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Here's What Happens When States Control Abortion

Here's What Happens When States Control Abortion

Donald Trump appeared on Sunday night's episode of "60 Minutes," giving his first prime-time television interview since he won the election last Tuesday. The president-elect used the opportunity to clarify his stance on a number of issues. Among the topics covered was abortion, which has proven to be a major source of curiosity among Americans this election season. In the months leading up to Election Day, Trump made it clear that he was anti-abortion (except in cases of rape, incest, and mother endangerment). He and running-mate Mike Pence said they wanted to appoint Supreme Court justices who would overturn Roe v. Wade, leaving abortion access in the hands of the states. And on Sunday, Trump reaffirmed this stance.

When asked about the justices he wants to appoint to the Supreme Court, Trump said his nominees would be pro-life (and pro-Second Amendment). "But having to do with abortion — if it ever were overturned, it would go back to the states," Trump said, reiterating a statement he made in the final presidential debate. When the interviewer asked Trump about women needing abortions in states where it's banned, he said, "Well, they’ll perhaps have to go — they'll have to go to another state." Worth noting: These comments were only made during an interview. Trump is under no obligation to follow through on these promises, and we can't know what he plans to do about abortion until he actually does it. But if he did decide to follow through, research has given us an idea of what women seeking safe, legal abortions would face — and it isn’t pretty.

Trump is right: If Roe v. Wade were overturned, abortion legislation would fall to the states.
We can't know for certain what states will do if put in this position, but it's likely that some will keep abortion access legal while others try to eradicate it entirely. As it stands, only seven states have laws in place to protect a woman's right to choose abortion. These are: California, Connecticut, Hawaii, Maine, Maryland, Nevada, and Utah. These laws prohibit anything that interferes with a woman's ability to get an abortion (before fetal viability or in cases where the mother's life or health is threatened), and will uphold abortion access if Roe v. Wade is overturned.

On the opposite end of the spectrum, 19 states have passed laws that could limit abortion access if Roe v. Wade were overturned (some states have passed multiple laws). Four of these states (Louisiana, Mississippi, North Dakota, and Utah) would automatically ban abortion, and 11 (Alabama, Arizona, Arkansas, Delaware, Massachusetts, Michigan, Mississippi, New Mexico, Oklahoma, West Virginia, and Wisconsin) would retain bans passed before Roe v. Wade. Eight states (Arkansas, Illinois, Kansas, Kentucky, Louisiana, Missouri, North Dakota, and Ohio) have laws expressing intent to limit legal abortion as much as possible in the absence of Roe v Wade.

So what happens to women when abortion is banned in their states? 
In 2013, Texas passed House Bill 2, a law that imposed severe restrictions on doctors and facilities that provide abortions, with the clear intent to limit abortion access in the state. (A so-called TRAP law, the Supreme Court overturned it in June, ruling that it placed an undue burden on women's access to reproductive health care.) While HB2 didn't ban abortion completely, it effectively shut down a number of abortion clinics, making it significantly more difficult for women to obtain abortions. Research released earlier this year in the American Journal of Public Health showed just how bad HB2 was for Texas women — giving us an idea of what women in other states may experience if Roe v. Wade is overturned. The study — which surveyed nearly 400 women seeking abortions from 10 different clinics — found that women had to travel substantial distances just to get an abortion. Women whose local clinics had closed traveled an average of 170 miles round trip, whereas women whose local clinics stayed opened traveled an average of 44 miles round trip.

A quarter of women surveyed traveled up to 278 miles. On top of that, women had to pay for things like gas, lodging, and childcare—thus placing a disproportionate burden on women from low-income households. HB2 also required women to have four medical consultations before obtaining medication-induced abortions (as opposed to surgical ones), which is especially hard for women who are already traveling long distances to get to the clinic. This resulted in fewer women being able to obtain the reproductive care they desired. "Anyone who cares about women and reproductive rights is horrified about what happened in Texas," Lauren Streicher, M.D., an associate professor of clinical obstetrics and gynecology at Northwestern University Feinberg School of Medicine, previously told SELF. "By having these kinds of obstacles and barriers, you’re not going to decrease the number of abortions, but you are going to increase the chance that women will have an abortion at a later time." This is hugely important, considering it increases the odds that women will experience health complications as a result.

Making abortion illegal doesn’t stop abortions from happening.
Before Roe v. Wade, many women were still having abortions — they were just illegal or self-induced. According to the Guttmacher Institute, estimates show that somewhere between 200,000 and 1.2 million illegal abortions were conducted in the 1950s and 1960s — and these procedures were incredibly dangerous. In 1930, abortion was listed as the official cause of death for nearly 2,700 women (accounting for 18 percent of the maternal deaths recorded that year). Women from low-income households were, once again, disproportionately affected. A study of New York City women in the 1960s found that 77 percent of low-income women who sought out an abortion attempted a self-induced procedure, and only 2 percent said a physician had been involved in any way. Thankfully, we've come a long way since then. Data from the Guttmacher Institute show the number of abortion-related hospital admissions and deaths dropped significantly after the Supreme Court upheld Roe v. Wade in 1973. Recent CDC abortion surveillance research shows that fewer than one woman dies in every 100,000 legal abortions carried out by a professional. But if Roe v. Wade is overturned, we risk returning to our somber past.

Research released this January shows that in states where abortion access has been severely limited, Google searches for "how to have a miscarriage" and "how to self-abort" have been on the rise. "We’re back to the days before Roe vs. Wade," Streicher previously told SELF. "We know that before abortion was legal, it wasn’t that it didn’t happen — but people died as a result." The future of abortion access in this country isn’t just a political issue — it's a women’s health issue. Again, no decisions have been made. Trump won't take office until January 20, and there's no telling what statements he will or won't follow through on. Still, it's important to understand what reality might look like for women seeking safe, legal abortions if Roe v. Wade is overturned as promised — and the potentially dire consequences if they’re not able to get them.

More From SELF:
• I Had An Abortion At Age 14 And I Don't Regret It
• A Woman Died After A Hospital Allegedly Refused To Give Her An Emergency Abortion
• I'm An Ob/Gyn And A Trump Presidency Scares Me — Here's Why

• Abortion Was The Most-Googled Issue For Much Of Election Day 2016

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