Texas this week seized the opportunity to ban abortions and blame it on COVID-19. The state banned “any type of abortion that is not medically necessary to preserve the life or health of the mother,” with no exceptions for severely ill fetuses, babies who will suffer and die at birth, rape victims, or similar groups. Ohio and Mississippi have enacted similar bans, and other states might soon follow suit.
While an abortion rights coalition that includes Texas abortion clinics has already sued to halt the Texas ban, it’s unclear how courts might rule. Moreover, federal courts are moving more slowly than ever, so even if choice advocates win, many women will be denied abortions before they do.
The Hypocrisy of Closing Abortion Clinics
Texas’s abortion ban ostensibly exists to save lives, but the state has taken a much more lax effect with other businesses. The businesses that the state has not ordered closed or restricted include:
• car dealerships
• liquor stores
• dry cleaners
• convenience stores
• numerous food businesses, including restaurants and farmers’ markets
• veterinary clinics
• other non-abortion clinics
• gas stations
• hardware stores
• convenience stores
Dozens of other types of businesses remain open, too. And abortion clinics are the only type of medical procedure that the government has specifically and formally restricted. Other “elective” medical procedures are left up to the judgment of the doctor. Somehow, in Texas, liquor stores are vital to the population’s health and safety but abortion clinics are not.
Texas’s ban on elective surgery states, “..all licensed health care professionals and all licensed health care facilities shall postpone all surgeries and procedures that are not immediately medically necessary to correct a serious medical condition of, or to preserve the life of, a patient who without immediate performance of the surgery or procedure would be at risk for serious adverse medical consequences or death, as determined by the patient’s physician.”
Abortion is the only medical procedure for which the elective nature of the surgery is not left up to the judgment of the doctor. This allows a doctor to determine that liposuction is medically necessary, but not an abortion that could prevent a stillbirth.
Why We Can’t Classify Abortion as Elective Surgery
Any government-imposed restriction on abortion will inevitably exclude people for whom abortion is very much necessary. That’s why the Supreme Court ruled that the decision about whether an abortion is necessary should be between a woman and her doctor.
Texas’s new ban is so amorphous and unclear that it could conceivably force a woman to carry a baby who has already died. It doesn’t clarify which health conditions in the mother qualify for abortion. This leaves doctors to exercise their own judgment and risk fines and other penalties for doing so.
The reality is that abortion rarely feels like a choice for the person seeking surgery. The myriad reasons people choose abortion, many of which are absolutely medical emergencies, include:
• Abusive relationships. Domestic violence increases during pregnancy, and murder is a leading cause of death in pregnant women.
• Poverty. Seventy-three percent of women who have abortions say they cannot afford a baby. Amid a global pandemic, when people are losing jobs and healthcare, these pressures can only intensify.
• Health issues in the baby. Women may seek abortions because the baby has catastrophic birth defects or will not survive outside of the womb. In a pandemic, the suffering of babies with severe birth defects will be even worse, and the resources available to treat them will be limited.
• Rape, incest, and other forms of abuse. Texas’s ruling offers no exception for rape victims—even children.
• Age. Under Texas’s new law, an abortion is not medically necessary for a 12-year-old incest survivor, or for a 9-year-old who doesn’t even understand what sex is.
To compare these very real tragedies to an elective surgery like breast augmentation or a vasectomy is to treat women’s lives and emotions as if they just don’t matter.
Abortion is unlike most other medical procedures because there is a ticking clock attached. Delay abortion for a few weeks and it becomes more dangerous and expensive. Delay for a few more and it’s illegal. Anti-choice activists know this, of course. That’s exactly why they’re using COVID-19 to delay abortions.
Birth Trauma and COVID-19
Birth trauma is already common, with many women describing stories of obstetric abuse, and sometimes even sexual violence in the delivery room. This is inevitable in a sexist society, and it’s a trend that will accelerate in the world of coronavirus. Many hospitals have already banned doulas. Some are banning partners from being present at their children’s births. Others are routinely separating mothers and babies at birth, even though there is no research supporting this and plenty of evidence that doing so harms both maternal and infant health.
We are forcing women to give birth at a time when doing so may yield lifelong trauma. A good birth isn’t just a nice thing to have. Maternal mental health matters, and can have far-reaching consequences for an entire family. We’re priming women giving birth now to spend years coping with the aftermath of trauma. And now Texas and other states want to force as many women as possible to face that trauma.
The Catastrophic Effects of Forced Birth
We don’t have to speculate about what happens to women denied abortions. We already know. The Turnaway Study uses data on women who sought abortions in various states. Some were past the state’s legal limit and therefore could not get an abortion. Researchers have compared outcomes over time. They have found:
• Women denied abortions are more likely to need government assistance.
• Women who can’t get abortions are more likely to live in poverty.
• Being denied an abortion is correlated with a higher risk of being in an abusive relationship.
• People denied abortions have worse mental and physical health.
Even if we don’t care about women at all, abortion is still a public good. Research finds that abortion improves men’s health and economic prospects, too.
In the United States, Pregnancy is Always Life-Threatening
Perhaps the most frightening thing about emerging abortion bans is this: The United States has the worst maternal mortality rate in the wealthy world. It is the only wealthy nation in which maternal mortality has increased in recent years. It is more dangerous for a woman to give birth now than it was for her mother three decades ago. Inadequate medical care is a primary culprit here. As hospitals fill and doctors get sick, medical care will decline. Increases in maternal mortality are inevitable. In a nation that refuses to slow the maternal mortality epidemic, every pregnancy is potentially life-threatening.
Here again, we don’t have to speculate. We have clear data proving the point. The Turnaway Study found that 1 percent of women denied abortions died. We also know that banning abortion has never stopped it, and in some cases may even increase the abortion rate. Abortion bans only make abortion less safe.
This is not about protecting life. Republicans have repeatedly asserted that it’s fine for millions of Americans to die at the altar of the economy. They don’t care about women or their babies. They only care about seizing control. And once the government gains control over something—especially if it’s women’s bodies—it’s very hard to get that control back.