eMagazine August 2022

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OUR PEOPLE, OUR MISSION Global Health eMagazine August 2022 Highlights Clinical Case of the Month Reflections Health Disparities Within Our Borders Nursing Division Art to Remind Us of Who We Can Be Our Beautiful Planet Among the Letters Congratulations Global Health Team Calendar Resources Editor: Nursing Division Catherine G Winkler, PhD, MPH, APRN-BC Director of the Nuvance Health Global Health Program Nursing Division Women’s Health Education Roe vs. Wade in America Written by Sarah Cordisco, BSN, RN Senior Nursing Student at the University of Vermont In January of 1973, the U.S Supreme Court decided on the famous case of Roe V Wade. This case was filed by Jane Roe, an unmarried woman living in Texas who wanted to terminate her pregnancy safely and legally. At the time, Texas had a law that made it a crime to perform an abortion unless the woman’s life was in immediate danger (Planned Parenthood Federation of America, 2014). When the Court initially ruled on this case, they recognized the constitutional right to privacy was “broad enough to encompass a woman’s decision whether or not to terminate her pregnancy” (Roe V. Wade 1973). This made abortion accessibly and safe for all people. To establish this decision, the Court drew on past cases that established the precedent that the government could not interfere with personal decisions regarding procreations, marriage, or other parts of family life. In 1965, the Court had ruled on Griswold v. Connecticut, which was an appeal case of the criminal conviction of the executive director of the Planned Parenthood League of Connecticut for providing birth control to married couples. The Court ruled that criminalizing the right to use birth control violated the privacy rights of married couples. Seven years later, the justices found that this right also applies to single people in the case Eisenstadt v. Baird, 1972 (Planned Parenthood Federation of America, 2014). The Court ruling came at the right time, as by 1965, 17% of all deaths due to pregnancy and childbirth were the result of illegal abortions (Planned Parenthood Federation of America, 2014). In the late 1960s, a nationwide effort was underway to change the law that criminalized the practice. Healthcare providers, women’s rights activists, clergy members, and the legal community all lobbied state legislatures and went to court to overturn this statue. Many of these laws date back to the mid- 1800s when legislatures banned abortions despite abortion being allowed prior to quickening during the colonial times. Prior to the Court ruling on Roe v. Wade states already began changing their laws. Between 1967 and 1973, four states overturned their abortion bans, and 13 states enacted limited reforms (Planned Parenthood Federation of America, 2014). 14
OUR PEOPLE, OUR MISSION Global Health eMagazine August 2022 Highlights Clinical Case of the Month Reflections Health Disparities Within Our Borders Nursing Division Art to Remind Us of Who We Can Be Our Beautiful Planet Among the Letters Congratulations Global Health Team Calendar Resources Roe V Wade gave women the right to make decisions about her pregnancy and protected it under the constitution. However, the Court also recognized that the right to privacy is not absolute; therefore, states may ban abortion after the point of viability, except when it is necessary to protect a women’s life or health. At the time Roe was decided on, the point of viability was 28 weeks. Today, it is 24 weeks. Most abortions take place within the first trimester. The CDC estimates that in 2019, 92.7% of all abortions were performed before 13 weeks gestation, 6.2% were formed at 14-20 weeks, and less than 1% were performed after 21 weeks. The rate of abortion in 2019, according to the CDC, was 11.4 abortions per 1000 women ages 15-44 years old (CDCs Abortion Surveillance System FAQs | CDC, 2021). Abortion occuring in later gestation is typically due to either the mother or fetus being at risk of death during delivery. Only a few fatal fetal abnormalities are detected by 13- 14 weeks, and many are not detected until around 20 weeks (20 Week Ultrasound (Anatomy Scan), n.d.). When creating legislation concerning pregnancy and pregnancy-related issues, women’s health must be at the forefront. Legal abortion is the only way to ensure safe abortion practices. As we have seen in history, women and girls will still try to obtain an abortion if they need one, and restricting access leaves many to resort to unsafe decisions and possibly die. While there have been many restrictions in place under Roe V Wade, like states banning funding for abortion clinics, or requiring people to gain consent from their parents, there has always been a choice. For the first time in 50 years, that choice is no longer a right, but a privilege that depends on where you live. On June 24, 2022 the Supreme Court once again voted on Roe V Wade, overturning the previous decision. This now means that abortion rights are left up to the states to decide. As of now, 44 states have some form of restrictions on abortions. Seven states have a complete ban on abortion, three have a ban at six weeks, and two have a ban at 15 weeks. Only 18 states allow abortion up to the point of viability, as it was under Roe V Wade (State Bans on Abortion Throughout Pregnancy, 2022). The states with total abortion bans do not allow for it in cases of rape or incest, and deem it only allowed when the women’s life is in immediate danger. This causes much confusion for healthcare workers, as the laws are not clear in defining what is considered immediate danger. While abortion is still legalized in several states, federal and constitutional protections no longer exist for women who seek this procedure. It is now up to the states. References 20 Week Ultrasound (Anatomy Scan): What to Expect. (n.d.). Cleveland Clinic. Retrieved July 26, 2022, from https://my.clevelandclinic.org/health/ diagnostics/22644-20-week-ultrasound CDCs Abortion Surveillance System FAQs | CDC. (2021, November 23). https:// www.cdc.gov/reproductivehealth/data_stats/abortion.htm Planned Parenthood Federation of America. (2014). Roe V Wade: It’s History and Impact. https://www.plannedparenthood.org/files/3013/9611/5870/Abortion_Roe_ History.pdf State Bans on Abortion Throughout Pregnancy. (2022, July 16). Guttmacher Institute. https://www.guttmacher.org/state-policy/explore/state-policies-laterabortions 15 15
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