What would the US look like if Roe v Wade was struck down? What if the states could decide what they wanted to allow? I feel like a lot of "pro-life" people think of abortion restrictions and have romantic notions of lots of beautiful, happy babies being born, yet don't give careful consideration to the logistics of making abortion illegal. Let's pretend, in a "best case scenario," that all of the states pass laws that make abortion illegal EXCEPT in the cases of rape and incest:
(I also want to preface this by saying that the language I use is not meant to be exclusive. Trans men can get pregnant and trans women can fertilize eggs. I speak of "men" being responsible for the pregnancies discussed below because, in my experience, it's almost exclusively cisgender men and women who tend to be vocal against abortion, not trans men or women. Again, this isn't meant at all to be exclusionary of transgender people.)
In a state where abortion is permissible in the case of rape, a woman may have safe, legal access to abortion. But what does this really entail? Firstly, it implies that there are people in charge who designate these scenarios as permissible by law. Who are these people? What are their qualifications to make medical decisions for others? I very sincerely doubt that these individuals will simply take a woman's word for it that she was raped and grant her an abortion. So, what will likely happen? Women will need to provide proof that they were raped in order to receive their abortion. This would mean police reports. Witness statements. Hospital records. Women would be required to furnish these things, or at the very least, someone would be assigned to her case to gather this information. If a woman cannot a) provide a police report, b) furnish witnesses or c) produce medical records with detailed tests that prove, on paper, that she was in fact raped, she will likely be deemed ineligible for abortion. It's even possible that she would need to prove that the pregnancy was caused by the rapist and not someone else, adding further burden to women to identify their rapists. More tests. More records. What if the rapist cannot be located? What if the woman was unable to go to the hospital for a rape kit? What if she couldn't report her rape at all? And what if a police report states that the woman in question had been drinking or been drugged? Will her case be thrown out because she was "asking for it?" She will be deemed ineligible for abortion and will be forced to carry her rapist's baby to term.
In the case of incest, judges or individuals or whoever is appointed to investigate women's claims for abortion will have to determine if incest took place. Again, what sort of people are qualified to do these investigations? Incest cases tend to be young girls. How are young girls supposed to access hospitals without parental consent to have their testing done? How are they supposed to file police reports if they have to navigate around an abusive parent, or uncle, or whoever is abusing them? These tests and reports will very likely be unattainable in these cases, and so these women and girls will be ineligible for abortion and forced to bear.
What about the cases of transgender men? Transgender men who can be impregnated will likely never be allowed abortion, simply because they are transgender. With RVW being struck down, so likely will follow same sex marriage and further and further down the line until all who are "different," transgender people, people of color, lgbtq people, etc. will have their rights taken away and granted less personhood than a zygote. I can even envision a scenario of spite in which judges will deem transgender men ineligible for abortion because, after all, they insist they're men. That may not happen, but it's a depressing possibility.
Back to who makes these decisions. How exactly are these individuals who will sit and judge abortion access by a case by case basis be selected? Will they require medical qualifications? Law degrees? Will they be screened to ensure that their decisions don't stand to be tainted by sincerely held religious beliefs that might make them rule in favor of denying abortion? Are we going to set up "abortion boards" in each state? Each county? Are they to be elected by the people by vote or will they just be chosen by the government of each state? Who will pay for these "abortion boards?" One can only assume that the taxpayer will be footing the bill. So, there will come a day where we will be taxed to pay people to investigate women. Anti-choice individuals consistently balk at the idea of their taxes going towards caring for these women and their babies. Will they be content instead to pay scores of individuals for all the "work" they would do investigating women, which could be a potentially astronomical amount of money? Money questions aside, investigators will be required to access private medical records. Private police reports. The friends, family, coworkers and acquaintances of these women will surely be interviewed, forcing the victim to relive her experience over and over, and making what happened to her and what she plans to do public knowledge. People will be elected to dig into women's private lives to make a judgement, without knowing the woman personally or maybe never even meeting her, on whether or not she will be able to terminate a pregnancy that she does not want.
Not to mention... who supervises and regulates the boards?
I didn't mention this above, but what about abortion in cases that will save the life of the mother? Again, let's not be so quick to assume that any state government or organization will just take the word of any doctor that, for example, says a D&C is absolutely necessary to save a patient. What if a decision needs to be made by the abortion panel before the procedure is done? Life-saving interventions will have to be put on hold, possibly causing irreparable damage or death to the patient, simply because they're waiting for a "thumbs up" from the authorities. And even if the abortion panels do grant doctors emergency decision-making privileges when a pregnancy will harm or kill the mother, what sort of investigation will occur after the procedure? Will the doctor be subject to scrutiny? Will they be required to furnish proof to these abortion boards that the procedure was, in fact, necessary? And what if the "board members" disagree? What if they don't even have medical expertise? Will doctors then be stripped of their licenses and the women punished after the fact? How many great doctors who save countless lives will be forced out of work because someone a hundred miles away from the operating room decided that their medical opinion was invalid?
As far as other medical professionals go, what of pharmacists? Pharmacists are permitted to decline filling a prescription for abortion drugs if they claim it goes against their "beliefs." It happens more than you'd think. If the abortion boards deem an abortion permissible, what if the woman struggles to find a pharmacist who will give her the medication? Will the abortion boards ensure that she has access to the drug?
Another thing to consider is that if abortion is illegal, and more and more women are having babies, hospitals may be overwhelmed. There are only so many OBs to go around. This surge in births may give rise to unqualified midwives offering their services in birthing centers and at home births. It's a fact that births outside of the hospital have higher death rates than in the hospital, inside the US, and I've furnished proof of this with a link in the comments*. In the US, lay midwives (not to be confused with certified nurse midwives) are not regulated and don't require any special medical training outside of a high school diploma, yet they are frequently touted as "safer" alternatives to undesirable hospital births and the interventions they provide which many, particularly in the natural birthing moment, consider to be unnecessary. Personal opinions on birthing methods aside, I think it very likely that more and more of these centers will pop up, more people will "train" to be midwives and mothers and babies will be harmed in the process.
And lastly, what of the women who miscarry? There may need to be entirely separate "boards" just to investigate and judge whether women who miscarry had any "fault" in the miscarriage. Women will be scrutinized, examined, questioned, and harassed to ensure that there's no chance she didn't attempt to self-abort. Will all doctors then be legally required to report all miscarriages they treat to the authorities? Will entire police forces need to be established to investigate each case of miscarriage in each city? A government bureau perhaps, similar to the FBI? If so, it would mean that all women are thought of as criminals until "proven" otherwise by people who have nothing to do with them. A woman in Texas was already arrested recently for being under suspicion of attempted abortion. Women will be jailed for "questionable" miscarriages in droves.
This is just a look at a possible future that we have if abortion is made illegal. And this is only if there are exceptions made for the cases of rape or incest. If it's illegal across the board, even women who will be killed by their pregnancies won't be granted any leniency.
Would all of these things happen? It's definitely possible. If you think, oh surely we wouldn't have to get *that* technical with things, surely doctor's notes or simple statements made by women will suffice to get them the care they need. I'm not that optimistic. Remember, these people don't want abortion to happen at all, ever. I just don't see them making it an easy process for any woman in any capacity. Their jobs, first and foremost, will be to assume that women don't need abortion. People who consider themselves to be pro-life must act responsibly and assist in constructing a properly-run and regulated system that supports their ideologies, and be willing to foot the bill for it too.
There are so many other aspects to the abortion debate and why it is crucial to have access to safe, legal procedures. The inherent misogyny behind demanding that women be "held accountable" for having sex. The hypocrisy of those who cry for the life of a fetus, but think women deserve what they get if they try to self abort. Overrun foster care systems. So many other things that I won't bother listing. Those who rally against abortion have made it clear that they either ignore those things or just don't care. I wrote this essay just to give a little perspective and make people sit down and think on the effects of the opinions they have and what they may mean for the women and child-bearing individuals in their lives. Not to mention what effect the votes that they cast will have and what exactly they will entail beneath the shiny, righteous veneer of fighting for the lives of sweet little babies.
I have four children, three that I birthed myself. I love them more than anything in this world. I'd die for them. I'd kill for them. But I chose to have them. That was my choice. There should always be choice. I refuse to live in a country in which my daughters will be treated as brood sows forced to bear. I won't bury one of them because they had an ectopic pregnancy that killed them. And I'll be god-damned if I ever let some panel of (let's face it, probably male) individuals tell me what I can and can't do with my own body. I will fight like hell to ensure that never happens. I hope you do, too.
