Women's Health

Women’s Lives are on the Ballot

Bev Dugan

How women’s health became a political issue

For millennia maternal healthcare, including pregnancy termination, was women’s domain

with the earliest birth attendants to women being nurses, midwives, and female relatives.

This collaborative arrangement began to change with the formation of the American

Medical Association in 1847. Member physicians, almost all men, argued that the power to

decide if an abortion should be performed belonged to them.

Although pregnancy termination was a common and accepted practice, the AMA launched

a successful criminalization campaign against abortion and the role of nurses and

midwives in reproductive care. By the turn of the century, abortion was banned in every

state and male physicians had taken control of reproductive healthcare.

The criminalization of abortion resulted in the deaths of thousands of women and history is

repeating itself a century later. By the time Roe v. Wade designated abortion as a

constitutional right in 1973, most Americans supported legalized abortion as a solution to

the public health crisis caused by its criminalization. In reaction to Roe, a thriving anti-

abortion movement sprung up, fueled largely by Republican appeals to the religious right in

an attempt to win over this voting bloc. Over the decades, Republicans successfully

seeded the judiciary with anti-abortion conservatives and the courts steadily chipped

away at women’s bodily autonomy.

After President Trump added three Christian conservatives to the Supreme Court, the

Dobbs v Jackson Women’s Health Organization decision (2022) overturned the

constitutional right to abortion and left the regulation of abortion up to the states. Since

then, 14 states have banned abortion and 21 others have limited the procedure with no

underlying medical rationale and without consultation with medical experts.

The abortion drug mifepristone and IVF fertility treatments are under attack. A case

currently before the Supreme Court could end emergency life-saving abortion care for

pregnant people in hospitals and emergency rooms.

The loss of reproductive rights is hurting people

Signs of a serious public health crisis are rapidly emerging post-Dobbs. Some of the

negative impacts of anti-abortion legislation include the following examples:

Physicians who face the threat of criminal prosecution are delaying or denying pregnancy

termination in cases that warrant it. Some are substituting Cesarean sections for much

safer and less invasive medical abortions or D&E procedures which can be construed as

“abortion care.” These unnecessary C-sections expose the patient to possible surgical

complications, a long recovery, and potential future pregnancy complications.

Doctors are reluctant to practice in states where abortion care is restricted. A survey of

more than 2,000 current and future physicians found that 76% of respondents would not

apply to work or train in states with abortion restrictions. States with abortion bans saw

fewer applications for medical residency in 2023 than those without bans.

Maternal care “deserts” are spreading. One study found that about 3.7 million women of

reproductive age live in counties that have limited or no access to maternity care and no

access to abortion services. Twenty-one counties in N.C. provide little to no access to

maternity care.

Women who live in these deserts may not be able to get sufficient prenatal and postpartum

care, a situation that will worsen as OBGYNs leave states with strict abortion laws.

Inadequate care increases the risk of pregnancy complications and maternal and infant

mortality. In addition, women may have to deliver their child in EDs where maternal care is

nota core service.

As a result of vague legislation describing when an abortion is allowed, emergency rooms

are denying care to pregnant women in crisis. Complaints that pregnant women were

turned away from U.S. emergency rooms spiked after Roe v Wade was overturned. A

woman in North Carolina gave birth in her car after the emergency room at Person

Memorial Hospital in Roxboro turned her away. Her baby later died.

How do we reverse the trend?

Support for reproductive healthcare, including abortion, is a key element in the Democratic

party platform. N.C. Democratic legislators voted against the 12-week abortion ban

passed by Republicans in 2023. The Governor’s veto was overridden by the Republican

supermajority. Democratic candidates for N.C. governor, Lt. governor, and attorney general

post explicit statements of support for legalized abortion on their campaign websites.

The Republican position on abortion is clear based on their statements and voting records.

At a recent rally in Pitt County, the Republican candidate for governor vowed to ban

abortion: “We’ve got it down to 12 weeks. The next goal is to get it down to six. And, then

just keep moving from there.”

Clearly N.C. Republicans will work to further restrict abortion access and put women’s

lives in jeopardy.

It is critical that we work to elect Democratic politicians and judges to overturn the

supermajority in the General Assembly and reverse the conservative leaning of the N.C.

court system.

We must vote, encourage our friends to vote, fund Democratic candidates and

organizations working to get out the vote, and volunteer to help elect officials who

support abortion.

Lives depend on it.

Bev Dugan lives in Chatham County. She has a Ph.D. in psychology from the University of

Tennessee at Knoxville and is a graduate of the Georgetown University Leadership

Coaching Program.