Women’s Right to Choose

In a perfect world, only those who are ready for and desire a child would become pregnant. But that’s not the world we live in. One fact remains: everyone has a right to bodily integrity, and more needs to be done to ensure that women have and maintain that right in private.

Inaccessibility to abortion has serious economic consequences for women, particularly women with lower incomes. It increases their chances of experiencing poverty, unemployment, and dependence on public assistance programs. Low income women make up about 75% of abortion patients, and women denied abortions are more likely to receive public assistance after childbirth than those who received an abortion. 

While denial of abortion rights hurts women economically, access to abortion has generational economic benefits. When we trust women to decide when to start a family, it dramatically increases their ability to graduate from college and start a career. They pass benefits on to their children, who are less likely to face poverty in childhood and more likely to go on to lead more educated and independent lives.

Unfortunately, despite the landmark 1973 Roe v. Wade decision that protects a woman’s right to choose, abortion laws look different from state to state. Without a federal law that confirms Roe v. Wade, which anchors a woman’s right to an abortion on the fundamental right to privacy, states have extensive power to limit or expand access to abortion.

Nearly 20 years after Roe v. Wade, the Planned Parenthood v. Casey decision was passed permitting courts an undue burden standard that gave states the authority to regulate abortions before 24 weeks, as long as it doesn't place an "undue burden" on the woman. Since then, increased leniency to regulate abortion has given way to laws that make abortion almost impossible for women. They include TRAP laws that require abortion service providers to maintain unnecessary licensing and hospital privileges, fetal heartbeat laws, and even a bill in Alabama that threatens doctors who perform abortions with severe criminal repercussions up to life in prison. These developments in restricting access to abortion are among many that have no basis in medical science and only exist to erode a woman’s right to choose.

The most common reason women seek an abortion is a lack of means to financially support a child ($233,610 for the average middle income family before college expenses). Abortion itself is not cheap, which explains why affordability is one of the most significant barriers women encounter when seeking abortion care in the United States. The average amount paid for an early medication abortion is $535, and abortion costs increase as a pregnancy progresses. This price tag does not include other associated expenses, such as time off from work, child care, travel, and lodging, which particularly affect women who live in abortion clinic deserts.

The Hyde Amendment bans federal funding for abortions other than to save a mother’s life or to terminate a pregnancy that arises out of rape or incest. The means that family planning providers like Planned Parenthood can use federal funds to operate their facilities, so long as those funds for administering abortion come from other sources. Planned Parenthood is one of the many high-quality, client-centered family planning providers that offers affordable and comprehensive family planning and sexual health care to millions of Americans. Currently, U.S. taxpayers save $7 for every dollar the government spends on family planning funds by averting costly medical expenses. Unfortunately, funding for Planned Parenthood and other family planning clinics that provide abortion referrals or abortion services is under attack by the Title X Gag Rule. 

A study of defunding Planned Parenthood by the nonpartisan Congressional Budget Office projected that the bill would reduce spending by $520 million in the short run between 2016 and 2025, but subsequently increase direct spending on extra births and the ensuing children by $650 million during the same period. This legislation will cost American taxpayers more at the expense of American women’s health. Both the Hyde Amendment and the Title X Gag Rule are cutting off critical preventative funding for family planning clinics like Planned Parenthood, and as a result, are costing taxpayers hundreds of millions of dollars every year.

The truth is, restricting abortion does not reduce the number of abortions because these laws are usually passed in tandem with restricted access to contraception and inadequate sex education. Restricted abortion laws leads to more unplanned pregnancies and forces women to seek unsafe procedures that put them at risk. Unsafe abortions are the third leading cause of maternal deaths worldwide and lead to an additional five million largely preventable disabilities. States with restrictive abortion laws, like Alabama, have some of the highest infant mortality rates and some of the worst health outcomes for women in the nation compared to states like California that offer strongly protected abortion access. The closing of clinics and cutting funds to Planned Parenthood in 2012, caused maternal deaths in Texas to soar from 72 deaths per 100,000 live births to 148 deaths per 100,000 live births. Women should not have to risk their health and their lives when it can all be prevented through access to safe and legal abortion. 

The majority of women who cannot afford or are denied abortion will carry the unwanted pregnancy to term. They have four times greater odds of living below the Federal Poverty Level, experience pregnancy complications, and experience barriers in their socioeconomic mobility. Children born to unwanted pregnancies also face a lifetime of underachievement and social distress, including a risk of becoming chronic juvenile delinquents 11 times higher than other children. 

About 91% of abortions occur in the first 12 weeks of pregnancy. The second-trimester abortions are more complicated, whether that is due to delay in becoming aware, affordability barriers, or detection of anatomic or genetic anomalies. Yet, only 7.7% of abortions are performed at 14 to 20 weeks’ gestation, and even fewer are performed at over 21 weeks’ gestation (1.2%). The decision of abortion belongs to the woman, not the state or the federal government. Abortion is often painful and distressing, and women should be trusted when making this private, difficult decision. If and when they do make this sensitive decision, their reasons should be private and respected. 

Despite 32 state legislatures passing 394 new restrictions on abortion between 2011 and 2017, abortion rates fell across all states. Eighteen states that did not enact any new abortion restrictions accounted for 57% of the decline in abortions nationwide. But the drop in abortion rates is not a result of more restrictive abortion laws. With birth rates down in nearly every state, the biggest reason for  the decline is that women are avoiding unintended pregnancies. By improving access to affordable sexual and reproductive health care that includes contraception, we are supporting patients' health and rights as a whole. 

When it comes to our laws regarding abortion, we need to trust women. As Justice Ruth Bader Ginsburg said, “Access to abortion is a woman’s autonomous charge of her full life’s course...her ability to stand in relation to man, society, and the state as an independent, self-sustaining, equal citizen.” A woman’s right to choose goes beyond autonomy, it is about equity, equality, and privacy.