We're not ready for what will happen if Roe is overturned.
Lisa Harris
Fri, June 3, 2022
Anti-abortion activists and abortion rights activists are separated by META Peace Team members during a Bans Off Our Bodies protest at U-M's Diag in Ann Arbor on Saturday, May 14, 2022.
Maternity portrait
Abortion rights activists rally during a Bans Off Our Bodies protest at U-M's Diag in Ann Arbor on Saturday, May 14, 2022.
Abortion rights activists rally during a Bans Off Our Bodies protest at U-M's Diag in Ann Arbor on Saturday, May 14, 2022.
A couple of the many signs that marchers who attended the Reproductive Rights March: Fight for Abortion Justice rally in Detroit on October 2, 2021, used as they head towards Greektown. The rally and march through downtown started at 36th District Court where speakers talked about abortion-rights and what is happening in parts of the country with a woman's right to choose.More
I’ve been an obstetrician-gynecologist for 24 years, caring for women giving birth, experiencing miscarriage, and deciding to have abortions. Most patients I see have experienced some or all of these events, at different times in their life.
Since abortion is so politicized and stigmatized, it’s often hard to see that it usually coexists alongside birth and miscarriage in many women’s lives, and in the medical practices of their doctors.
I became an ob-gyn to offer compassion and expertise across all these reproductive experiences; I hope my patients have felt that. I didn’t go into medicine to be part of political debates. But I am acutely aware that such debates impact the women and families I care for.
Indeed, as we wait for the outcome of the Supreme Court’s upcoming abortion decision, my colleagues and I are trying to plan ahead for all of the ways the healthcare landscape in Michigan may dramatically shift — not only for women who might seek abortion care, but also for those whose pregnancies end in miscarriage, or for anyone who continues a pregnancy, as well.
Many Michiganders don’t realize we have a 1931 abortion ban on the books. It is among the strictest in the country, permitting abortion only to “preserve the life” of a pregnant woman. The U.S. Supreme Court’s 1973 Roe v Wade decision made it unenforceable, determining abortion is a Constitutional right.
More: Opinion: Michigan's economy headed for disaster if abortion is criminalized
More: Michigan woman: Hear my story, feel my pain before outlawing abortion
But if Roe is reversed in June, as a draft opinion suggests is likely, our ban will become enforceable, and abortion will be a crime again in Michigan, impacting thousands of women from every walk of life.
Lawsuits brought by Gov. Gretchen Whitmer and Planned Parenthood of Michigan aim to stop the 1931 ban from being enforced, should Roe fall. Last week a Michigan judge temporarily blocked the ban from coming into effect, pending the final outcome of the Planned Parenthood case. Those following abortion headlines may see the legal back-and-forth as partisan or political wins or losses.
But as a doctor in Michigan, I see it as a healthcare issue.
Bracing for tumult
Alongside my physician, nurse and midwife colleagues at Michigan Medicine, we are getting ready for the possibility that abortion will become illegal in Michigan.
Myriad preparations are needed. We are not yet ready, nor are our healthcare colleagues statewide.
First, we need to determine what, precisely, “life-preserving” abortion means.
What must the risk of death be, and how imminently? I have performed abortions on critically ill patients in intensive care units, where it is clear abortion is life-saving.
More: Whitmer to Michigan Supreme Court: 'Time is of the essence' on abortion lawsuit
More: University of Michigan forms task force to 'mitigate the impact' of possible abortion ban
Pregnancy demands so much from all body organ systems, especially heart and lungs; sometimes ending a pregnancy is the only way to help a patient survive. But outside of these situations, it gets unclear.
Maternal-fetal medicine specialists care for patients with a range of “high-risk” conditions. For patients with pulmonary hypertension, they may cite a 30% to 50% chance of dying with ongoing pregnancy.
Is that high enough to permit abortion? Or must it be 100%?
When oncologists diagnose cancer during pregnancy, some patients end the pregnancy to start treatment immediately; some cancers advance faster due to pregnancy’s extra hormones, and chemotherapy and radiation can cause significant fetal injury.
Will abortion be permissible in this situation, or must patients delay cancer treatment and give birth first? When patients have advanced cancer that was preventable with earlier treatment, increased risk of death may be a few years away.
We’ve identified many similar questions.
Just three options
Most pregnant patients seeking abortion care are not facing life-threatening conditions, and will have only three options: travel outside Michigan for abortion care, self-manage an abortion, or give birth. At Michigan Medicine we are preparing for all of this.
People with enough money and support will seek care out-of-state. For most Michiganders, this means driving to Illinois, making the average travel distance for abortion care more than 260 miles if our ban is re-enacted. This will be impossible for many, since lack of financial resources is why many women seek abortion care.
Nationally, half of patients seeking abortions live on incomes under the federal poverty level; another 25% live on just one-to-two times that.
Many cannot afford gas, tolls, hotels. They cannot afford to lose hourly wages or will be fired for missing work.
Most patients I see are already parents. Travel is much harder when you need childcare arrangements, too, especially overnight.
I’m thinking of a patient I saw not long ago, who worked the night shift, drove several hours to her abortion appointment, three children in tow, and then afterwards headed home for another night shift. Efforts like this are already the norm in abortion care, and it will only get harder.
Nevertheless, if legally permissible, our Michigan health system will need to assist those who can travel.
If allowed, we can offer referrals out-of-state and pre-travel “teeing-up.” This may include ordering an ultrasound or bloodwork and, for patients with underlying illnesses, speedy specialist consultation to ensure they can safely receive care on arrival. We must figure out if Illinois medical centers have capacity to see our patients requiring hospital-level care, knowing these hospitals will also be seeing patients from Ohio, Missouri, Indiana and other states.
Insurers will need to decide if out-of-state abortion care and associated travel expenses are covered, and patients will likely find themselves battling with insurers for such coverage, which may require costly out-of-network fees.
Will legal hazards magnify distrust?
The second option is self-managed abortion.
For over twenty years, people have safely used the FDA-approved mifepristone and misoprostol combination to end pregnancies at home, after receiving medications in a doctor’s office. Mifepristone and misoprostol obtained online from the many available, reliable sources are equally safe and effective.
However, patients without internet access, a credit card, or who don’t know about those medications may use ineffective or deadly methods: ingesting poisons, intentional trauma like falling down stairs, or putting objects into their uterus to disrupt pregnancy.
My colleagues and I will want to steer people toward safe methods, though it’s unclear Michigan’s law will permit such education.
Emergency department and primary care practitioners will need to quickly become familiar with treating abortion complications in this landscape, including complications not seen since before Roe, nearly 50 years ago.
Because mifepristone and misoprostol are so safe, legal risks may be the more serious ones for patients — meaning the people they turn to for medical care might report them, or loved ones who helped them, to police, even though that violates current privacy laws and Michigan doesn’t require reporting of suspected self-managed abortion.
Indeed, all patients who have bleeding in pregnancy or experience pregnancy loss may be vulnerable to criminal prosecution because miscarriage and self-managed abortion are virtually indistinguishable. National data show that healthcare providers disproportionately report Black pregnant patients and those living on low incomes to police.
More babies will strain pre-natal care
Third, more people will give birth. Based upon projections of who will travel or self-manage abortion, we anticipate a 5% to 17% birth increase in Michigan.
We already have significant maternal healthcare deserts — places without prenatal or birth care — where patients travel far distances to deliver.
It’s not clear how a greater need will be met.
Our own hospital’s labor and delivery unit is already at capacity from COVID birth surges.
When we work over capacity, all birthing patients are affected, not just those who might otherwise have ended their pregnancies.
Newborn and pediatric care needs will increase, too. Many families who get terrible news about their developing baby will be forced to give birth, and those babies and children will need complex, costly medical care, and often a lifetime of specialized support.
More than ever, families statewide will need robust medical and social safety nets that may not exist.
We can expect mental health care needs in pregnancy to intensify, as girls and women continue undesired pregnancies, including those resulting from rape and incest.
Michigan’s abortion ban makes no exceptions for either. Our already-overburdened mental healthcare system is unlikely to adequately meet this need.
Mothers will die
Finally, maternal mortality will increase — as much as 21% overall by one demographer’s estimate — because abortion is safer than childbirth. Centers for Disease Control data show that in the U.S., the risk of dying from childbirth is 50 to 130 times greater than dying from abortion.
This new burden of maternal death will not be felt equally in Michigan, or anywhere in the country, because Black women are more than twice as likely as white women to die from pregnancy and childbirth.
Maternal mortality for white women is projected to increase by 13%. For Black women, the projected increase is 33%, meaning that an abortion ban will disproportionately harm Black women and the families who lose them. It will become more pressing than it already is to remedy systemic inequities and racism that generate such disparities.
Unsafe abortion will add to this burden and loss.
Other reproductive healthcare will be impacted, too.
Fearing criminal prosecution, doctors may hesitate to treat ectopic pregnancy, hemorrhage or serious infection from miscarriage, when fetal cardiac activity remains.
Healthcare providers will need to decide whether they’ll continue prescribing the best evidence-based medications for miscarriage — mifepristone and misoprostol.
Since those medications are used in abortion care, doctors may fear their use carries legal jeopardy. Infertility doctors may stop providing in vitro fertilization given the potential for embryo loss in IVF.
We're not ready
Re-enactment of Michigan’s abortion ban will affect medical education. Abortion training is an accreditation requirement for ob-gyn residencies.
Michigan Medicine will need out-of-state training arrangements. Ultimately, our top-ranked program may cease to draw talented applicants. Roughly 40% of our ob-gyn graduates stay in Michigan to practice medicine, so the statewide reproductive health workforce may be impacted.
Patients will ultimately feel the impact of shifts in abortion training: If residents can’t learn "non-lifesaving" abortion care, soon no one will be trained to perform the "lifesaving" abortions Michigan’s 1931 ban permits.
Patients experiencing miscarriage will feel the loss of abortion training, too, because doctors who have such training are more likely to offer patients the full range of appropriate miscarriage treatments than doctors without it.
Finally, Michigan’s health system workforce, like those everywhere, is disproportionately female. When more of the workforce is pregnant, on parental leave, or traveling for abortion care, patients will likely feel the impact.
All of this is my way of saying that we are not yet ready to manage what is coming if abortion becomes illegal in Michigan.
Every morning I wake up with another new question. Those who view abortion exclusively as a political or partisan issue, maybe one they’d like to avoid, will soon see that abortion care, or lack thereof, is a healthcare and health equity issue that impacts everyone.
I trust my patients
Avoiding this issue isn’t possible.
Amid the flurry of logistical planning, I remain aware that abortion is complex and emotional topic for many.
That makes sense. Abortion asks us to hold two opposite things at the same time: Abortion means a baby won’t be born, and that is weighty. Banning abortion means that a girl or woman must continue a pregnancy and give birth when she can’t or doesn’t want to, shifting the course of her, and her family’s, lives. That is weighty, too.
In our polarized times we don’t really learn how to hold complexity like this. Instead we are asked to resolve our feelings one way or another, even when “pro-life” or “pro-choice” boxes may not precisely fit how we feel.
From the hundreds of times my patients have shared their lives, hopes, and hurts, I know they hold this complexity, too, as do I.
Ultimately, I trust my patients to know what they and their families most need.
My colleagues and I will continue to provide support as the legal landscape shifts, even if we don’t yet know exactly what the contours of that support will look like.
Lisa Harris
Lisa Harris, MD, PhD, is a professor of obstetrics and gynecology and professor of women's and gender studies at University of Michigan.
This guest column is adapted from an essay recently published in the New England Journal of Medicine.
This article originally appeared on Detroit Free Press: Opinion: Michigan hospitals aren't prepared for end of Roe v. Wade
Lisa Harris
Fri, June 3, 2022
Anti-abortion activists and abortion rights activists are separated by META Peace Team members during a Bans Off Our Bodies protest at U-M's Diag in Ann Arbor on Saturday, May 14, 2022.
Maternity portrait
Abortion rights activists rally during a Bans Off Our Bodies protest at U-M's Diag in Ann Arbor on Saturday, May 14, 2022.
Abortion rights activists rally during a Bans Off Our Bodies protest at U-M's Diag in Ann Arbor on Saturday, May 14, 2022.
A couple of the many signs that marchers who attended the Reproductive Rights March: Fight for Abortion Justice rally in Detroit on October 2, 2021, used as they head towards Greektown. The rally and march through downtown started at 36th District Court where speakers talked about abortion-rights and what is happening in parts of the country with a woman's right to choose.More
I’ve been an obstetrician-gynecologist for 24 years, caring for women giving birth, experiencing miscarriage, and deciding to have abortions. Most patients I see have experienced some or all of these events, at different times in their life.
Since abortion is so politicized and stigmatized, it’s often hard to see that it usually coexists alongside birth and miscarriage in many women’s lives, and in the medical practices of their doctors.
I became an ob-gyn to offer compassion and expertise across all these reproductive experiences; I hope my patients have felt that. I didn’t go into medicine to be part of political debates. But I am acutely aware that such debates impact the women and families I care for.
Indeed, as we wait for the outcome of the Supreme Court’s upcoming abortion decision, my colleagues and I are trying to plan ahead for all of the ways the healthcare landscape in Michigan may dramatically shift — not only for women who might seek abortion care, but also for those whose pregnancies end in miscarriage, or for anyone who continues a pregnancy, as well.
Many Michiganders don’t realize we have a 1931 abortion ban on the books. It is among the strictest in the country, permitting abortion only to “preserve the life” of a pregnant woman. The U.S. Supreme Court’s 1973 Roe v Wade decision made it unenforceable, determining abortion is a Constitutional right.
More: Opinion: Michigan's economy headed for disaster if abortion is criminalized
More: Michigan woman: Hear my story, feel my pain before outlawing abortion
But if Roe is reversed in June, as a draft opinion suggests is likely, our ban will become enforceable, and abortion will be a crime again in Michigan, impacting thousands of women from every walk of life.
Lawsuits brought by Gov. Gretchen Whitmer and Planned Parenthood of Michigan aim to stop the 1931 ban from being enforced, should Roe fall. Last week a Michigan judge temporarily blocked the ban from coming into effect, pending the final outcome of the Planned Parenthood case. Those following abortion headlines may see the legal back-and-forth as partisan or political wins or losses.
But as a doctor in Michigan, I see it as a healthcare issue.
Bracing for tumult
Alongside my physician, nurse and midwife colleagues at Michigan Medicine, we are getting ready for the possibility that abortion will become illegal in Michigan.
Myriad preparations are needed. We are not yet ready, nor are our healthcare colleagues statewide.
First, we need to determine what, precisely, “life-preserving” abortion means.
What must the risk of death be, and how imminently? I have performed abortions on critically ill patients in intensive care units, where it is clear abortion is life-saving.
More: Whitmer to Michigan Supreme Court: 'Time is of the essence' on abortion lawsuit
More: University of Michigan forms task force to 'mitigate the impact' of possible abortion ban
Pregnancy demands so much from all body organ systems, especially heart and lungs; sometimes ending a pregnancy is the only way to help a patient survive. But outside of these situations, it gets unclear.
Maternal-fetal medicine specialists care for patients with a range of “high-risk” conditions. For patients with pulmonary hypertension, they may cite a 30% to 50% chance of dying with ongoing pregnancy.
Is that high enough to permit abortion? Or must it be 100%?
When oncologists diagnose cancer during pregnancy, some patients end the pregnancy to start treatment immediately; some cancers advance faster due to pregnancy’s extra hormones, and chemotherapy and radiation can cause significant fetal injury.
Will abortion be permissible in this situation, or must patients delay cancer treatment and give birth first? When patients have advanced cancer that was preventable with earlier treatment, increased risk of death may be a few years away.
We’ve identified many similar questions.
Just three options
Most pregnant patients seeking abortion care are not facing life-threatening conditions, and will have only three options: travel outside Michigan for abortion care, self-manage an abortion, or give birth. At Michigan Medicine we are preparing for all of this.
People with enough money and support will seek care out-of-state. For most Michiganders, this means driving to Illinois, making the average travel distance for abortion care more than 260 miles if our ban is re-enacted. This will be impossible for many, since lack of financial resources is why many women seek abortion care.
Nationally, half of patients seeking abortions live on incomes under the federal poverty level; another 25% live on just one-to-two times that.
Many cannot afford gas, tolls, hotels. They cannot afford to lose hourly wages or will be fired for missing work.
Most patients I see are already parents. Travel is much harder when you need childcare arrangements, too, especially overnight.
I’m thinking of a patient I saw not long ago, who worked the night shift, drove several hours to her abortion appointment, three children in tow, and then afterwards headed home for another night shift. Efforts like this are already the norm in abortion care, and it will only get harder.
Nevertheless, if legally permissible, our Michigan health system will need to assist those who can travel.
If allowed, we can offer referrals out-of-state and pre-travel “teeing-up.” This may include ordering an ultrasound or bloodwork and, for patients with underlying illnesses, speedy specialist consultation to ensure they can safely receive care on arrival. We must figure out if Illinois medical centers have capacity to see our patients requiring hospital-level care, knowing these hospitals will also be seeing patients from Ohio, Missouri, Indiana and other states.
Insurers will need to decide if out-of-state abortion care and associated travel expenses are covered, and patients will likely find themselves battling with insurers for such coverage, which may require costly out-of-network fees.
Will legal hazards magnify distrust?
The second option is self-managed abortion.
For over twenty years, people have safely used the FDA-approved mifepristone and misoprostol combination to end pregnancies at home, after receiving medications in a doctor’s office. Mifepristone and misoprostol obtained online from the many available, reliable sources are equally safe and effective.
However, patients without internet access, a credit card, or who don’t know about those medications may use ineffective or deadly methods: ingesting poisons, intentional trauma like falling down stairs, or putting objects into their uterus to disrupt pregnancy.
My colleagues and I will want to steer people toward safe methods, though it’s unclear Michigan’s law will permit such education.
Emergency department and primary care practitioners will need to quickly become familiar with treating abortion complications in this landscape, including complications not seen since before Roe, nearly 50 years ago.
Because mifepristone and misoprostol are so safe, legal risks may be the more serious ones for patients — meaning the people they turn to for medical care might report them, or loved ones who helped them, to police, even though that violates current privacy laws and Michigan doesn’t require reporting of suspected self-managed abortion.
Indeed, all patients who have bleeding in pregnancy or experience pregnancy loss may be vulnerable to criminal prosecution because miscarriage and self-managed abortion are virtually indistinguishable. National data show that healthcare providers disproportionately report Black pregnant patients and those living on low incomes to police.
More babies will strain pre-natal care
Third, more people will give birth. Based upon projections of who will travel or self-manage abortion, we anticipate a 5% to 17% birth increase in Michigan.
We already have significant maternal healthcare deserts — places without prenatal or birth care — where patients travel far distances to deliver.
It’s not clear how a greater need will be met.
Our own hospital’s labor and delivery unit is already at capacity from COVID birth surges.
When we work over capacity, all birthing patients are affected, not just those who might otherwise have ended their pregnancies.
Newborn and pediatric care needs will increase, too. Many families who get terrible news about their developing baby will be forced to give birth, and those babies and children will need complex, costly medical care, and often a lifetime of specialized support.
More than ever, families statewide will need robust medical and social safety nets that may not exist.
We can expect mental health care needs in pregnancy to intensify, as girls and women continue undesired pregnancies, including those resulting from rape and incest.
Michigan’s abortion ban makes no exceptions for either. Our already-overburdened mental healthcare system is unlikely to adequately meet this need.
Mothers will die
Finally, maternal mortality will increase — as much as 21% overall by one demographer’s estimate — because abortion is safer than childbirth. Centers for Disease Control data show that in the U.S., the risk of dying from childbirth is 50 to 130 times greater than dying from abortion.
This new burden of maternal death will not be felt equally in Michigan, or anywhere in the country, because Black women are more than twice as likely as white women to die from pregnancy and childbirth.
Maternal mortality for white women is projected to increase by 13%. For Black women, the projected increase is 33%, meaning that an abortion ban will disproportionately harm Black women and the families who lose them. It will become more pressing than it already is to remedy systemic inequities and racism that generate such disparities.
Unsafe abortion will add to this burden and loss.
Other reproductive healthcare will be impacted, too.
Fearing criminal prosecution, doctors may hesitate to treat ectopic pregnancy, hemorrhage or serious infection from miscarriage, when fetal cardiac activity remains.
Healthcare providers will need to decide whether they’ll continue prescribing the best evidence-based medications for miscarriage — mifepristone and misoprostol.
Since those medications are used in abortion care, doctors may fear their use carries legal jeopardy. Infertility doctors may stop providing in vitro fertilization given the potential for embryo loss in IVF.
We're not ready
Re-enactment of Michigan’s abortion ban will affect medical education. Abortion training is an accreditation requirement for ob-gyn residencies.
Michigan Medicine will need out-of-state training arrangements. Ultimately, our top-ranked program may cease to draw talented applicants. Roughly 40% of our ob-gyn graduates stay in Michigan to practice medicine, so the statewide reproductive health workforce may be impacted.
Patients will ultimately feel the impact of shifts in abortion training: If residents can’t learn "non-lifesaving" abortion care, soon no one will be trained to perform the "lifesaving" abortions Michigan’s 1931 ban permits.
Patients experiencing miscarriage will feel the loss of abortion training, too, because doctors who have such training are more likely to offer patients the full range of appropriate miscarriage treatments than doctors without it.
Finally, Michigan’s health system workforce, like those everywhere, is disproportionately female. When more of the workforce is pregnant, on parental leave, or traveling for abortion care, patients will likely feel the impact.
All of this is my way of saying that we are not yet ready to manage what is coming if abortion becomes illegal in Michigan.
Every morning I wake up with another new question. Those who view abortion exclusively as a political or partisan issue, maybe one they’d like to avoid, will soon see that abortion care, or lack thereof, is a healthcare and health equity issue that impacts everyone.
I trust my patients
Avoiding this issue isn’t possible.
Amid the flurry of logistical planning, I remain aware that abortion is complex and emotional topic for many.
That makes sense. Abortion asks us to hold two opposite things at the same time: Abortion means a baby won’t be born, and that is weighty. Banning abortion means that a girl or woman must continue a pregnancy and give birth when she can’t or doesn’t want to, shifting the course of her, and her family’s, lives. That is weighty, too.
In our polarized times we don’t really learn how to hold complexity like this. Instead we are asked to resolve our feelings one way or another, even when “pro-life” or “pro-choice” boxes may not precisely fit how we feel.
From the hundreds of times my patients have shared their lives, hopes, and hurts, I know they hold this complexity, too, as do I.
Ultimately, I trust my patients to know what they and their families most need.
My colleagues and I will continue to provide support as the legal landscape shifts, even if we don’t yet know exactly what the contours of that support will look like.
Lisa Harris
Lisa Harris, MD, PhD, is a professor of obstetrics and gynecology and professor of women's and gender studies at University of Michigan.
This guest column is adapted from an essay recently published in the New England Journal of Medicine.
This article originally appeared on Detroit Free Press: Opinion: Michigan hospitals aren't prepared for end of Roe v. Wade
The Great Resignation resulted in women leaving the workforce in droves. Denying them abortion care could dent the labor market
François Picard—AFP/Getty Images
Amiah Taylor
Fri, June 3, 2022,
Last month, on May 11, the Women’s Health Protection Act of 2022—which would have made abortion access a federal law—failed to pass due to opposition from Senate Republicans. The pro-life versus pro-choice debates that our nation is deeply embroiled in have reached a boiling point as the looming threat of a reversal of Roe v. Wade lingers on. While testifying before the Senate Banking Committee on May 10, Treasury Secretary Janet Yellen argued that banning abortion would have “very damaging effects on the economy and set women back decades.”
Five decades to be exact, according to Yana van der Meulen Rodgers, the faculty director for the Center for Women and Work at Rutgers University.
“If we were to restrict women’s access to abortion, that means going back potentially decades to when we saw sharp declines in women’s labor force participation after giving birth to children,” van der Meulen Rodgers told Fortune. “So I think this could mean a step back by 50 years, and diminishing all the progress women have made since they’ve had access to safe abortion services on a national level, starting in 1973.”
Here’s how the elimination of safe and legal abortion access would turn back the clock and, as a result, affect the labor market.
Abortion denial could be the final straw for women already struggling in the workplace
In the first 12 months of the pandemic, women accounted for 53% of U.S. labor force departures, and about 2.3 million women exited the workforce in 2020, per a McKinsey study. One of the main reasons that women left the workforce in droves was childcare, referencing the Society for Human Resource Management. In fact, 23% of female workers with children under 10 years old considered leaving the workforce in 2020 as opposed to 10% of women without children, citing McKinsey.
“Cultural expectations of women to prioritize child-rearing, combined with women’s lower average pay, occupational status, and benefits than men (along with the high costs of childcare), mean that women in many heterosexual couples decide to leave work with the birth of a child,” Erin Hatton, associate professor of sociology at the State University of New York at Buffalo, told Fortune. “It just makes sense financially.”
It is clear that whether a woman is childless or not factors into her job tenure and career advancement. And growing data suggests that children reduce women’s labor force participation. Because of that, laws restricting or eliminating abortion would directly affect women workers in terms of their career advancement.
“For women, being able to choose when to start a family is really key to her career mobility, her earnings, and when and how she enters the labor market,” Nicole Mason, the CEO of the Institute for Women’s Policy Research, told Fortune. “And so taking away that choice will definitely have an adverse effect on women’s participation in the labor market, their career mobility, and being able to stay in the workforce. We already know that women are more likely than their male counterparts to leave the workforce as a result of having a child. So, restricting abortion access for women will definitely increase the likelihood that they will exit the workforce if they’re forced to carry unintended babies to term.”
Eliminating abortion would negatively impact workplace diversity
“I just want to make the connection here that, at this moment, companies and businesses are in fierce competition for top talent,” Mason told Fortune. “So the impending Supreme Court decision to limit abortion access or the range of reproductive health care options to women will definitely impact a business’s ability to attract and retain top talent: women.”
In terms of diversity, limiting abortion access would not solely impact gender diversity, but could also have a negative impact on racial diversity. Black women typically have the highest labor force participation rate of all women, according to the U.S. Department of Labor. In 2014, Black women over the age of 16 had the highest national workforce participation rate at 59.2%, as opposed to white and Latina women who had participation rates of 56.7% and 56% respectively, citing the Institute for Women’s Policy Research. As of November 2021, Black women’s labor force participation rates have risen to 60.3%, according to Brookings. Black women are attractive job candidates because they are among the most educated groups in the country, but they also have the most to lose from abortion bans.
The unintended pregnancy rate is almost 2.5 times higher for Black women than for white women, according to Duke University Press. Black women also have the highest abortion rates in the nation. In addition, they are the most likely to be unable to afford interstate travel to terminate pregnancies, in the case that abortion is outlawed in their home state, due to wage disparities.
Restricting access to abortion care could mean that women of color exit the labor force for good. Historically, women who dropped out of the workforce during a recession to care for children often struggled to return, being unable to find a job in their prior role or command their prior wages, as reported by CNBC. Nationally, labor force exits associated with the presence of children were more common among Latina women and Black women, and these exits accounted for approximately 25% of the labor force exits above pre-pandemic rates among Latina women and Black women relative to white women, citing the Federal Reserve Bank of Minneapolis. A key reason that Black and Latina women don’t return to work is that childcare centers in their neighborhoods are much more likely to close, according to a study by researchers at Columbia University’s Center on Poverty & Social Policy. Between mass childcare closures in minority neighborhoods during the pandemic, and the fact that as of 2020, 46.3% of Black children lived solely with their mothers, per the U.S. Census Bureau, the sole burden of childcare often falls onto Black women, which can detrimentally affect their careers. Latina and Black women are more likely to be their family’s sole breadwinners, according to a report from McKinsey. In addition, among those ages 25 to 54, 62% of Black women were unpartnered in 2019, according to the Pew Research Center. This means that forcing Black women to carry unwanted children to term could also be forcing them to give up their means of earning a living, without the cushion of leaning on a partner’s income, given that Black women often do not raise their children in two-partner households. Eliminating abortion access for women, but Black women in particular, increases their odds of falling into poverty and being overwhelmed with childcare, and as a result not adding valuable diversity to the office.
Women workers could suffer increased mental health issues
According to the Center for American Progress, women living in states with greater access to reproductive health care have higher earnings, higher rates of full-time employment, and greater job opportunities. But an additional byproduct of abortion access is a higher sense of well-being.
Women who receive “a wanted abortion are better able to aspire for the future than women who are denied a wanted abortion and must carry an unwanted pregnancy to term,” citing BMC (Boston Medical Center) Women’s Health, a peer reviewed health journal. And the majority of surveyed women—99%—said having an abortion was the right choice five years later, in a Social Science & Medicine study.
In contrast, denying women abortions would likely have negative effects on their mental health.
People who were denied abortions reported more symptoms of stress and anxiety one week after the event than those who received abortions, per the University of California, San Francisco’s Turnaway study.
Victims of sexual violence would face mental health and job consequences
Women could likely suffer mental health consequences from carrying an unwanted pregnancy to term, emotions that would likely be amplified further in incidences of rape.
“I think limiting women's access to the full range of reproductive health care, including abortion access, is violence against women,” Mason told Fortune. “And in the case of a woman who was sexually assaulted or experiencing intimate partner violence, not allowing her to be able to have abortion access does have a definitive impact on her mental health and well-being but also her labor force participation.”
The correlation between sexual violence and female labor participation has been documented in countries such as Zimbabwe, Germany, the United Kingdom, as well as the United States. Sexual violence is associated with a 6.6% decline in female labor force participation and a 5.1% decline in wages, according to the American Economic Review. When an assault is followed by an unwanted pregnancy that the mother is legally mandated to keep, the effects could be psychologically devastating in addition to the previous suffering and work penalties.
Statistics on the incidents of rape that end in pregnancy are scarce and have not been updated for at least the last 20 years. However, in 1996 the national rape-related pregnancy rate was 5% per rape among victims of reproductive age—ages 12 to 45, according to the American Journal of Obstetrics and Gynecology.
Hatton believes that overturning access to safe abortions will amplify the ramifications of sexual violence against female workers.
“In addition to physical trauma, sexual violence has long-term mental and physical health consequences, including depression, PTSD, anxiety disorders, sleep disorders, and more,” Hatton told Fortune. “The negative consequences of such violence—which are already incredibly harmful and long-lasting—will only be prolonged and deepened if women are forced to keep pregnancies resulting from that violence. Not surprisingly, such consequences will negatively affect women as workers as well as women as human beings who have a right to autonomy, equality, and freedom from degradation.”
This story was originally featured on Fortune.com
François Picard—AFP/Getty Images
Amiah Taylor
Fri, June 3, 2022,
Last month, on May 11, the Women’s Health Protection Act of 2022—which would have made abortion access a federal law—failed to pass due to opposition from Senate Republicans. The pro-life versus pro-choice debates that our nation is deeply embroiled in have reached a boiling point as the looming threat of a reversal of Roe v. Wade lingers on. While testifying before the Senate Banking Committee on May 10, Treasury Secretary Janet Yellen argued that banning abortion would have “very damaging effects on the economy and set women back decades.”
Five decades to be exact, according to Yana van der Meulen Rodgers, the faculty director for the Center for Women and Work at Rutgers University.
“If we were to restrict women’s access to abortion, that means going back potentially decades to when we saw sharp declines in women’s labor force participation after giving birth to children,” van der Meulen Rodgers told Fortune. “So I think this could mean a step back by 50 years, and diminishing all the progress women have made since they’ve had access to safe abortion services on a national level, starting in 1973.”
Here’s how the elimination of safe and legal abortion access would turn back the clock and, as a result, affect the labor market.
Abortion denial could be the final straw for women already struggling in the workplace
In the first 12 months of the pandemic, women accounted for 53% of U.S. labor force departures, and about 2.3 million women exited the workforce in 2020, per a McKinsey study. One of the main reasons that women left the workforce in droves was childcare, referencing the Society for Human Resource Management. In fact, 23% of female workers with children under 10 years old considered leaving the workforce in 2020 as opposed to 10% of women without children, citing McKinsey.
“Cultural expectations of women to prioritize child-rearing, combined with women’s lower average pay, occupational status, and benefits than men (along with the high costs of childcare), mean that women in many heterosexual couples decide to leave work with the birth of a child,” Erin Hatton, associate professor of sociology at the State University of New York at Buffalo, told Fortune. “It just makes sense financially.”
It is clear that whether a woman is childless or not factors into her job tenure and career advancement. And growing data suggests that children reduce women’s labor force participation. Because of that, laws restricting or eliminating abortion would directly affect women workers in terms of their career advancement.
“For women, being able to choose when to start a family is really key to her career mobility, her earnings, and when and how she enters the labor market,” Nicole Mason, the CEO of the Institute for Women’s Policy Research, told Fortune. “And so taking away that choice will definitely have an adverse effect on women’s participation in the labor market, their career mobility, and being able to stay in the workforce. We already know that women are more likely than their male counterparts to leave the workforce as a result of having a child. So, restricting abortion access for women will definitely increase the likelihood that they will exit the workforce if they’re forced to carry unintended babies to term.”
Eliminating abortion would negatively impact workplace diversity
“I just want to make the connection here that, at this moment, companies and businesses are in fierce competition for top talent,” Mason told Fortune. “So the impending Supreme Court decision to limit abortion access or the range of reproductive health care options to women will definitely impact a business’s ability to attract and retain top talent: women.”
In terms of diversity, limiting abortion access would not solely impact gender diversity, but could also have a negative impact on racial diversity. Black women typically have the highest labor force participation rate of all women, according to the U.S. Department of Labor. In 2014, Black women over the age of 16 had the highest national workforce participation rate at 59.2%, as opposed to white and Latina women who had participation rates of 56.7% and 56% respectively, citing the Institute for Women’s Policy Research. As of November 2021, Black women’s labor force participation rates have risen to 60.3%, according to Brookings. Black women are attractive job candidates because they are among the most educated groups in the country, but they also have the most to lose from abortion bans.
The unintended pregnancy rate is almost 2.5 times higher for Black women than for white women, according to Duke University Press. Black women also have the highest abortion rates in the nation. In addition, they are the most likely to be unable to afford interstate travel to terminate pregnancies, in the case that abortion is outlawed in their home state, due to wage disparities.
Restricting access to abortion care could mean that women of color exit the labor force for good. Historically, women who dropped out of the workforce during a recession to care for children often struggled to return, being unable to find a job in their prior role or command their prior wages, as reported by CNBC. Nationally, labor force exits associated with the presence of children were more common among Latina women and Black women, and these exits accounted for approximately 25% of the labor force exits above pre-pandemic rates among Latina women and Black women relative to white women, citing the Federal Reserve Bank of Minneapolis. A key reason that Black and Latina women don’t return to work is that childcare centers in their neighborhoods are much more likely to close, according to a study by researchers at Columbia University’s Center on Poverty & Social Policy. Between mass childcare closures in minority neighborhoods during the pandemic, and the fact that as of 2020, 46.3% of Black children lived solely with their mothers, per the U.S. Census Bureau, the sole burden of childcare often falls onto Black women, which can detrimentally affect their careers. Latina and Black women are more likely to be their family’s sole breadwinners, according to a report from McKinsey. In addition, among those ages 25 to 54, 62% of Black women were unpartnered in 2019, according to the Pew Research Center. This means that forcing Black women to carry unwanted children to term could also be forcing them to give up their means of earning a living, without the cushion of leaning on a partner’s income, given that Black women often do not raise their children in two-partner households. Eliminating abortion access for women, but Black women in particular, increases their odds of falling into poverty and being overwhelmed with childcare, and as a result not adding valuable diversity to the office.
Women workers could suffer increased mental health issues
According to the Center for American Progress, women living in states with greater access to reproductive health care have higher earnings, higher rates of full-time employment, and greater job opportunities. But an additional byproduct of abortion access is a higher sense of well-being.
Women who receive “a wanted abortion are better able to aspire for the future than women who are denied a wanted abortion and must carry an unwanted pregnancy to term,” citing BMC (Boston Medical Center) Women’s Health, a peer reviewed health journal. And the majority of surveyed women—99%—said having an abortion was the right choice five years later, in a Social Science & Medicine study.
In contrast, denying women abortions would likely have negative effects on their mental health.
People who were denied abortions reported more symptoms of stress and anxiety one week after the event than those who received abortions, per the University of California, San Francisco’s Turnaway study.
Victims of sexual violence would face mental health and job consequences
Women could likely suffer mental health consequences from carrying an unwanted pregnancy to term, emotions that would likely be amplified further in incidences of rape.
“I think limiting women's access to the full range of reproductive health care, including abortion access, is violence against women,” Mason told Fortune. “And in the case of a woman who was sexually assaulted or experiencing intimate partner violence, not allowing her to be able to have abortion access does have a definitive impact on her mental health and well-being but also her labor force participation.”
The correlation between sexual violence and female labor participation has been documented in countries such as Zimbabwe, Germany, the United Kingdom, as well as the United States. Sexual violence is associated with a 6.6% decline in female labor force participation and a 5.1% decline in wages, according to the American Economic Review. When an assault is followed by an unwanted pregnancy that the mother is legally mandated to keep, the effects could be psychologically devastating in addition to the previous suffering and work penalties.
Statistics on the incidents of rape that end in pregnancy are scarce and have not been updated for at least the last 20 years. However, in 1996 the national rape-related pregnancy rate was 5% per rape among victims of reproductive age—ages 12 to 45, according to the American Journal of Obstetrics and Gynecology.
Hatton believes that overturning access to safe abortions will amplify the ramifications of sexual violence against female workers.
“In addition to physical trauma, sexual violence has long-term mental and physical health consequences, including depression, PTSD, anxiety disorders, sleep disorders, and more,” Hatton told Fortune. “The negative consequences of such violence—which are already incredibly harmful and long-lasting—will only be prolonged and deepened if women are forced to keep pregnancies resulting from that violence. Not surprisingly, such consequences will negatively affect women as workers as well as women as human beings who have a right to autonomy, equality, and freedom from degradation.”
This story was originally featured on Fortune.com
Amanda Shires Demands More Artists Stand Up for Abortion Rights: ‘I Can’t Live With the Idea of Not Speaking Up’
Brittney McKenna
Fri, June 3, 2022
Jason Isbell & The 400 Unit And Shemekia Copeland In Concert - Nashville, TN
Brittney McKenna
Fri, June 3, 2022
Jason Isbell & The 400 Unit And Shemekia Copeland In Concert - Nashville, TN
- Credit: Erika Goldring/Getty Images
Soon after a Supreme Court draft ruling that would overturn Roe v. Wade was leaked last month, Amanda Shires shared some personal news on social media. “Recently, I had an ectopic pregnancy,” she tweeted. “On August 9, 2021 my fallopian tube ruptured. On August 10, my life was saved…these are some dark days.”
Shires, an incisive songwriter and solo artist and occasional member of husband Jason Isbell’s 400 Unit band, has been vocal about protecting a woman’s right to choose in the past. In 2020, she penned an op-ed for Rolling Stone about why abortion rights matter. In a new interview, Shires — who returns with her latest album Take It Like a Man in July — goes deeper into her own experiences and calls on artists, especially those in Nashville, to start using the platforms they’ve been given.
When I wrote my first piece for Rolling Stone, I’d had an abortion before. Since writing that op-ed, I have had reproductive healthcare — that some might call an abortion — when I was hospitalized in Texas on August 9, 2021, with a ruptured fallopian tube caused by an ectopic pregnancy. For those who are unfamiliar, it is impossible for an ectopic pregnancy to go to term. I would have died; my daughter, Mercy, would have lost her mother; my husband, Jason, would be a widower.
I was lucky. This happened to me two and a half weeks before Texas’ abortion ban went into effect. And I was still dealing with all of it two and a half weeks later. I mean, only just now — nine months later, interestingly enough — have I returned to having normal periods. This fight is about more than just abortion. I think that’s what people keep forgetting.
The majority of people are in favor of women’s reproductive rights and health; it’s others we’re trying to get to. But I think folks forget that access to abortion and reproductive healthcare is not just about terminating unwanted pregnancy. People forget that, if you take away access to reproductive healthcare, you’re going to be killing moms like me. I would have died had this procedure not been available to me. Where would that leave my own daughter?
We’ve had legal abortions for 50 years and now, suddenly, a long-held right will be illegal. How are we going to police that? People will have to prove that they have been raped. And any policing will disproportionately affect people of color, low-income folks and other marginalized groups. It’s yet another thing that, when policing does happen, is going to happen haphazardly and ruin lives. Where does that get us with our Fourth and Fifth Amendment rights?
When Roe is overturned, some healthcare workers may feel afraid to help people. A person having a miscarriage may have to fly to another state, just so they or their doctor doesn’t get into legal trouble. People are still going to get abortions, and we’re going to have to keep people’s secrets, and house people, and try to do the best we can. When we overturn Roe, we risk going back to, “Oh, now same-sex marriages can’t happen. Interracial marriages can’t happen.” Privacy rights are going to be gone.
Demographer Diana Greene Foster conducted a 10-year study tracking both people who had abortions and people who were denied abortions. Her study essentially proves that when folks can’t have an abortion, it affects their mental health, their economic standing, their overall well-being. Ninety-five percent of study participants who did have an abortion still stood by their decision. It’s just like you would expect, but there’s real, scientific proof for it now. In the past, white men have said otherwise.
Since publishing my op-ed, I’ve heard from some folks who are in their eighties. And that, to me, was incredible, because they had abortions in what was a pre-Roe v. Wade environment and they’re only now sharing their stories for the first time. I’m glad to be a listener and also glad to see folks from those generations supporting the right to choose. It made me think, “You know, I bet our grandmothers are more pro-choice than everybody leads us to believe.”
As it turns out, it did start some conversations within our own families. We found out that, yes, our grandmothers are pro-choice. They might not have had a voice before or might have been cast out into the streets without any place to sleep had they mentioned it earlier in their lives. But finding a voice now and sharing their stories now is as good as any time. Hearing these stories, I think that it makes your backbone stronger. It makes it feel like you’re tough enough for the fight, all the way down to your bones.
I also received responses from trolls. I had people threatening me. But whatever. It’s not more threatening than the idea of taking away the services and the work that doctors and nurses do. I don’t care if somebody wants to put a target on me. I wouldn’t go back and change it. If we tell our stories, it helps other people feel empowered. It de-stigmatizes the conversation. If you share your story or share your beliefs, you’re going to get some haters and trolls. But if you don’t, you’re going to be wondering, “What didn’t I do? What didn’t I say that could have helped change one mind?” I can’t live with the idea of not speaking up.
We have to work hard now to mobilize and help people vote. The election is November 8. You don’t see a lot of men speaking up, and every voice is helpful. Which brings up the question, why were Jason and I, and Margo Price, the biggest celebrities — quasi-celebrities — at the march in Nashville? Why didn’t more people show up and speak up? I know everyone is scared of losing their rung on the ladder, but there are more important things, I think, than your fame. Not saying something is not helping. Not standing up for folks is not helping and it’s not right. I would like to think that fans can hold their role models and their favorite musicians accountable. Don’t support artists who don’t support your rights.
I would like to challenge other folks who have platforms to actually use them. Where the fuck are the rest of them? We have Olivia Rodrigo and Phoebe Bridgers speaking up, and Ariana Grande. Where are our Nashville folks? They aren’t helping. Are they just going to sit around and drink beer? I want Garth Brooks out there telling people that women’s health is a priority. That’s what I want. Why not? What does he have to lose?
My best hope is that people continue to get angrier and that the folks who have been fighting so hard for so long, and are already tired, find some strength to keep fighting and also to mobilize others, especially youth, along the way. I hope that if Roe v. Wade is overturned, it causes such a fucking uproar that we end up with more rights than we had before.
Soon after a Supreme Court draft ruling that would overturn Roe v. Wade was leaked last month, Amanda Shires shared some personal news on social media. “Recently, I had an ectopic pregnancy,” she tweeted. “On August 9, 2021 my fallopian tube ruptured. On August 10, my life was saved…these are some dark days.”
Shires, an incisive songwriter and solo artist and occasional member of husband Jason Isbell’s 400 Unit band, has been vocal about protecting a woman’s right to choose in the past. In 2020, she penned an op-ed for Rolling Stone about why abortion rights matter. In a new interview, Shires — who returns with her latest album Take It Like a Man in July — goes deeper into her own experiences and calls on artists, especially those in Nashville, to start using the platforms they’ve been given.
When I wrote my first piece for Rolling Stone, I’d had an abortion before. Since writing that op-ed, I have had reproductive healthcare — that some might call an abortion — when I was hospitalized in Texas on August 9, 2021, with a ruptured fallopian tube caused by an ectopic pregnancy. For those who are unfamiliar, it is impossible for an ectopic pregnancy to go to term. I would have died; my daughter, Mercy, would have lost her mother; my husband, Jason, would be a widower.
I was lucky. This happened to me two and a half weeks before Texas’ abortion ban went into effect. And I was still dealing with all of it two and a half weeks later. I mean, only just now — nine months later, interestingly enough — have I returned to having normal periods. This fight is about more than just abortion. I think that’s what people keep forgetting.
The majority of people are in favor of women’s reproductive rights and health; it’s others we’re trying to get to. But I think folks forget that access to abortion and reproductive healthcare is not just about terminating unwanted pregnancy. People forget that, if you take away access to reproductive healthcare, you’re going to be killing moms like me. I would have died had this procedure not been available to me. Where would that leave my own daughter?
We’ve had legal abortions for 50 years and now, suddenly, a long-held right will be illegal. How are we going to police that? People will have to prove that they have been raped. And any policing will disproportionately affect people of color, low-income folks and other marginalized groups. It’s yet another thing that, when policing does happen, is going to happen haphazardly and ruin lives. Where does that get us with our Fourth and Fifth Amendment rights?
When Roe is overturned, some healthcare workers may feel afraid to help people. A person having a miscarriage may have to fly to another state, just so they or their doctor doesn’t get into legal trouble. People are still going to get abortions, and we’re going to have to keep people’s secrets, and house people, and try to do the best we can. When we overturn Roe, we risk going back to, “Oh, now same-sex marriages can’t happen. Interracial marriages can’t happen.” Privacy rights are going to be gone.
Demographer Diana Greene Foster conducted a 10-year study tracking both people who had abortions and people who were denied abortions. Her study essentially proves that when folks can’t have an abortion, it affects their mental health, their economic standing, their overall well-being. Ninety-five percent of study participants who did have an abortion still stood by their decision. It’s just like you would expect, but there’s real, scientific proof for it now. In the past, white men have said otherwise.
Since publishing my op-ed, I’ve heard from some folks who are in their eighties. And that, to me, was incredible, because they had abortions in what was a pre-Roe v. Wade environment and they’re only now sharing their stories for the first time. I’m glad to be a listener and also glad to see folks from those generations supporting the right to choose. It made me think, “You know, I bet our grandmothers are more pro-choice than everybody leads us to believe.”
As it turns out, it did start some conversations within our own families. We found out that, yes, our grandmothers are pro-choice. They might not have had a voice before or might have been cast out into the streets without any place to sleep had they mentioned it earlier in their lives. But finding a voice now and sharing their stories now is as good as any time. Hearing these stories, I think that it makes your backbone stronger. It makes it feel like you’re tough enough for the fight, all the way down to your bones.
I also received responses from trolls. I had people threatening me. But whatever. It’s not more threatening than the idea of taking away the services and the work that doctors and nurses do. I don’t care if somebody wants to put a target on me. I wouldn’t go back and change it. If we tell our stories, it helps other people feel empowered. It de-stigmatizes the conversation. If you share your story or share your beliefs, you’re going to get some haters and trolls. But if you don’t, you’re going to be wondering, “What didn’t I do? What didn’t I say that could have helped change one mind?” I can’t live with the idea of not speaking up.
We have to work hard now to mobilize and help people vote. The election is November 8. You don’t see a lot of men speaking up, and every voice is helpful. Which brings up the question, why were Jason and I, and Margo Price, the biggest celebrities — quasi-celebrities — at the march in Nashville? Why didn’t more people show up and speak up? I know everyone is scared of losing their rung on the ladder, but there are more important things, I think, than your fame. Not saying something is not helping. Not standing up for folks is not helping and it’s not right. I would like to think that fans can hold their role models and their favorite musicians accountable. Don’t support artists who don’t support your rights.
I would like to challenge other folks who have platforms to actually use them. Where the fuck are the rest of them? We have Olivia Rodrigo and Phoebe Bridgers speaking up, and Ariana Grande. Where are our Nashville folks? They aren’t helping. Are they just going to sit around and drink beer? I want Garth Brooks out there telling people that women’s health is a priority. That’s what I want. Why not? What does he have to lose?
My best hope is that people continue to get angrier and that the folks who have been fighting so hard for so long, and are already tired, find some strength to keep fighting and also to mobilize others, especially youth, along the way. I hope that if Roe v. Wade is overturned, it causes such a fucking uproar that we end up with more rights than we had before.
