Consider This from NPR - Roe's Legal Fate Is Unclear. But Studies Already Show Who'd Likely Be Hit Hardest

Episode Date: May 9, 2022

Debates about the status of Roe v. Wade continue after the Supreme Court's draft opinion was leaked last week. This week, the Senate is planning to vote on legislation that would codify abortion rights into a federal law, but it's likely to fail given the 50-50 split between Democrats and Republicans. That means abortion access will be left up to states — and some already have restrictive abortion laws. Reproductive justice advocates are concerned about the disproportionate impact those laws will have on Black and Brown communities if Roe is overturned.NPR's Sandhya Dirks spoke to some advocates about how women of color are situated in this abortion access debate. And NPR's Selena Simmons-Duffin explains how restricting abortion access means restricting health care for people across all demographic backgrounds. You can also hear more from Dr. Diana Green Foster, who spoke to NPR's science podcast Shortwave, which examined what happened when people had access to abortion and what happened when they were denied.In participating regions, you'll also hear a local news segment to help you make sense of what's going on in your community.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

This message comes from Indiana University. Indiana University performs breakthrough research every year, making discoveries that improve human health, combat climate change, and move society forward. More at iu.edu slash forward. The fire that was ignited by the Supreme Court's leaked draft opinion is in full blaze, including across the Sunday political talk shows. Republican Senator Ted Cruz told Fox News, if Roe versus Wade is overturned, it's best to let individual states decide whether to ban abortions. If, in fact, the court does overturn Roe, the result is not that abortion is illegal across the country. The result is that it's up to the people, that

it's up to democracy. But Democrats are warning that Republicans want to take it farther, that the GOP will turn its focus to a nationwide abortion ban. And indeed, Mitch McConnell, the Republican Senate Majority Leader, told USA Today over the weekend that a national law banning abortion is possible if Republicans get power. Here's Minnesota Senator Amy Klobuchar, a Democrat, on ABC's This Week. Who should make this decision? Should it be a woman and her doctor or a politician? Should it be Ted Cruz making this decision or a woman and her family? Where are women's equal? The Senate is planning to vote on Wednesday on legislation

that would codify abortion rights into federal law. Any federal abortion law would need 60 votes to enshrine it, and that's highly unlikely given the 50-50 split in the Senate, meaning abortion laws would be left up to states, and not every state would feel the impact the same way. So that's how I see abortion within the context, a larger context, of a public health crisis. Not a political issue, but a public health crisis. Geddy Israel is founder of a women's health clinic called Sisters in Birth. It's in Mississippi, where the current Roe Challenge is centered. And Israel says that while she hears about who is more likely to seek an abortion in her state, she doesn't hear enough about why. No one ever says, what do you need?

What can we do to help improve your life so that you don't find that you need to have an abortion? What's going on with you? What can we do in your community? Consider this. As we wait to see if a monumental political shift is coming for abortion rights across the country, we already have data on what the social, economic and medical shifts could look like. From NPR, I'm Mary Louise Kelly. It's Monday, May 9th. This message comes from WISE, the app for doing things in other currencies. Send, spend, or receive money internationally, and always get the real-time mid-market exchange rate with no hidden fees. Download the WISE app today or visit WISE.com.

T's and C's apply. It's Consider This from NPR. There are consequences for those who need an abortion and can't get one. People who become pregnant and are unable to get a safe legal abortion in their state will experience long-term physical health and economic harm. Dr. Diana Green Foster is a demographer. She and her team of researchers tracked the lives of women who had an abortion and those who tried but were unable to get one. They followed up with the women every six months for five years.

When denied an abortion, some women experienced worse physical health outcomes. Carrying a pregnancy to term and delivering a child is much more physically risky than having an abortion, even a later abortion. We see much more severe physical health complications from birth. Being denied an abortion also changed women's finances. This is not just about poverty, although we see that people who are denied abortions are more likely to live in households where there just isn't enough money for basic living needs. And they're more likely to be raising children alone if they are denied the abortion than if they receive one.

Foster's group found that more than 95% of the women they interviewed who received an abortion later said it had been the right choice for them. Foster explained more of that study to our colleagues at NPR's daily science podcast, Shortwave. There's a link to the full discussion in our episode notes. It helps when you're trying to make sense of the current debate over Roe v. Wade to have contexts and facts about who exactly in America is getting abortions and what further restricted abortion access could mean for health care? So here's NPR's Selena Simmons Duffin speaking with my colleague, Scott Simon.

Well, people of every race, age, class in every state get abortions. Here's Dr. Iman Al-Saidan, the medical director of Planned Parenthood in Great Plains, which covers Kansas, Arkansas, Oklahoma, and Western Missouri. When I talked to her, she was in Wichita. We see people that are homeless. We see people that live in mansions. We are actually seeing like literally the full gamut of who needs abortions in our clinics. According to CDC, most patients in the U.S. who get abortions are in their 20s. More than 90% of abortions are done early in pregnancy before week 13. According to the Guttmacher Institute, in 2020, more than half of abortions were what's called a medication abortion, which involves taking pills. Also, most people who get abortions are already parents, which kind of debunks the narrative that it's mostly teenagers who aren't ready for children. And you've been speaking with abortion providers about the range of circumstances by which patients come to them. What did you learn? Right. So one OBGYN I spoke with

is Dr. Jamila Parrott here in Washington, D.C. She's president and CEO of the group's Physicians for Reproductive Health. We can go through a laundry list, you know, broken condoms, missed pills, travel, missed appointments. We can talk about sexual assault. We can talk about all kinds of reasons, genetic abnormalities, maternal indications. That's just a quick list. But regardless of the circumstances, Dr. Parrott and the other providers I talked with pushed back on the idea of unwanted or unplanned pregnancies. These adjectives just don't capture what's going on in people's lives.

So to explain, I talked with Dr. Jennifer Kearns, who works at the University of California, San Francisco, and travels to Oklahoma to provide abortions. And here's what she told me about one of her patients. I saw a patient in Oklahoma who had four kids. She was in her mid-20s. She had been unemployed for a while. She had just gotten a job, and she found herself pregnant. And as much as she, I think, felt connected to the pregnancy and connected to her identity as a mom, she knew that she would be a better mom to the four kids and that she would be better able to care for them if she didn't bring another kid into the world. So she said she talks to her patients with the understanding that people know best what's the right next step in their lives. Of course, abortion is still legal in the

U.S. now. If Roe were to be overturned and half of the states ban or restrict abortion, what could that mean for health care? Right. So let's just run through some of the clinical situations in which someone may need abortion services. If they have a miscarriage, if their water breaks too early and they're at risk of infection, if they receive a serious diagnosis like cancer and they need to begin chemo, if fetal anomalies are detected. In all of those situations, state laws restricting abortion can have serious clinical impact on a patient's care. Our colleague Sarah McCammon told the story of one woman whose water broke at 19 weeks. She was at risk of hemorrhage or septic shock, and she had to fly

from Texas to Colorado to receive care. And people who can't travel may seek unsafe abortions and face serious health consequences because of that or even die. So we will likely hear more and more situations like this when the ruling becomes final and more state restrictions take effect. NPR health policy correspondent Selina Simmons-Duffin. The communities that have been hit hardest by restrictive abortion laws in certain states are black and brown, and black women are already three to four times more likely to die in childbirth than white women. Reproductive justice activists say abortion access is a racial

justice issue. NPR's Sandhya Dirks reports on how women of color are situated in this abortion access debate. Michelle Colon calls herself an abortion freedom fighter. She's the founder of SHERO, which fights for abortion access in Mississippi. We are here for all women and girls, all people, but our specific target, and we're unapologetic about that, is Black and brown.

Colon says communities of color have already been disproportionately impacted by abortion restrictions. And when Roe is overturned, they'll continue to bear the brunt. There's a lot of reasons for that, starting with geography. The states that are most likely to ban abortion have much higher, much greater proportions of people of color. That's Ushma Apadhyay, a public health social scientist at the University of California, San Francisco. We also know that about 60 percent of people obtaining abortions are people of color. Just take a closer look at Mississippi, where Michelle Colon lives. People of color make up 44 percent of the state. According to the Kaiser Family Foundation,

they receive 81 percent of the state's abortions. When Roe is overturned, it will likely shutter Mississippi's last abortion clinic. But it won't stop Colon. The reality of it is, is that we're going to have to get people from Mississippi, outside of the state, across the country. But traveling isn't always easy. Having a car, money, the ability to take time off of work, all things that a lot of lower-income folks of all races don't have access to. And research has shown being denied access to an abortion only makes things worse. UCSF's Ushma Apadhyay points to the Turnaway study, which followed women who couldn't get an abortion over 10 years. They were living at higher rates of poverty five years later. It has economic health outcomes

and social outcomes for years to come when people are denied their wanted abortions. For Black and brown women, just giving birth puts them at increased risk. Class doesn't matter here. All Black women are three to four times more likely to die in childbirth than white women. The root cause is racism. When Black women are experiencing complications of pregnancy, they're not listened to, they're not believed, they are believed to have higher pain thresholds. And then there's what will happen when abortion becomes criminalized. Here's Melissa Murray, a professor of law at New York University. Ectopic pregnancies, miscarriages, like all of these are going to be questioned,

I think, in a world in which abortion is either unlawful or entirely criminal. Women are already being prosecuted and charged after miscarriages and stillbirths. Those women are often poor and disproportionately women of color. Who's going to be singled out for that kind of treatment, for that kind of surveillance? It's likely going to be the people who are already adjunct to the criminal justice system. In Justice Samuel Alito's leaked draft opinion, he wrote that abortion is not deeply rooted in this nation's history. Murray says that's not right. Abortion wasn't illegal until after the Civil War. And the reason it was criminalized? Murray's talking about the past here, but she could be describing the present.

The immigrant birth weight is swelling and the white birth rate is shrinking. And they are deeply, deeply worried that America is no longer going to look like America. So, shades of Tucker Carlson. Murray says what is deeply rooted in American history is racism. But just as deeply rooted is resistance. NPR national correspondent Sandhya Dirks. You heard additional reporting in this episode from NPR's Leila Fadl and the team at Morning Edition. It's Consider This from NPR. I'm Mary Louise Kelly.