bans enacted in the United States.

Abortion restrictions have been introduced in various forms across many states for years, but since June 2022, when the right to abortion was no longer federally protected, we have seen a rapid increase in these restrictions. We are just starting to quantify and qualify their effects. Two recent studies published in JAMA offer early indications of the effects of draconian bans.

In “Association of Texas’ 2021 Ban on Abortion in Early Pregnancy with the Number of Facility-Based Abortion in Texas and Surrounding States,” White et al. used a large dataset containing information before and after the passage of SB8 in September 2021. 1 This bill banned most abortions after 6 weeks in the state of Texas. The data presented in this article allow for a careful examination of the law’s effects, and the authors paint a picture of how rapidly destabilizing such bans can be. The study clearly shows that, in the immediate aftermath of SB8’s implementation, there was both an absolute drop in documented abortions and a shift in the location of abortions as Texans went to neighboring states for medical care.

The paper explicitly examines abortions after 12 weeks as an important indicator of change, not because of the small decrease in safety and efficacy with increasing gestational durations, but rather because of the major increase in burdens to affected individuals (cost, time, travel) and to clinics (resources, scheduling) with gestations beyond this point.

A clearer and more detailed sense of how these patient travel dynamics play out can be found in the “Estimated Travel Time and Spatial Access to Abortion Facilities in the US Before and After the Dobbs v Jackson Women’s Health Decision” by Rader et al., which uses simulation and spatial analysis to measure changes in surface travel time to the closest abortion facility before and after the June 2022 Dobbs decision. 2

The average travel time to reach the nearest abortion facility significantly increased in the simulated post-Dobbs world, and, while the median change from 11 to 17 min is not jaw dropping, the spread of the data and the extremes of the curve are where the biggest problems lie. The authors show a doubling of the number of individuals who must travel more than 60 min to access abortion care. Then, through sensitivity analyses on geographic heterogeneity, they illustrate some of the extreme increases in travel time for people in the South, as in Texas, with a mean increase of over 7 h.

While the White paper notes that their data did not include individual-level demographic information (and thus was not able to explore the disparate effects of the ban on various subpopulations), the Raden paper is able to shed some light on the disproportionate impacts of abortion restrictions by use of census data. The latter paper shows that longer travel times occur more frequently in populations without insurance, with lower incomes, and who are racial and ethnic minorities. Documentation of these effects is important for advocacy, policy change, and resource allocation.

The White et al. paper wisely uses care in describing the data they have as “documented facility-based abortions,” acknowledging the now-frequent practice of non-facility-based self-managed abortion with pills. Similarly, Rader et al. note that their data are predicated on the idea of traveling to a physical facility and do not account for the mailing of pills to a person’s home. The TelAbortion study from 2016 to 2021 provided evidence on the safety and efficacy of direct-to-patient telemedicine abortion with mailing of pills, 3 , 4 and the FDA now allows for this method of abortion pill provision. We also know that self-managed abortion can be a safe and effective option 5 and is currently common in the United States. 6 , 7 There is increasing interest in determining its role in the care landscape. 8 , 9 , 10 Moving forward, it would be beneficial to see more information on how remote provision of care and self-management play into the dynamics illustrated in these articles.

These two papers, used together, can help prepare clinics in protective states for the influx of affected individuals as additional oppressive laws are passed in other states. The lessons documented only grow in relevance as the map of the United States darkens with more and more states passing restrictive abortion laws. We can use these data both to decry the negative and disproportionate effect of these bans and to call for action to prepare receiving clinics in protective states as they take on the care of more people who are denied medical services in their home states.

Declaration of interests

The authors declare no competing interests.

Opinion Abortion was already a top issue. Alito made the Supreme Court one, too.

A Democratic agenda: Lose the filibuster, reform the court and revive Roe.

Failure to appreciate the salience of the abortion issue is one reason so many pundits, reporters and pollsters wrongly predicted a “red wave” in 2022. It’s one thing to poll a specific congressional race in, say, September; it’s another when voters finally enter the voting booth to register their views.

This year, abortion remains a powerful issue for Democrats. And the focus on abortion might also make the Supreme Court itself a top issue for Democrats in a presidential campaign for the first time in a generation. The radical Supreme Court that reversed Roe v. Wade is increasingly unpopular and scandal-ridden.

The importance of abortion — and, in turn, the Supreme Court responsible for overturning Roe in Dobbs v. Jackson Women’s Health Organization — marks a dramatic shift in the political landscape. In election after election going back to the early 1980s, Republicans used the Supreme Court to gin up their voters on a variety of issues, but especially on abortion. Democrats never really expected abortion access to disappear, so their presidential nominees did not rely as much on the Supreme Court to turn out their base. Now the tables are turned, at the very time the court has made a spectacle of itself.

Angst over the Supreme Court’s serial ethical blunders remind Democrats and Democratic-leaning independents that the problem is not just abortion but the court itself. Justice Samuel A. Alito Jr. — who authored Dobbs and also committed arguably the worst ethical lapse on the court in memory — helps connect the dots for voters.

This month, NPR reported on a Public Religion Research Institute poll showing that abortion rights remain extremely popular in the United States. “Nationwide, 64% percent of voters said abortion should be always or mostly legal; 35% said it should be always or mostly illegal. In most states — including states with Republican-controlled state governments — a majority of voters support legal abortion, and very few favor total bans.” Pro-choice advocates have won every abortion referendum since Dobbs , even in red states such as Ohio and Kansas.

Abortion has outsize importance as an electoral matter, as the poll’s executive summary explains:

Democrats are 12 percentage points more likely than Republicans in battleground states to say that they will only vote for a candidate who shares their abortion views (46% vs. 34%). Women in battleground states are 9 points more likely than men (41% vs. 32%) to say that they will only vote for a candidate who shares their views on abortion. Half of Democratic women in battleground states (50%) say they will only vote for a candidate who shares their views on abortion, compared with 42% of Democratic men in battleground states.

When it comes to the Comstock Act, which some Republicans are eyeing as a means to criminalize abortion medication or literature sent through the mail, the numbers are even more stunning. “Among all Americans, over two-thirds (68%) oppose laws that make it illegal to use or receive through the mail FDA-approved drugs for medical abortion, often called abortion pills, while about three in ten (29%) favor these laws,” the pollsters found . “Democrats (79%) and independents (71%) are significantly more likely than Republicans (54%) to oppose laws that make it illegal to use or receive abortion pills through the mail.”

The renewed focus on abortion should hardly be a surprise. From tragedies caused by forced birth laws to attempts to ban in vitro fertilization and mifepristone , voters have been reminded continually of the damage wrought by Dobbs . Abortion might be one of the few issues that permeates every race in every state.

Abortion bans are the manifestation of the underlying problem: a reckless Supreme Court accountable to no one. The rogue right-wing court that took away millions of women’s reproductive rights is the same court that is in dire need of ethical reform and, most Americans believe, term limits.

Democrats, as a result, are willing to be daring when it comes to ending the filibuster. “Democratic incumbents and challengers running for the Senate this year say they want to restore a national right to abortion, and many, like [Wisconsin Democratic Sen. Tammy] Baldwin, openly say they would support suspending the filibuster to do so,” the Associated Press reports . “It’s become a key talking point as they try to capitalize on the nationwide battle over abortion rights.” With Sens. Joe Manchin III ( D-W.Va .) and Kyrsten Sinema (I-Ariz.) gone next year, filibuster reform might finally come to pass if Democrats hold the Senate.

The choice is stark. If voters reelect President Biden , new justices with pristine ethical records might replace aging, corrupt radicals. Long-term court reform would also be possible. Elect four-times indicted former president Donald Trump (who brags about ending Roe ) and he will look to put younger, and even more radical, justices (not to mention lower court judges) who will control Americans’ lives for decades. In other words, abortion will be the impetus, but a wider battle about the future of the court is inevitable.

Democrats are more than happy to make abortion and the Supreme Court central issues in the campaign. In certain states the attention might be particularly intense. Last week, abortion measures qualified for the November ballot in Colorado and South Dakota . Those join Florida, New York and Maryland as states with measures to protect abortion rights on the ballot. Others might qualify in Nevada, Arizona, Montana and Nebraska. (A Missouri measure has qualified but the Republican governor might put it on the Aug. 6 primary ballot.) That will ensure abortion — and the Supreme Court — is front and center in debates, ads, interviews and coverage for state and federal office in multiple states as well as national coverage.

The MAGA GOP, which created the most radical court in history, is wildly out of step with voters who want access to abortion, ethical rules and term limits for the court. Republicans need to be forced to defend grossly unpopular abortion bans, a disgraced court and unending judicial imperialism. No wonder they’d rather talk about Hunter Biden or troop up to New York to support criminal defendant Trump.

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New rules are in the works about abortion bans in texas. almost nobody's happy..

Selena Simmons-Duffin

Diane Webber

The "Rally for Life" march at the Texas State Capitol in Austin in January. Even groups that oppose abortion are asking for more clarity on exceptions to the state's abortion bans. Suzanne Cordiero/AFP via Getty Images hide caption

The stakes are high for doctors in Texas when it comes to abortion.

With three overlapping laws , Texas bans nearly all abortions and has some of the strictest penalties for doctors in the country, including thousands of dollars in fines, the loss of a medical license and even life in prison.

That’s the backdrop for a process happening now to give doctors more clarity about when abortions can be performed and considered in compliance with the narrow medical exception in Texas abortion law.

The state’s Supreme Court asked – and an official petition required – the Texas Medical Board to clarify how doctors should interpret the exception, which says abortion is allowed to save a woman’s life or “major bodily function.”

The board has drafted those clarifying rules but at a public meeting on Monday, the board heard repeatedly that they’d missed the mark.

The rules say doctors need to document in significant detail efforts that were made to save the pregnancy. And it says, if time allows, they should transfer patients “by any means available” to hospitals with a higher level of expertise to try to save a fetus. If there isn’t enough time for a transfer, doctors have to document that.

Texas Medical Board President Dr. Sherif Zaafran , an anesthesiologist based in Houston, presided over the online meeting along with the board’s executive director Brint Carlton.

It lasted more than four hours. The Texas Medical Association, representing 57,000 physicians, residents and medical students, the Texas Hospital Association, representing 460 hospitals, and the American College of Obstetricians and Gynecologists all told the board its rules are still not clear enough.

In some respects, the proposed rules “may do more harm than good,” said Steve Wohleb of the Texas Hospital Association.

The two dozen commenters also included Texas doctors, lawyers, representatives from organizations that oppose abortion rights, and patients, including Kate Cox.

Cox is a Texas woman who was in the middle of a serious pregnancy complication when she appealed to the Texas Supreme Court to try to get an abortion. She was denied the procedure and traveled to another state to end her pregnancy. The case , however, did lead the court to pressure the Texas Medical Board to come up with guidance.

Kate Cox, right, attended the State of the Union address in March. She's seated next to Maria Shriver, the author and former First Lady of California. Andrew Caballero-Reynolds/AFP via Getty Images hide caption

Cox said the state of Texas didn’t help her when she needed an abortion in December 2023. “I'm afraid the rules this board is now proposing wouldn't have helped me either,” she told the panel.

Many people commented that the rules failed to reassure physicians that they can provide an abortion without having to wait for a patient to get sicker and sicker.

Elizabeth Weller, who first told her story to NPR in 2022, had that experience. Her water broke too early for her pregnancy to survive, but she had to wait until she showed signs of infection before she was given an abortion. She concluded her remarks with this:

“I hope that you can all go to sleep at night and that you never have any blood on your hands for the women that are going to have to suffer through this. I hope that your rules are clear. I hope no one has to die because of this.”

Both Cox and Weller are plaintiffs in a lawsuit against the state that seeks to clarify the medical exception. Four other plaintiffs in that case, Dr. Austin Dennard, Lauren Miller, Amanda Zurawski, Dr. Judy Levison, and lead attorney Molly Duane of the Center for Reproductive Rights, also commented on the rules. The Texas Supreme Court is expected to issue its decision by the end of June. Two patients who are not involved with the case commented as well about their experiences with delayed care during serious pregnancy complications.

The message from anti-abortion groups was strikingly similar – they also wanted the rules to say more clearly that doctors need not wait for a woman’s condition to become life-threatening before they act. Texas Right to Life’s Miranda Willborg said the board should clarify “the fact that imminence” of death is not required.

“Women do not need to be at death's door for a physician to take action,” Willborg said, although she added that, overall, her group was pleased with the proposed rules.

Board President Zaafran pushed back on the idea that, under the proposed rules, doctors would have to delay care as long as possible. “I don't think that there's any information that you have to wait until the patient became septic and potentially at death's door before you would need to act or intervene,” he said. “If there's something that we said in the proposed rules that intimate that, then we're happy to take suggestions along those lines, but that's certainly nothing that we intended.”

Steve Bresnen, an attorney and lobbyist in Austin, replied, “It's what was not said, doctor.”

Bresnen, along with his wife and business partner Amy Bresnen, filed the petition that forced the Texas Medical Board to write the rules.

He said the board needs to say in writing that a patient doesn’t need to be imminently in danger of harm to be able to receive an abortion legally.

“If you fail to do that, you're not achieving anything,” Bresnen said. He also encouraged the board to scrap their proposed rules and try again. “Don’t be afraid to start with a blank slate.”

For now, nothing changes with the Texas abortion ban. If the board decides to start over, the process could take months.

• abortion bans

Abortion: Why It Should Be Banned Research Paper

Abortion has brought about one of the most controversial social debates worldwide; debating the moral and lawful aspect of abortion has been an intense debate between the conservatives and the liberalists worldwide. There have been various definitions formed to describe the word ‘abortion’. One of the definitions that best describes the word ‘abortion’ is “the removal of an embryo or fetus from a uterus induced medically or surgically.”

Apart from that, some conservative Christian groups define abortion as ‘purposeful termination of pregnancy”. Abortions are induced by various medical methods, including the use of sharpened tools and abdominal pressure. There is an estimated figure of about 46 million abortions taking place every year worldwide. Some abortions also happen as a result of miscarriage or naturally, although most abortions, as reported by research in 1988, happen intentionally.

There are many reasons as to why women do abortions, as shown in a research done by the AGI, meta-study in 1998 with women from 27 different countries. Most women feel that having children interrupts their careers, and they want to delay having a child because of that. Women tend to feel that they should be responsible for what they do; thus, when they have a kid, they feel that they should raise them as they want to and not let them be raised by some foreign maid.

Thus, as more and more women are becoming career-oriented, the childbirth rate is declining at a very steep rate. Apart from that, couples also view having children as being very expensive. The cost of raising a child is becoming more expensive in the present world. Thus, most couples prefer to have pets instead of children as they wouldn’t have to spend on their education and so on.

Furthermore, more and more marriages are becoming more of a temporary commitment as divorce rates are becoming high. Thus, women are becoming aware of this fact and are taking precautions by not having children during the first few years of their marriage, just to ensure that they have enough time to be stable and sure of their relationship. Besides that, modern women these days tend to have been raised in very wealthy family backgrounds. Thus they would have been spoiled by their parents and so on. As a consequence, they think they are not capable of handling a child, and they perceive themselves as being immature.

This is another reason why women do abortions. Other reasons include women who want to maintain their slim figure, and those pregnancies that happen as a result of being raped, preference of children of a specific sex, disapproval of single motherhood, population control such as in China where every couple is only allowed one child as well as the lack of access to getting pregnant in some countries as well as the lack of access in getting condoms to prevent pregnancies and so on.

However, in my opinion, I am against abortion. I feel that people tend to make excuses to free themselves from guilt and responsibility. Abortion is equivalent to killing life as a fetus is considered a living thing in the human body, and since when is killing an acceptable act? Killing is an act of violence, and it’s deemed as being morally wrong. Most people are suffering from various pregnancy-related traumas as more and more couples are experiencing conceiving difficulties due to the current unhealthy food intake and environmental conditions; thus, having a baby could change a lot of things.

Couples, who have a baby out of accident or so on, should give birth to it and pass it on to the couples who really want a baby but can’t conceive. This way, you are actually making someone else happy and at the same time doing the right thing. Apart from that, people fail to realize that the birth of a newborn baby, a new fresh brain, could probably have changed the world. We will never know how many killed babies could have had genius ideas that could have changed the world, but we can change it around right now and stop killing these creative babies from abortion. The world could use more inventive ideas and more cures.

It is also a wonder of how people can have the heart to kill such an innocent being that has done absolutely nothing wrong. A baby is known to signify innocence and as a sign of love that brings couples closer to one another. Currently, looking at this very disturbing world, a baby could definitely bring about many changes in people’s lives, especially in bringing them closer and spreading around more love.

Having a kid could change a lot of people, including criminals who learn how to love their own kid and want to change and be the best that they can be for the sake of their children. Most criminals become criminals due to a lack of love and attention from their family members, so what better way to make them feel loved and to feel useful than having their own kid? This could also bring about a drastic social change in lowering the crime rates around the world. One would be surprised what a child could do in a family.

In addition to the above, most teenagers and young couples that go thru abortion; regret it later on in their lives. They tend to carry the guilt with them for life. Research has also shown that women who undergo an abortion have various consequences later on in their life. This could be as a physical effect, for example, some uterus pain or problems if not handled by the proper doctor earlier on.

Apart from that, women also suffer from psychological complications later on in their life, when they are in their 40’s or during their mid-life crisis. Thus, having a counselling session with these women before they have an abortion could be really helpful. The counsellor could highlight the negative effects of abortions and the risks involved later on. Most doctors would not highlight these things to avoid arguments or for monetary purposes. However, having these conversations earlier on can be quite helpful to most women.

In conclusion, I still would strongly suggest that abortion be banned in all countries. This could bring about various positive changes to the world. Doctors should be more responsible in explaining all the effects, risks, consequences and should really try to discourage the couple from doing the abortion. Apart from that, banning abortion could make people become more responsible for their actions. This would be, for example, not having random sex or using a condom to avoid pregnancy or even just thinking properly before doing something, as they will soon realize that all their actions will have consequences, and not anything can be compromised just for the sake of fun, as well as that they can’t escape from it every time.

Bibliography

Abortion: A Collective Story, by Cara J MariAnna. Web.

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IvyPanda. (2021, August 31). Abortion: Why It Should Be Banned. https://ivypanda.com/essays/abortion-why-it-should-be-banned/

"Abortion: Why It Should Be Banned." IvyPanda , 31 Aug. 2021, ivypanda.com/essays/abortion-why-it-should-be-banned/.

IvyPanda . (2021) 'Abortion: Why It Should Be Banned'. 31 August.

IvyPanda . 2021. "Abortion: Why It Should Be Banned." August 31, 2021. https://ivypanda.com/essays/abortion-why-it-should-be-banned/.

1. IvyPanda . "Abortion: Why It Should Be Banned." August 31, 2021. https://ivypanda.com/essays/abortion-why-it-should-be-banned/.

IvyPanda . "Abortion: Why It Should Be Banned." August 31, 2021. https://ivypanda.com/essays/abortion-why-it-should-be-banned/.