Wednesday, June 28, 2023

A Year Without Roe: In the Data ~~ Jessica Valenti ``

 jessica.substack.com/p/a-year-without-roe-in-the-data?utm_source=post-email-title&publication_id=11153&post_id=131506543&isFreemail=true&utm_medium=email

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Hey, it’s Grace Haley, Abortion, Every Day’s researcher. I’m taking over the newsletter today and I thought I’d talk about the post-Roe statistics we’ve been tracking:

The data and research that's come out over these last few weeks paint a stark picture of our first year without Roe. We wanted to share with you what people’s lives have looked like by pulling out a few statistics to pay particular attention to. There are three main themes encapsulated by these reports: documenting the harm done by abortion bans, the shifting public view on abortion, and accounting for what the future will look like in the post-Roe world. 

Harm Done

NARAL Pro-Choice America found that in the year following the Dobbs decision, 26.1 million women of reproductive age are living under a regime that has eliminated or severely restricted abortion access. That number will continue to grow as new abortion restrictions that are currently being litigated in court go into effect.

In 2022, there were 563 pieces of legislation introduced that restrict abortion access. The Center of American Progress found four common types of anti-abortion laws: abortion bans and restrictions; medication abortion challenges; federal and state funding for crisis pregnancy centers; and enforcement laws like bounty hunter mandates and laws with criminal penalties.

And in 2023, the Guttmacher Institute found that so far nearly 700 abortion bills have been introduced—about half would expand access, and about half would restrict it.

Over the last year, Abortion, Every Day has reported the day-to-day toll of these bans, including Texas’ abortion ‘complication’ reporting law, the plan to open a national network of crisis-pregnancy-center-led ‘maternity homes’, the shuttering of maternity wards, an OBGYN exodus, and the constant barrage of horror stories of women being denied care. These bans put patients’ lives in jeopardy, along with a host of communities around them. And they have disproportionately affected young women and women of color.

In the last year, we’ve also seen an unprecedented attack on medication abortion. A report prepared by the offices of Sens. Elizabeth Warren, Tina Smith, Tammy Duckworth, Mazie Hirono, Dianne Feinstein and Maria Cantwell—which relied on the expertise of medical organizations—found that concern went beyond just the legal attacks on abortion medication. They also flagged: 

  • Misinformation and disinformation. This has led to massive confusion among patients and providers alike about the safety and legality of the medication;

  • Attacks on the drug regulation system—and fears that those could lead to mifepristone being removed from the market altogether; 

  • Threats of criminalization and violence, which made it harder for pregnant people to get care and health care workers to do their jobs. 

Guttmacher’s report also details how abortion extremism is not just fueling attacks on providers and patients, but on democracy and the separation of powers. In states with abortion bans, governors and state legislators are attempting to restrict the discretionary power of district attorneys in seven states. Anti-abortion legislatures with majority rule have exploited their preemption legal doctrine in order to “concentrate their power” and restrict municipalities attempting to protect abortion rights. States with conservative majorities have rejected or changed ballot measure rules (or are trying to) in order to prevent voters from approving pro-abortion referendums. And “rules of decorum” are being abused to silence the voices of dissenting lawmakers in these states.

Abortion, Every Day has spent the last year ensuring that you have all the information you need to fight back against Republican abortion bans. Help us keep going and growing by signing up for a paid subscription:

At the same time we saw these attacks on democracy and citizens, the care crisis compounded. The Society of Family Planning’s #WeCount research project showed that tens of thousands of people were displaced, unable to get abortions, or had to travel long distances in order to find care over the past year. They reported that in the nine months after Dobbs, 94,000 people who sought abortions were unable to receive legal care in states with bans or severe restrictions. (These numbers didn’t include medical abortions through telehealth options, or self management of abortions). 

Additionally, there were over 25,000 cumulative fewer abortions from July 2022 through March 2023: 

“Even in places that reported increases in numbers of abortions in states where abortion was permitted did not compensate for the reductions seen in states where abortion was banned.” 

These numbers show how tens of thousands of people were denied the pivotal abortion care necessary for their safety and wellbeing. They were forced to travel across the country, to self-manage their abortions, or to ultimately continue a pregnancy against their will.

Reports from 538 and #WeCount also analyzed what the shifts in these numbers meant for the rest of the country, as even pro-choice states reeled from the aftershock of the trigger bans and subsequent legislation. They noted that several states in the Southeast—North Carolina, South Carolina, and Florida—saw some of the largest initial surges in patients after the Dobbs decision and were vital access points for those forced to travel for abortion care. We know that these numbers will only get worse as the full weight of new bans go into effect and the Southeast corridor becomes a blackout for abortion care. 

Clinics in abortion-accessible states reported large increases in patients, as did telehealth providers who are seeing a surge in demand. Virtual providers have become an integral component in helping to absorb capacity and tackle long appointment wait times in abortion-friendly states. Hey Jane, for example, reported a 164% increase in the last year since Roe was overturned. 

Again, these bans aren’t only affecting states with abortion bans and restrictions. Planned Parenthood has reported on “the bottleneck of patients who are trying to fit into appointments in states where abortion is accessible.” 

For example: Illinois’s Planned Parenthood saw a 54% increase in the number of abortion patients traveling from another state. They reported they saw patients from 34 states. And Planned Parenthood of Greater Washington and North Idaho saw a 20-30% influx in out-of-state patients in recent months. 

Some other notable data points from these reports: the number of patients needing financial assistance doubled for many clinics, and they are seeing an increase in second trimester abortions, as restrictions and clinic wait times push appointments back for patients. 

Patients’ rapidly increasing need for financial help is also demonstrated in a report from the National Abortion Federation (NAF), which is America’s most-used abortion support hotline. The group reported seeing a 235% increase in plane or bus trips, and a 195% increase in hotel room bookings since Roe was overturned. As abortion becomes increasingly inaccessible further into pregnancy, people have fewer options the longer their appointments are pushed (the 19th* has a good piece on this).

Abortion, Every Day has reported the financiallogistical and emotional toll involved with this displacement. And Advancing New Standards in Reproductive Health (ANSIRH) at the University of California in San Francisco published a report this year showing that those who need to travel for abortions experienced stress, anxiety, and shame as a result. From one patient in this report:

“It’s forcing shame and stigma on you during what is already the worst moment of your life (of learning your fetus is unhealthy)...At no point did anyone that we knew personally try to put shame on to us—it was the state, but no one that we knew and loved did.”

And while access to birth control is more crucial than ever, anti-abortion groups are already mobilizing efforts to ban contraception. American women can see the writing on the wall. From a survey from KFF

“Reproductive-age women are taking more precautions around pregnancy because of concerns about their ability to access abortion: About 3 in 10 women between the ages of 18 and 49 say that they or someone they know has started using long-term contraceptives or stocked up on emergency contraceptives, and about 1 in 5 delayed getting pregnant, while a similar number got permanently sterilized.” 

CNN reported a 300% increase in demand for emergency contraception. And TIME survey found that a quarter of their respondents changed their method of birth control within a month of the Dobbs decision.

But increased birth control use is not always a good thing: The Guardian reports that people feel pushed to go on contraception to prevent forced pregnancy.y

Public Shift

While abortion bans and restrictions increase, so does approval for abortion rights. In response to the statistics above, we’ve seen broad swaths of voters mobilizing for reproductive rights—and shifting views. Most Americans think abortion should be legal (61%), and that share is growing since Dobbs, according to the recent polling coming out over the past few months. Long-standing patterns in public opinion are also changing for the better: conservatives are increasingly more supportive of abortion rights than they were before Dobbs, and more Americans are open to unrestricted abortions during the second and third trimester. A 538 report noted that “no subgroup in Gallup’s data has become notably more conservative on first-trimester abortion since Dobbs,.”

A record high number of people believe abortion should be legal through the first trimester (69%), according to a recent Gallup poll. And according to 538’s report, support for second and third trimester abortions was especially strong among young people, women and Democrats. The majority of Americans supported the federal right to abortion (around 50-60%), but Dobbs cemented more liberal views on abortion that are breaking records. They reported that “the gap between the youngest and the oldest Americans jumped from one point in 2011 to 18 points in 2023” for support for legal abortions in the second trimester, and “women’s support for legality [for third trimester abortions] more than quadrupled.”

According to a new Perry Undem poll, the Dobbs decision also had a measurable impact on voting behavior during the midterms—a trend likely to continue into the 2024 elections. Dobbs brought out new voters; abortion was the top issue for Democrats, young women, and independent women voters; and the decision changed what people think other people are thinking about abortion. (Less people believe that most Americans are anti-abortion). The poll also found that “59% of registered voters say Dobbs will affect their vote in the long-term—beyond the ‘22 midterms” (most of those voters are pro-abortion rights). Their data also suggested that political ads focused on abortion kept the decision salient for voters.

Two points I find particularly important in so many of these reports: just how important this is to young women, and how anti-abortion candidates are not getting the same united support compared to pro-abortion candidates. Often the political priorities of young women are sidelined, but political moment after political moment have shown that abortion rights will make or break upcoming elections.

The past year has solidified the interconnectedness of Dobbs’ in Perry Undem’s polling: those who support abortion access felt that the decision made them think about a host of issues—including the loss of women’s rights, the government having control over people’s bodies, the state of our democracy, less access to birth control, and maternal mortality. 

These polls, along with election outcomes, all point to similar conclusions: that banning abortion remains deeply unpopular across the spectrum. 

Future Look

Despite the immense suffering over the past year, more abortion protections have passed than abortion bans, according to CAP. And a majority of voters have supported abortion in post-Dobbs ballot measures. That does not mitigate the harm done, but it does provide a glimpse of a better future and hope for those with boots on the ground in the fight for abortion rights.

States have passed protections and acted proactively to support abortion rights alongside abortion bans. From the CAP report

“State lawmakers across the nation introduced 369 bills to protect access to abortion, and passed 77 of them across 18 states. These protections range from increased security for abortion providers and patients, expanded insurance coverage for abortion services, improved access to medication abortion, shield laws to keep providers from being prosecuted in states where abortion is illegal, and explicit abortion protections in state constitutions.” 

States also moved to protect providers, patients and practical support volunteers with “shield laws”(varying state by state) from criminalization in states with abortion bans.

Additionally, a Coalition of 30 Black Reproductive Justice came together to create the first-ever Black Reproductive Justice Policy Agenda that brings forward a vision beyond the scope of Roe that helps women and girls. So much of the health, socio-economic and political crisis we are seeing today predates Roe, and many are calling on leaders to take on this moment to build a better future than the abortion landscape we inherited over the past five decades. This ranges from greater federal infrastructure to account for maternal health and pregnancy care to unrestricted access to abortion to contraceptive equity.

Jade Hurley, the communications manager behind the DC Abortion Funddescribed to the Huffington Post our current moment where the abortion rights movement has become unapologetic along with a future that provides protections beyond the lines Roe drew in the sand. “When we have nothing, we are forced to be imaginative,” she said. “I’m looking forward to seeing what we can build.” 

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