Abortion: US marks a year since Roe v. Wade reversal

The landmark Roe v. Wade ruling of 1973 gave pregnant people in the US the right to decide themselves whether to have an abortion up to the 24th week of pregnancy.

But in June 2022, the Supreme Court, which since the presidency of Donald Trump has a conservative majority on the bench, overturned the decision. The highest court in the land gave back jurisdiction in this issue to the 50 federal states — a shock for all those who in principle are in favor of the right to abortion. And, according to surveys, those people make up a constant majority of Americans.

It's true that even before this reversal, there had been a decadeslong "culture war" as US states interpreted Roe v. Wade according to whether they had liberal or conservative governments, which led to a patchwork of different abortion rules. But the removal of the basic right to terminate a pregnancy has caused an even higher degree of polarization, and made it possible to introduce yet stricter restrictions on abortion, or absolute bans.

A country drifting apart

Nicole Huberfeld, a professor of health law at Boston University who is also co-director of a reproductive justice program there, said "[t]he difference was that states always had to be mindful of the line of viability, the time at which a fetus would potentially be viable outside of the womb, outside of a pregnant person's uterus. [...] And if the state law outlawed abortion before 24 weeks, approximately, of pregnancy, then the federal court would say: 'Well, this is a pre-viability law. We're going to strike it down,' and that law would have no effect."

She said this "guardrail" was really important, including for the legal security of doctors who carry out abortions. But, she added: "Now that guardrail does not exist anymore."

The US Guttmacher Institute, which does a lot of research on the issue of abortion, has drawn up a map showing, in seven gradations, how restrictive or liberal the rules on abortion are in the individual states. Of the 50 in total, 13 are dark red and thus highly restrictive. In these states, abortions are more or less forbidden.

Conservative, highly religious states such as Texas, Tennessee and Mississippi already had strict rules for those with unwanted pregnancies and people providing the relevant medical services. They and the other states marked dark red on the map had prepared "trigger laws" — laws banning abortion that would automatically go into force if there were a new ruling at the federal level, which came in 2022.

Long trips for those seeking abortions

One person who knows from personal experience how difficult the additional hurdles to getting an abortion can be is Sarah King. In 2006, at the age of 17, she had an abortion in Alabama.

"The guy I had been seeing broke up with me, told me it wasn't his baby," she said. "It was a very difficult decision. Basically, I would have been stuck in the small town that I was in. I would end up having to give up my scholarships because I wouldn't be able to start [to study at university] immediately."

At the time, abortions were, in principle, still possible in Alabama. But there were still restrictions, such as requiring people to go to an abortion clinic first for information before coming back 24 hours later to have the procedure carried out — something that is no trivial matter when there are so few abortion clinics and people have to travel long distances to get to them.

King said that at the time there were three clinics in the entire state, meaning that she spent the night at the clinic in Montgomery where she had the abortion done.

Far-reaching consequences

The complete bans on abortion in some states makes the problems caused by the lack of adequate medical care in parts of the US even worse, said Huberfeld. 

"What we're starting to see is that physicians are actually moving to abortion-protective states," she said. Huberfeld believes that "[w]e may start to see some real shifts in terms where access to care generally exists in the United States."

There is some comfort for those who defend the right to abortion: Some Democrat-ruled states have stepped up their efforts in the opposite direction as a kind of countereffect. For example, they have enshrined in their constitutions the individual freedom to decide whether to have an abortion, or now provide more financial assistance for terminations of pregnancy. California, Michigan, Minnesota, New York and Oregon, for instance, even reimburse people for travel costs if they come tp access abortion clinics.

The reversal of Roe v. Wade has exacerbated the conflict between liberal and conservative states and caused great instability and confusion, said Huberfeld.

"There's also conflict between the states and the federal government over things like the Emergency Medical Treatment and Labor Act. That makes it so that hospitals have to provide emergency care regardless of the state law," she said. 

Loss of physical autonomy

Sarah King said the overturning of Roe v. Wade made her extremely angry, adding that she has taken part in abortion-rights demonstrations as a protester and speaker. 

"It's really scary because I feel like as a woman, I don't even have control over my own body [...] It's OK that your religion or spirituality guides you through life. But it should not dictate what is done to other people," she said.

The ruling last summer also attracted great international attention and met with criticism from many countries and governments. But some countries, such as Poland, saw it as validating its own restrictive abortion rules.

Cristina Rosero, the senior legal adviser for Latin America and the Caribbean at the NGO Center for Reproductive Rights, has been closely following events in the US.

"What happens in the United States is always a global reference, but a year after this event we can say that the historic legal guarantees we have achieved for access to abortion in Latin America are still in place," she said. "It should not lead us to think, from a colonialist vision, that the advances achieved in the Global South are vulnerable because of what happens in the North."

However, she also said that "[w]hat happened in the US tells us that we cannot simply take for granted the rights we have won. It is a warning that should encourage us to keep up the historical legal and political struggles."

This article has been adapted from German.

Correction, June 24, 2023: This article has been updated to correct the spelling of Cristina Rosero's name. DW apologizes for the error.