The Supreme Court on Friday, June 24, issued a ruling in the case of Dobbs v. Jackson Women’s Health organization that will dramatically re-shape the legal reality of reproductive rights in the United States.
The ruling overturns the landmark Roe v. Wade ruling and is expected to lead to a restriction of abortion rights in numerous states.
Northwestern University faculty from a range of disciplines participated in a virtual news conference to address how the ruling will affect Americans and businesses from a medical, legal and cultural standpoint. In order to help make sense of the developing news, Northwestern Now summarizes some of their comments.
What implications could this decision have for future elections and Congressional votes?
“Until now, lawmakers were able to vote on abortion bans and get their 100% anti-choice rating with no consequences because none of them could ever go into effect due to the Roe v. Wade precedent,” said Katie Watson, associate professor of medical education, medical social sciences and obstetrics and gynecology at Northwestern Feinberg School of Medicine.
“Now that there’s going to be a real effect on actual pregnant individuals and at the polls, we may see variation in voting patterns. I think we’ll see chaos in the next months and years as folks adjust and then recalibrate.”
“The fight over Roe v. Wade is a fight, in large measure, over who should be deciding these issues — whether agencies, a court or legislature,” said Ronald J. Allen, the John Henry Wigmore Professor of Law at Northwestern Pritzker School of Law. “Congress needs to bear down on this question. They could condition federal funds, as they do with driving. Your ire should be directed at legislators; that’s who should be acting here, and that means people have to get out and vote.”
Are there legal risks if a person travels to another state for an abortion?
“This ruling allows a state — it does not require a state — to criminalize abortion,” said Laura Beth Nielsen, professor and chair of the department of sociology and director of legal studies at the Weinberg College of Arts and Sciences. “Some states may pass laws that include criminal penalties not just for abortion itself, but also for crossing state lines to obtain an abortion.”
“You might see an effort to prosecute, but I don’t think it’s going to be successful,” Allen said. “There has never been a suggestion that a state can control a person’s behavior that is legal in other states. For example, Indiana can’t make it illegal to go to Las Vegas to gamble. The probability of that being tried is about zero.”
Do abortion procedures threaten maternal health?
“People come in with a huge array of maternal health issues that make pregnancy, which is already a physiologic tax on the body, even more taxing,” said Dr. Cassing Hammond, an associate professor of obstetrics and gynecology at Feinberg.
“At baseline, any pregnancy has a 13-fold greater likelihood of leading to maternal deaths than any abortion procedure. The risk of having an abortion is less than dying from a single shot of penicillin; it’s less than the risk of death from a car ride into the hospital; it is less than the risk of death from wearing a tampon for three days during your menstrual cycle.”
“As doctors, we have taken the Hippocratic oath to do no harm and provide the best care possible, but what do we do when we are faced with a person who is bleeding to death from an ectopic pregnancy?” said Melissa Simon, vice chair for research in the department of obstetrics and gynecology and the director of the Center for Health Equity Transformation at Northwestern Feinberg.
“If the state outlaws you from removing the pregnancy, your choice is to be put in jail or let the person die. It is absolutely untenable and awful.”
What effect will this ruling have on inequality in the United States?
“The United States already has one of the highest maternal mortality rates of all high-income nations, and it is three to four times higher if you are Black in this country,” Simon said. “Maternal mortality rates for Latinas, who have had the most protections in not dying from pregnancy, also have risen. We are at the precipice of a really dangerous mixture of malpractice.”
“This issue will affect people from different social classes, races and ethnicities very differently,” said Lauren Rivera, professor of management and organizations at the Kellogg School of Management. “It will be more appealing to live and work in states with protections, but it takes a fair amount of privilege to be able to relocate and make that choice.”
Rivera added that she is the mother of a child with medical complexities, noting that her care is extremely expensive. “I am fortunate that I have health insurance, but what are we going to do with these children who are increasingly going to be born in this country? Who is going to split the bill? This is a ticket to poverty when there is no support — no support for the pregnant person’s life and no support for the child’s life.”
What are the implications of this ruling for issues such as trans rights, same-sex marriage and contraception access?
“When we look across the landscape of the conservative movement’s legislative efforts in different states, it’s part of a general program of attacking bodily autonomy and private rights to necessary health care,” said TJ Billard, an assistant professor in the School of Communication and member of Northwestern’s Center for Communication and Public Policy and Institute for Sexual and Gender Minority Health and Wellbeing.
“At this point, we have in excess of 200 anti-trans bills being considered by states, and this movement will be emboldened by the fact that they now have a venue to pursue further bans. I think we can absolutely expect this to go all the way up to the Supreme Court, and we’ve been given a preview of what rulings we will receive.”
“It’s important to keep in mind that we also have many voting rights issues, where the people who will be most impacted by these decisions about bodily autonomy are increasingly less protected in their right to a representative vote,” Nielsen said. “We have a lot of structures, systems and institutions that had been working for hundreds of years based on custom and habit, but those aren’t operating the way they used to anymore.”
How will the ruling affect availability of the abortion pill?
“There will be a reduction in availability from clinicians who will, of course, not be allowed to prescribe or administer that pill. However, people who are self-managing abortion will still get the pill from internet pharmacies and other organizations. We are already seeing that data from Texas,” said Watson, referencing behavioral changes following Texas’s ban on abortions after six weeks that took effect in September 2021.
“When people say we’re going back to the days before Roe v. Wade, there is no such thing as a time machine. We have a half century of trained clinicians who are used to practicing in an environment of legality. People will take matters into their own hands, and clinicians and advocates will find ways to support them, so the availability of the abortion pill will go down in one way and up in another.”
What can individuals do in terms of safe-sex practices to prevent unwanted pregnancies?
“I hope that teenagers and young adults and every single person in the United States who can get pregnant really thinks long and hard about long-term, reversible contraception,” Simon said. “They’re not your mother’s or your grandmother’s IUDs anymore. We have a lot of really great, safe options, and you don’t have to worry about taking a pill or the failure of a condom or anything else. No matter where you are right now, contraception is not banned.”