It's Time to Move Beyond Roe

By Janet Chung

At 42 years, measured by standard reproductive age (ages 15-44), Roe v. Wade is reaching an advanced age. But rather than this anniversary marking advances sufficient to end the need to fight for this most basic right – the right to decide whether, when, and how to bear and parent children – it sometimes feels closer to marking the end of Roe.

Women comprise more than half of the U.S. population. Over 99 percent of women of reproductive age who have ever had sexual intercourse have used at least one contraceptive method. One in three women will have an abortion in her lifetime. Simply put, a full range of reproductive health care is an essential part of primary care for women.

Yet increasingly, women’s access to reproductive health care has been eroded by restrictions. During the 2014 state legislative session alone, state lawmakers introduced 341 provisions aimed at restricting access to abortion. Earlier this month, during the first few days of session for the current Congress, lawmakers introduced five different bills restricting abortions, including a bill to ban abortions after 20 weeks that was scheduled to be voted on today. (House Republicans scrapped that vote yesterday evening, but will instead vote on a bill that restricts taxpayer funding of abortion, which disproportionately impacts low-income women.)

These bills are not only anti-women, but also often infused with disrespect toward communities of color. Another new federal bill would ban sex-selective abortions, cynically claiming the title “Prenatal Nondiscrimination Act” (Arizona’s similar law is even more cynically named the Susan B. Anthony and Frederick Douglass Prenatal Nondiscrimination Act). Already on the books in seven states, these bills don’t combat any form of discrimination, but rather, are based on, and perpetuate, racist and anti-immigrant stereotypes about women of color and their communities.

Currently, according to the Guttmacher Institute, 87 percent of U.S. counties do not have an abortion provider, and 35 percent of women aged 15–44 live in those counties. In Washington State, 64 percent of counties had no abortion clinic (2011 data), and from 2008 to 2011, Washington experienced a 10 percent decline in overall providers (from 50 to 45). Nonhospital providers estimated in 2005 that nearly two in 10 women traveled 50–100 miles to access abortion services, and almost one in 10 traveled more than 100 miles.

And the restrictions on reproductive health care access are not limited to abortion care. It’s already the case that in many communities, independent clinics have had to fill the gap in comprehensive reproductive services for women. For example, while Planned Parenthood is best known for providing abortion services, those account for about 3 percent of Planned Parenthood’s activities, which include contraception (35 percent), STD testing (also 35 percent), and cancer screening and prevention (16 percent).

Further accelerating the segregation of women’s health care from “general” health care is the rise in mergers between religious and secular hospital systems. Because Catholic policy forbids providing certain services including contraceptive counseling and care, sterilization, as well as abortions, access to comprehensive reproductive care often falls victim to corporate dealmaking.

Instead of further restricting access to basic reproductive health care, lawmakers should be working to increase access. As the President stated earlier this week in his State of the Union address, surely we can agree it's a good thing that unintended pregnancies and abortions are nearing all-time lows, and that every woman should have access to the health care she needs.

Support for improving reproductive health care access is widespread. For instance, a poll commissioned by In Our Own Voice: National Black Women’s Reproductive Justice Agenda initiative shows overwhelming support in the Black community, across ideological and generational divides, for not just abortion rights but also comprehensive sex education and access to contraception. It is time not only to defend Roe, but move beyond it.

In her novel A Handmaid’s Tale, Margaret Atwood famously depicted a dystopia in which women were valued and segregated based on their reproductive capacity. Maybe we aren’t quite there yet, but only through proactively expanding protections can we reverse this trend toward a separate and unequal health care system for women. Washington can start with ensuring that every woman has access to coverage for contraception and abortion care, regardless of who her employer is, and ensuring that hospital systems can’t restrict providers from providing the care their patients need. Equity demands no less.

Janet Chung is Legal and Legislative Counsel at Legal Voice, based in Seattle, Washington, where she works to advance reproductive and economic justice for women through advocacy, litigation, and legal rights education. She is a Ford Foundation Public Voices Fellow with the OpEd Project.

Photo courtesy of William Murphy.