When the United States Supreme Court announced its famous ruling in the case of Roe v. Wade on January 22, 1973, it did not introduce abortion to the American public. Indeed, it was far from the first time that the procedure was made legal in the United States. Instead, the ruling brought into the open the common secret of abortion, a procedure that was estimated to have been accessed by 1.2 million people per year in the years immediately prior to legalization. The effect of this landmark decision was not to direct people to get abortions, but to provide those who decide to seek the procedure access to safe and legal care.
Virtually from the moment the ruling was handed down, however, those opposed to abortion sought to put up every obstacle they could between patients and a safe procedure. Nationally as well as on the state level, more than a thousand laws and regulations – many ideologically driven – have gone into place in the last 44 years. North Carolina legalized certain abortions prior to 1973 and established a state abortion fund in the mid-1970’s – making it a less hostile southern state on the issue. However, state leaders also have a history of creating restrictive regulations and policies from virtually the moment the Supreme Court decision was issued.
Starting with an arbitrary and unconstitutional 20-week abortion ban in 1973, the 1970’s also saw laws that restricted the procedure to certain medical professionals (physicians) and certain facilities (hospitals and licensed clinics). Physicians also faced significant penalties for providing the procedure in ways deemed "contrary” to these regulations.
The 1980’s saw additional attacks on funding for abortion, with numerous regulations banning federal and state funds – from Medicaid to military insurance to insurance for government employees – from covering the procedure. North Carolina minors were also targeted at this time. Originally and unconstitutionally not being allowed to consent at all to an abortion due to a 1977 law, they were later given an opportunity to obtain an abortion, but only with the consent of a parent. (It’s worth noting that North Carolina minors are not required to notify a parent if they decide to carry a pregnancy to term – something that is often vastly more dangerous to their health).
The North Carolina state abortion fund was repealed in 2006, after years of being deliberately underfunded. And recent years have brought an avalanche of new regulations, with more laws being enacted in the past six years than in the previous thirty. Recent times have brought waiting periods (24, then 72 hours) and additional funding restrictions, even dictating what private insurance is allowed to cover if working with state or local governments.
And while state funds are forbidden from flowing to any health or medical organization that has anything to do with abortion, these same funds are funneled to anti-abortion groups that operate programs designed to deceive, pressure and shame patients out of seeking abortion. Additional ideologically-driven standards have been placed on physicians and abortion clinics, and more intrusive patient data, such as ultrasound images, is being collected by the state. With an incoming federal administration hostile to reproductive freedom, a Congress that has already introduced legislation to defund vital reproductive health services and ban virtually all abortions, and a state legislature emboldened by an opportunity to overturn Roe v. Wade, we anticipate even more attacks on the right to access abortion in 2017.
Abortion is a legal medical procedure, but the politically motivated restrictions on funding and availability have made it virtually inaccessible for many North Carolinians. Nine out of ten North Carolina counties have no abortion provider, and calls to the Carolina Abortion Fund have increased drastically. It is estimated that one in four low-income patients seeking abortion are not able to obtain services due to lack of funds and other restrictions (including having to travel long distances, and making more than one trip to a clinic). What’s more, the low-income patients who do obtain an abortion often find themselves forced to forgo essentials like rent, groceries, utility bills and other medical payments to cover the costs.
While abortion was even more of a taboo subject in 1973 than it is today, there was still public support for making sure women were able to access the procedure safely. And even by conservative estimates, that support has remained solid during the intervening decades. Rather than punishing patients seeking abortion, a solid majority of Americans support providing a safe and legal procedure if that is what the woman has decided to do. Forty-four years on from Roe v. Wade, it’s time lawmakers followed the public’s lead once and for all.