Sunday, May 12, 2024

Abortion in America: An Analysis of Abortion Policy

 In 1973 the Supreme Court’s decision in Roe V. Wade ruled that abortion would be secured as legal across the United States. This meant that access to abortion would be guaranteed, no matter which state you resided in. The logic of the court was that a relationship between a doctor and patient (i.e. pregnant woman) was protected by a right to privacy, and the government had no business interfering in the medical decisions of a doctor and patient up to the point that a fetus had developed to near the point of “viability” when a premature birth could conceivably lead to a child who would survive. The idea of privacy rights was assumed based on the Constitution and documents from the time of the Constitution making it clear that the Bill of Rights in the Constitution were not a complete list of all rights enjoyed by citizens, and the unnamed rights could be assumed. As privacy was a concept that people at the time of the Constitution’s writing in the 1780s were well-aware of, and valued, it seemed to a majority of the court that the Constitution should be understood to protect abortion (at least in the first 23 weeks of gestation, until viability), and no state had any right to restrict this right. At the state level, state legislatures and governors could not overrule the federal ruling of a Supreme Court decision, so abortion was legal. In 2022 the Supreme Court overruled Roe V. Wade, bringing this decision back to the state level. Some states have their own policies on abortion, many dating back to pre–Roe V. Wade. These policies were not updated for decades because the federal ruling overruled any laws passed at the state level anyway. When Roe V. Wade was overturned June 24, 2022 in the Dobbs v. Jackson Women’s Health Organization decision, this put laws about abortion back into the hands of state governments, and many states had previous state level laws that came back into force. Some states had no laws preventing abortions; some states, like Michigan had archaic laws from 1931 banning all abortions no matter the reason. With the sudden overturn of Roe v Wade, Michigan was facing being forced into reverting to the prior laws. 

Abortion is a very controversial topic for many people. Some argue that it is considered murder and should be illegal. Some people believe that abortion should be legal up until 12 weeks, or 21 weeks. In some situations, it is believed to be acceptable to perform a live birth abortion. No matter the level of abortion, the topic is heated, and many people are either fiercely in favor of the right to abortion, also referred to as “pro-choice”, or against, referred to as “prolife”. 

For those who are pro-choice there are many arguments. The most common argument for choice is bodily autonomy. A person should have the right to choose what they wish to do with their own body. Many women find themselves pregnant despite their precautions. Sometimes this is due to failure of birth control; for others, it has been due to the lack of control of the situation, or consent; in other words, they are raped. Prior to Roe v. Wade, abortions were being performed “in back alleys”, or other unsafe conditions. Many times, these abortions would lead to serious complications for the woman, and commonly result in death. Making abortions illegal was not stopping them from happening, it was just forcing them to be completed in ways that were not regulated or considered safe. Another argument of many prochoice supporters is that a fetus is not viable until 24 weeks (with modern science this is closer to 21 weeks—about 5 months—now). If a baby were to be born prior to 21 weeks (about 5 months) they have slim-to-no chance of surviving. There are so many situations that lead a woman to seek abortions, and pro-choice supporters believe that it should only be up to the mother and her medical professional to decide which path is best for her situation. Abortions performed after the 18th or 19th week of gestation are almost always conducted because the fetus has a terrible health problem that will cause suffering and death within hours of birth, or because carrying the baby to term would create a strong possibility of death for the mother. 

On the other hand, pro-life supporters also have arguments. They believe the fetus has a heartbeat as early as 18 days (about 2 and a half weeks) after conception, and the baby has a right to life equal to the right enjoyed by persons who have been born, because the moment that a life becomes of concern to the state and worth protecting begins early, perhaps when the heart starts to beat. In some states people believe that once the baby is conceived, it has its own rights to have a chance of living a life. Conception is rarely defined—is conception the fertilization of the egg by the sperm (1st hour), the implantation of a blastocyst on the uterine epithelium (end of first week), or formation of the umbilical cord (end of the third week)?  These supporters believe it is not the mother’s place to decide whether the baby should be able to be born or not. Adoption is always an option for the mother. Pro-life supporters believe that a mother who does not want the pregnancy should carry out the pregnancy to full term and put the baby up for adoption. In this case, the mother would not have any legal responsibilities for the child, and the child also has a chance to live a long successful life. There are also medical risks that come with abortion for both the mother and baby. The mother knows that risks of the procedure, but the baby does not. Pro-life supporters believe it is not the place for anyone to put a child through the procedure of abortion, as this can cause pain and even lifelong consequences in the case of a failed abortion. 

With these arguments, we are left to look at the whole picture of abortion. There are many cases where abortion is performed safely and successfully ends the pregnancy. This is the best solution for some women. In other situations, there may be medical complications leaving the woman to still be pregnant and carry out a pregnancy of a baby who has serious medical defects due to the failed attempt at abortion. 

It is hard to determine when life begins. A heart may beat at 18 days (about 2 and a half weeks) after conception and the fetus still would not be viable to live outside the woman's body at that phase. Looking at these arguments, do we consider this to be the start of life? Or is the start of life when the fetus is viable outside the womb without the mother? Is it the woman's choice to decide what is best for her life and her body, or does she lose that right once she becomes pregnant because the zygote or embryo or fetus has a right to life that should take precedence over the mother’s right to choose whether to carry to term? 

To have an abortion performed one must seek medical attention. The medical provider will evaluate the situation, and in a state that allows abortions, if the gestation is prior to 24 weeks, they may proceed. Few doctors would proceed after 18 or 19 weeks gestation unless there were indications that the fetus had severe problems or the mother had health complications, as abortions used merely for birth control are usually conducted soon after a pregnancy is noticed.  The medical unit providing an abortion will make the woman partake in informed consent, which means the women will be given information about the procedure, the risks, and the benefits. Then providers also mention the alternate options. According to https://www.cdc.gov/reproductivehealth/data_stats/index.htm “93% of reported abortions in 2019 were performed at or before 13 weeks (about 3 months) of pregnancy, 6% were conducted between 14-20 weeks (about 4 and a half months) and 1% were performed at or after 21 weeks (about 5 months)”. The abortions that were performed at or after 21 weeks (about 5 months) were due to medical necessity. Many times, these abortions are performed due to some sort of medical reasoning that is usually life or death for the mother. 

TABLE 10. Number of reported abortions in 42 states, by known weeks of gestation* and reporting area of occurrence — selected reporting areas,† United States, 2019 

State/Area

Weeks of gestation

Total abortions reported by known gestational age

≤6

7–9

10–13

14–15

16–17

18–20

≥21

No. (%)§

No. (%)

No. (%)

No. (%)

No. (%)

No. (%)

No. (%)

No. (% of all reported abortions)

Alabama**

1,280 (21.3)

2,807 (46.8)

1,257 (20.9)

317 (5.3)

163 (2.7)

133 (2.2)

46 (0.8)

6,003 (99.9)

Alaska

292 (23.0)

639 (50.4)

271 (21.4)

64 (5.0)

††

††

0 (—)

1,269 (99.9)

Arizona

3,863 (29.5)

5,985 (45.7)

2,079 (15.9)

496 (3.8)

261 (2.0)

245 (1.9)

168 (1.3)

13,097 (100.0)

Arkansas**

479 (16.2)

1,265 (42.7)

862 (29.1)

150 (5.1)

82 (2.8)

97 (3.3)

28 (0.9)

2,963 (100.0)

Colorado

3,639 (40.4)

3,666 (40.7)

1,062 (11.8)

198 (2.2)

150 (1.7)

110 (1.2)

173 (1.9)

8,998 (100.0)

Connecticut

4,046 (45.7)

3,155 (35.7)

947 (10.7)

263 (3.0)

175 (2.0)

164 (1.9)

95 (1.1)

8,845 (96.1)

Delaware

536 (26.3)

1,071 (52.5)

328 (16.1)

73 (3.6)

16 (0.8)

6 (0.3)

9 (0.4)

2,039 (99.9)

Florida

52,850 (73.5)

11,641 (16.2)

4,843 (6.7)

973 (1.4)

691 (1.0)

699 (1.0)

217 (0.3)

71,914 (100.0)

Georgia

16,086 (43.6)

13,864 (37.6)

4,396 (11.9)

927 (2.5)

653 (1.8)

752 (2.0)

229 (0.6)

36,907 (100.0)

Hawaii

678 (33.9)

861 (43.0)

268 (13.4)

80 (4.0)

43 (2.1)

49 (2.4)

22 (1.1)

2,001 (99.9)

Idaho

493 (32.9)

707 (47.1)

257 (17.1)

37 (2.5)

††

††

††

1,500 (99.1)

Indiana

1,924 (25.2)

4,055 (53.1)

1,618 (21.2)

9 (0.1)

8 (0.1)

17 (0.2)

6 (0.1)

7,637 (100.0)

Iowa

1,652 (46.3)

1,305 (36.6)

412 (11.6)

68 (1.9)

58 (1.6)

54 (1.5)

17 (0.5)

3,566 (100.0)

Kansas

2,761 (40.0)

2,722 (39.5)

921 (13.4)

195 (2.8)

121 (1.8)

137 (2.0)

37 (0.5)

6,894 (100.0)

Kentucky

1,302 (35.5)

1,493 (40.7)

550 (15.0)

116 (3.2)

65 (1.8)

109 (3.0)

29 (0.8)

3,664 (100.0)

Louisiana

2,815 (34.6)

3,567 (43.8)

1,274 (15.7)

273 (3.4)

173 (2.1)

38 (0.5)

0 (—)

8,140 (100.0)

Maine

595 (29.5)

996 (49.3)

317 (15.7)

48 (2.4)

33 (1.6)

31 (1.5)

0 (—)

2,020 (100.0)

Michigan

9,016 (33.0)

11,496 (42.1)

4,055 (14.9)

1,110 (4.1)

667 (2.4)

584 (2.1)

353 (1.3)

27,281 (99.8)

Minnesota

3,597 (36.7)

3,845 (39.2)

1,381 (14.1)

379 (3.9)

194 (2.0)

216 (2.2)

187 (1.9)

9,799 (98.6)

Mississippi

1,117 (35.0)

1,421 (44.5)

468 (14.7)

171 (5.4)

16 (0.5)

††

††

3,194 (100.0)

Missouri

86 (5.8)

496 (33.7)

505 (34.3)

130 (8.8)

87 (5.9)

112 (7.6)

55 (3.7)

1,471 (100.0)

Montana

599 (38.2)

628 (40.1)

211 (13.5)

51 (3.3)

34 (2.2)

34 (2.2)

11 (0.7)

1,568 (100.0)

Nebraska

976 (47.2)

683 (33.0)

284 (13.7)

62 (3.0)

46 (2.2)

16 (0.8)

0 (—)

2,067 (100.0)

Nevada

3,214 (38.6)

3,510 (42.1)

1,078 (12.9)

250 (3.0)

142 (1.7)

89 (1.1)

52 (0.6)

8,335 (99.1)

New Jersey§§

8,513 (39.3)

7,499 (34.6)

2,923 (13.5)

961 (4.4)

638 (2.9)

613 (2.8)

514 (2.4)

21,661 (97.7)

New Mexico

1,487 (42.7)

957 (27.5)

381 (10.9)

80 (2.3)

73 (2.1)

101 (2.9)

406 (11.6)

3,485 (88.4)

New York City

22,364 (44.9)

17,579 (35.3)

5,579 (11.2)

1,335 (2.7)

897 (1.8)

934 (1.9)

1,096 (2.2)

49,784 (100.0)

North Carolina

9,598 (33.9)

12,098 (42.8)

4,432 (15.7)

982 (3.5)

672 (2.4)

484 (1.7)

15 (0.1)

28,281 (99.4)

North Dakota

435 (38.8)

447 (39.9)

180 (16.1)

42 (3.7)

17 (1.5)

0 (—)

0 (—)

1,121 (100.0)

Ohio

5,523 (27.5)

9,070 (45.1)

3,558 (17.7)

848 (4.2)

531 (2.6)

477 (2.4)

95 (0.5)

20,102 (100.0)

Oklahoma

2,177 (43.6)

1,835 (36.8)

710 (14.2)

125 (2.5)

64 (1.3)

64 (1.3)

16 (0.3)

4,991 (99.9)

Oregon

4,064 (47.2)

2,924 (33.9)

949 (11.0)

241 (2.8)

129 (1.5)

149 (1.7)

160 (1.9)

8,616 (99.2)

Rhode Island

929 (44.4)

705 (33.7)

270 (12.9)

90 (4.3)

52 (2.5)

32 (1.5)

13 (0.6)

2,091 (99.6)

South Carolina**

1,063 (20.8)

1,970 (38.6)

1,740 (34.1)

298 (5.8)

8 (0.2)

13 (0.3)

9 (0.2)

5,101 (100.0)

South Dakota

64 (15.6)

224 (54.8)

††

††

0 (—)

††

7 (1.7)

409 (98.8)

Tennessee

1,836 (18.9)

4,939 (50.9)

2,188 (22.5)

436 (4.5)

176 (1.8)

119 (1.2)

9 (0.1)

9,703 (99.8)

Texas**

22,356 (39.0)

22,721 (39.7)

8,232 (14.4)

1,870 (3.3)

957 (1.7)

838 (1.5)

301 (0.5)

57,275 (100.0)

Utah

1,018 (34.8)

1,185 (40.6)

478 (16.4)

92 (3.1)

51 (1.7)

67 (2.3)

31 (1.1)

2,922 (100.0)

Vermont

550 (46.0)

423 (35.4)

129 (10.8)

32 (2.7)

21 (1.8)

22 (1.8)

18 (1.5)

1,195 (100.0)

Virginia

7,917 (50.8)

5,215 (33.5)

1,938 (12.4)

121 (0.8)

131 (0.8)

170 (1.1)

90 (0.6)

15,582 (99.9)

Washington

7,046 (41.0)

6,768 (39.4)

2,061 (12.0)

420 (2.4)

265 (1.5)

273 (1.6)

363 (2.1)

17,196 (99.6)

West Virginia

325 (27.5)

536 (45.3)

235 (19.9)

58 (4.9)

18 (1.5)

††

††

1,183 (100.0)

Wyoming

18 (58.1)

12 (38.7)

††

††

0 (—)

0 (—)

0 (—)

31 (100.0)

Total

211,179 (42.9)

178,985 (36.4)

65,739 (13.4)

14,471 (2.9)

8,581 (1.7)

8,064 (1.6)

4,882 (1.0)

491,901 (99.6)¶¶

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