14 May 2022 | New Scientist | 15More Insight online
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newscientist.com/insightUS senators discuss the
leaked draft decision to
overturn Roe v Wadeof abortions in the US while
making up 14 per cent of women
in the US. The other reason is
rooted in systemic racism, says
Shah. “Disparities are downstream
effects of what we see from a
commonly rooted sense of
accepted inequity,” she says.
Most deaths occur during or
shortly after labour, but about
30 per cent occur earlier in
pregnancy. In many of these
cases, an abortion would save
the person’s life, but some states
would deny people care even
then – similar to high-profile cases
in Poland and Ireland over the past
decade in which people died after
being denied an abortion.
Even if an exception is made
when the pregnant person’s life isstate or via self-management –
the country’s maternal mortality
rate would increase by 21 per
cent. Black people again would
be disproportionately affected,
with an increase of 33 per cent.
One reason for this disparity
is that Black women are over-
represented among those seeking
abortion, obtaining 28 per centKE
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MAGESmean that self-managed abortions
are much safer than they used
to be. “Pre-Roe, pre-misoprostol,
there were clear correlations
between legal abortion and safe
abortion, and illegal abortion
and unsafe abortion,” she says.
“Those have been decoupled a
little bit because mifepristone
and misoprostol are so safe.”
The US Food and Drug
Administration (FDA) approved
mifepristone for abortion in 2000.
It is now typically combined with
misoprostol to end pregnancies
in the first trimester. Mifepristone
used to only be attainable from
a doctor’s office, but during the
covid-19 pandemic, the FDA made
it available via the post and with a
telehealth appointment. That was
made permanent in December.
However, many states expected
to ban abortion would also restrict
these medications, and if a person
was caught using them, they could
be charged with murder. That
happened last month in the case
of a woman in Texas, though the
charges were later dropped.
Even if self-managed abortion
is dramatically safer than it used to
be, and these medications continue
to be used, experts still expect
deaths during pregnancy and
childbirth to increase if Roe v Wade
is overturned. That is because
pregnancy can be deadly. The US
has the highest maternal mortality
rate among high-income nations at
23.8 deaths per 100,000 live births.
For Black women, that skyrockets
to 55.3 deaths per 100,000 live
births – about three times greater
than that of white women.
Forcing more people to carry
to term will result in a greater
number of deaths from pregnancy
and childbirth. A study published
last year estimated that if abortion
were completely banned in the
US – meaning it wasn’t possible
to obtain an abortion in another
at stake, at what point is a
condition deemed deadly? “The
entire premise is that we have to
let people get really, really sick or
near death before it is acceptable
to intervene, which, of course,
is the exact opposite of what we
want to do in pregnancy or in
health in general,” says Prager.
There are also concerns that
other reproductive health services
could be restricted. A bill being
considered in Louisiana declares
life begins at fertilisation. It is
unclear how the law would be
enforced, but it is conceivablethat the definition could apply to
embryos created during IVF. As a
result, someone could be charged
with a crime for destroying excess
or abnormal embryos.
Some Republican law-makers
have also declared some forms of
birth control, such as intrauterine
devices and the morning after
pill, to be abortion-inducing
substances, even though they
aren’t. These primarily work
by stopping ovulation or
fertilisation, but they may also
prevent implantation of an
embryo in the lining of the uterus,
which would be deemed homicide
under the proposed Louisiana law.
These consequences are still
hypothetical, but the Turnaway
study shows that people denied
abortion are more likely to have
poor physical and mental health,
live in poverty and stay with an
abusive partner. What’s more,
some studies have shown that
children born from an unwanted
pregnancy and a family’s other
children are less likely to bond
with the mother and achieve
developmental milestones. ❚“Racial disparities are
downstream effects of
a commonly rooted sense
of accepted inequity”