Since the U.S. Supreme Court ruled in June that abortion policy should be decided at the state level, a number of high-profile abortion issues have appeared on state ballots. In each of these cases — even in conservative states — voters have chosen to support abortion rights. With voters increasingly being asked to make abortion policy, it is critical that they understand the facts in order to make informed decisions.
During the last 50 years, lies and intentional misinformation have dictated abortion health policy in the U.S. Abortion has been demonized and characterized by utter falsities; it has gone under the radar for far too long. After the Roe decision in 1973, many of these lies became enshrined in targeted regulation of abortion providers, or TRAP, laws meant to erode access to abortion by creating unnecessary and unsafe obstacles for abortion providers and patients that ultimately damage women’s physical and mental health.
Because lies have dictated health policy, it is even more important to correct them now that voters are choosing policy on the state level.
The first lie is that abortion bans prevent abortion. They do not. Criminalizing abortion results in irreparable harm. In fact, it actually has the opposite policy effect that anti-abortion rights advocates say they want: It can increase abortion rates, unintended pregnancies, maternal mortality and infant mortality. Outlawing abortion makes it more risky, not less common. In El Salvador, where the government imposed a total abortion ban in 1998 with no exceptions, unsafe abortion is the second cause of maternal mortality overall and the third cause of mortality among adolescent girls. Hundreds of women have been jailed for abortion and aggravated homicide.
Lie No. 2: Abortions kill babies. Almost 90% of abortions occur during the first 10 weeks of pregnancy when there are no babies or fetuses. There are only blastocysts or embryos so tiny they are too small to be seen on an abdominal ultrasound. This lie has been used to justify TRAP legislation in almost a quarter of U.S. states that require a person seeking an abortion be subjected to an ultrasound against their will and six states that force women to view the ultrasound images even if they do not want to.
Routine ultrasounds are not considered medically necessary, nor are they recommended for abortions during this first-trimester period. At this early stage of gestation, internal transvaginal ultrasounds are necessary to view the embryo. This means that women in states with these laws are subjected to vaginal penetration, with a 12-inch plastic wand called a transducer, against their will in order to receive abortion health care. This is sexual violence. And it is particularly unconscionable that poor and minority communities are disproportionately subjected to it.
Lie No. 3: Abortion is dangerous. This could not be further from the truth. Research shows abortion is safe and does not have long-term effects on physical or mental health. It doesn’t cause cancer, it doesn’t affect future fertility, and most people feel relief after an abortion and do not regret their decision. Up to 11 weeks, medication abortions are generally performed using mifepristone and misoprostol, which are safer than taking Tylenol. And yet, this lie has resulted in TRAP laws that force physicians to read scripts that provide false and inaccurate medical information to patients who cannot refuse it.
It also allows “crisis pregnancy centers,” which are anti-abortion rights propaganda sites, to operate and provide false information to women who are lured to them believing they will receive legitimate medical care. Unfortunately, the opposite is true. Women who are denied an abortion experience a panoply of negative outcomes physically, mentally and occupationally. This includes diminished physical and mental health, worse economic positions post-childbirth and comparatively worse economic outcomes for existing and subsequent children.
The fourth lie is that legislative carve-outs for the life and health of the mother, for rape and incest and life-threatening fetal anomalies, mean that abortion bans affect only pregnant people. Doctors and medical professionals in abortion ban states are also burdened by bans. This is because abortions and miscarriages are indistinguishable, and research suggests that approximately 30%, and possibly up to 50%, of pregnancies result in miscarriage and stillbirth. Intentionally vague legislation creates perverse incentives for physicians to wait before delivering lifesaving care to pregnant patients while they contact lawyers, hospital administrators and even legislators.
Abortion restrictions also affect people who have no desire to or involvement in ending a pregnancy. The drugs used for medication abortions are also used to treat miscarriages. Misoprostol is also used for stomach ulcers, and methotrexate is used in treatments for cancer, psoriasis, rheumatoid arthritis and lupus. In states with trigger laws, there is evidence pharmacies are refusing or making it difficult to dispense these drugs for fear of prosecution.
And, finally, perhaps the most egregious lie is that women are having elective abortions “up until birth.” The truth is that for the 1% or less of people who need abortions at or after 21 weeks of gestation (and most of those happen by week 24), it is almost always a matter of life or death, and the pregnancy was very much wanted. TRAP laws that ban certain procedures later in pregnancy force patients to undergo significantly less safe medical procedures. They make all pregnancies less safe by reducing the number of physicians trained to perform lifesaving procedures that are also used to manage miscarriages and stillbirths.
This constitutes a public health crisis.
As voters increasingly determine abortion policy at the state level, we need to start talking and writing about abortion objectively and clinically. Only then can voters use the cold, hard truth to make decisions that are life-altering, no matter what side of the abortion fence they fall on.
Tamara Kay is a professor of global affairs and sociology and Susan Ostermann an assistant professor of global affairs and political science at the University of Notre Dame. The authors’ opinions are their own and do not necessarily reflect those of the university.
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